What Is a Complicated Migraine?

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A migraine is more than a headache. The characteristic extreme, throbbing pain is typically accompanied by nausea, vomiting and sensitivity to light or sound. Some sufferers experience an aura before the migraine attack, consisting of numbness or tingling in their hands or face, a metallic taste or visual disturbances such as blind spots or flashing lights. Complicated migraines are those accompanied by intense neurological symptoms.


Migraines were formerly classified as common, classic or complicated, explains the National Headache Foundation. Common migraines are those without an aura, whereas classic migraines include an aura. Complicated, or complex, migraines are uncommon types that included neurological symptoms resembling a stroke. Symptoms of a complicated migraine include an aura that could last hours to days or paralysis of the eye muscles. People with a complicated migraine also may experience weakness, difficulty speaking or vision loss, notes Robert Shmerling, M.D., on HealthCentral.com. The three migraine classifications are no longer used, because many migraine sufferers often experience more than one type.


In addition to specific neurologic symptoms, the term "complicated migraine" also refers to uncommon migraine types, says the Headache Foundation. Hemiplegic migraine is an inherited form in which sufferers experience stroke-like symptoms. People with basilar migraine experience an aura with dizziness or auditory or visual disturbances on both sides of the head. Retinal migraine is characterized by visual disturbances in one eye that are caused by the retina rather than the brain as with other migraine types.


The exact cause of migraines is theoretical, explains Dr. Shmerling. The process begins when a trigger, such as a specific type of food, allergy or hormonal fluctuation, causes blood vessels in the brain to constrict or spasm. The constriction temporarily reduces the blood flow to certain areas of the brain, causing the aura. The blood vessels then dilate and cause the characteristic one-sided pain.


Complicated and uncommon migraines are treated the same as other types of migraine, although the Headache Foundation recommends consulting a migraine specialist. Migraine medications fall into three categories. Preventives are daily medications that reduce the frequency of migraines by decreasing blood vessel dilation. Common preventives include antidepressants, beta-blockers, divalproex sodium or calcium channel blockers. Pain relievers address migraine pain but not the accompanying symptoms. Examples include over-the-counter ibuprofen, acetaminophen, aspirin, and combination acetaminophen, aspirin and caffeine. Prescription migraine pain relievers include naproxen and ketorolac. Abortive medications act on the dilated blood vessels causing the migraine. These include triptans, such as sumatriptan, zolmitriptan and naratriptan, ergotamine tartrate and dihydroergotamine.


Migraines do not affect your general health, although they may raise your risk for stroke, says Daniel B. Hoch, Ph.D., M.D., a neurology professor at Harvard Medical School. See your health care provider if the pattern or severity of your migraine changes, or if your current medication loses effectiveness. Seek immediate medical attention if your headache is the worst you have ever experienced. If you experience neurological symptoms, such as loss of balance or speech or visual difficulties, for the first time with your migraine, seek emergency medical attention.