Types of Migraine: A Simple Map of the Main Forms

By Laurine NicolettiOctober 8, 202610 min

You get a migraine and your friend says hers always starts with sparkly lights. Someone online talks about "vestibular" migraine, and your doctor mentions "chronic". Suddenly it feels like there are a dozen different types of migraine and you are not sure which one is yours.

The good news is that the types of migraine are easier to sort than they look. This article is a simple map: the main forms, what sets each one apart, and where to read more. If you want the bigger picture first, our Migraine symptoms hub covers the basics.

In short

Most migraine is classified in two main ways: with or without aura (the warning signs that can come before the pain), and episodic or chronic (how often attacks happen).
Migraine without aura is the most common form, and about 1 in 3 people with migraine also have aura at least some of the time.
Vestibular migraine, hemiplegic migraine, migraine with brainstem aura and retinal migraine are less common forms where dizziness, weakness, balance problems or vision in one eye take centre stage.
You can have more than one type at once, and only a doctor can tell you which applies to you.

How are migraines classified?

Doctors sort migraine into types mainly by what happens around the pain and how often attacks occur. The two big categories are migraine without aura and migraine with aura, and the American Migraine Foundation notes that some people have both.

A second, separate question is frequency: episodic or chronic. And then there are rarer forms where the main symptom is not really a headache at all.

Think of it as layers rather than boxes. You might have migraine with aura that is also episodic, for example. If any of the words below are new, the migraine glossary explains them in plain language.

Migraine without aura: the most common form

Migraine without aura is the most common type: attacks come with head pain and other symptoms, but without the warning signs that define aura. The American Migraine Foundation describes it as the most common type of migraine.

Typical features include throbbing pain (often on one side), nausea, and sensitivity to light and sound. Attacks can last many hours or even days if untreated. For a closer look at symptoms and timing, see our guide to migraine without aura and our article on how long a migraine lasts.

If you are not sure whether what you get is a migraine or "just" a headache, our piece on migraine vs headache helps you tell them apart.

Migraine with aura: when signs come before the pain

Migraine with aura means you get temporary changes, usually in your vision, shortly before or during the headache. The NHS says about 1 in 3 people with migraines have these warning symptoms, such as flashing lights, zigzag patterns or blind spots.

Aura is not only visual. The American Migraine Foundation lists visual, sensory, speech or language, and motor forms. Most auras build up over a few minutes and fade within about an hour, according to Cleveland Clinic.

You can read the full story in migraine with aura.

Aura without a headache

Some people get an aura and no head pain afterwards. Cleveland Clinic reports that this "silent migraine" affects about 5% of people with migraine. It can still be disruptive, and it is worth mentioning to a doctor, especially if it is new for you.

Episodic or chronic migraine: a question of frequency

Episodic versus chronic describes how often you have headache days, not how bad each attack is. The American Migraine Foundation defines chronic migraine as headaches on 15 or more days a month for at least three months, with at least 8 of those days having migraine features. Fewer headache days than that is called episodic.

Chronic migraine is much less common than episodic. Cleveland Clinic estimates that it affects 1% to 2.2% of people worldwide, and that between 26% and 70% of chronic cases move back to episodic over time.

That last point matters: it is not a life sentence. If you are counting headache days and the number keeps creeping up, our article on headaches every day explains possible reasons. Medicines such as Botox for chronic migraine or CGRP inhibitors are options doctors may discuss, but that conversation is one to have with your own doctor.

Vestibular migraine: when dizziness leads

Vestibular migraine is a form where dizziness, vertigo or balance problems are the main symptoms, with or without a headache. Cleveland Clinic describes it as migraine linked to vestibular (balance system) symptoms such as spinning, unsteadiness and sensitivity to movement.

Episodes can last from minutes to a few days. Doctors typically look for repeated episodes of vestibular symptoms, a current or past history of migraine, and migraine features such as light sensitivity during at least half of the episodes, according to a review in the medical literature. Headache is not required during every episode.

There is no single test for it. Because dizziness has many possible causes, getting checked is important rather than guessing. The American Migraine Foundation has a clear overview if you want to read more.

The rarer forms: hemiplegic, brainstem aura and retinal

Some migraine types are uncommon, and they can look alarming, so it helps to know they exist. They are all forms of migraine with aura.

Hemiplegic migraine

Hemiplegic migraine causes temporary weakness on one side of the body, along with other aura symptoms. Cleveland Clinic lists one-sided weakness, vision changes, tingling or numbness, and difficulty speaking, and says it can look like a stroke. The American Migraine Foundation calls it rare.

Because you cannot tell it from a stroke on your own, call emergency services if you notice sudden weakness, numbness or speech trouble. Our guide on when to go to the ER for a migraine goes through these situations.

Migraine with brainstem aura

Migraine with brainstem aura involves at least two symptoms from the brainstem area. The American Migraine Foundation lists vertigo, double vision, trouble with balance, slurred speech, ringing in the ears, hearing problems and fainting. It was formerly called basilar-type migraine.

Retinal migraine

Retinal migraine causes short attacks of vision loss or flashing lights in one eye only. The NHS 111 Wales page says vision usually returns to normal, but sudden loss of eyesight should be checked urgently because other causes need to be ruled out. Mayo Clinic also stresses that "ocular migraine" is not a precise term and needs proper assessment.

Many people use "ophthalmic migraine" or "ocular migraine" loosely for visual aura in both eyes, which is different. Our complete guide to ophthalmic migraine sorts out the terms.

Migraine, tension headache, cluster headache: how do you tell them apart?

Migraine is not the only headache type, and a few features help you separate them. Tension-type headaches are usually pressing or dull, on both sides, mild to moderate, and rarely cause nausea, according to Mayo Clinic-linked sources and the American Migraine Foundation.

Cluster headache is different again: pain usually sits around one eye, on one side, lasts about 30 to 90 minutes, and people tend to feel restless and pace rather than lie in a dark room, as Mayo Clinic experts explain. Migraine more often makes you want to rest in a quiet space.

Real life is messier, though. Many people have more than one headache type, so a diagnosis from a professional is more reliable than a self-check.

How can you tell which type of migraine you have?

You cannot diagnose yourself, but you can collect the details that make a diagnosis easier. A doctor will ask what happens before, during and after an attack, how long it lasts, and how many days a month you are affected.

Useful things to note:

Whether anything comes before the pain (flashing lights, tingling, speech changes)
How long attacks and any warning signs last
Whether dizziness, balance problems or one-sided weakness ever show up
How many headache days you have each month, and whether that is changing
Possible triggers and, if relevant, links to your cycle (see menstrual migraine)

Children and teenagers can have migraine too, sometimes with different symptoms, as covered in migraine in children and teens. And if you wonder whether it runs in your family, our article on whether migraine is hereditary looks at what genetics really says.

Your map in five lines

Here is the short version to keep:

Without aura: the most common type, head pain with nausea and sensitivity to light and sound.
With aura: temporary signs, often visual, before or during the pain.
Episodic or chronic: fewer than 15 headache days a month, or 15 and more for at least three months.
Vestibular: dizziness or balance problems lead, with or without headache.
Rare forms: hemiplegic, brainstem aura and retinal migraine, which always deserve medical attention.

None of these labels defines you. They are tools that help your doctor choose the right approach with you, and a few weeks of notes can make that conversation much clearer.

Frequently asked questions

What is the most common type of migraine?

Migraine without aura is the most common type, according to the American Migraine Foundation. It brings head pain and symptoms like nausea and sensitivity to light, but no aura beforehand.

Can I have more than one type of migraine?

Yes. Many people have both migraine with aura and migraine without aura, and either can be episodic or chronic. Your doctor can help you work out which labels fit you.

Is vestibular migraine the same as vertigo?

Not exactly. Vertigo (a spinning feeling) is one possible symptom of vestibular migraine, but the condition can also cause unsteadiness and motion sensitivity, with or without a headache. Because dizziness has many causes, it should be assessed by a doctor.

Is hemiplegic migraine dangerous?

It is rare, and Cleveland Clinic notes that it is not itself a medical emergency, but it can look like a stroke. If you have sudden weakness on one side, numbness or trouble speaking, call emergency services rather than trying to decide yourself.

Does chronic migraine mean my migraines will never get better?

No. Cleveland Clinic reports that between 26% and 70% of people with chronic migraine move back to episodic migraine. Talk to your doctor about what might help in your situation.

Sources

Written by Laurine Nicoletti, founder of Mellow, who has lived with migraine since she was 21. Learn more · How we write our articles

October 5, 202610 min

Migraine Without Aura: Symptoms, Duration and How It Differs From Migraine With Aura

Migraine without aura is the most common type of migraine. Learn the symptoms, how long it lasts and how it differs from migraine with aura in plain words.

October 22, 202610 min

Vestibular Migraine: When Migraine Makes You Dizzy or Unsteady

Vestibular migraine can cause vertigo or unsteadiness, sometimes with no headache. Learn the signs, how long it lasts and how it differs from other causes.

May 10, 202610 min

Menstrual Migraine: When Periods Trigger Migraine Attacks

Menstrual migraine explained: pure vs menstrually-related criteria, the estrogen drop behind attacks, and treatment options to discuss with your doctor.

All “Symptoms” articles