Dr. Nada Ahmad Hindiyeh discusses the most common types of migraine and their associated symptoms

Out of the 37 million Americans living with migraines, no two patients are exactly alike. Migraine attacks can occur in a variety of different frequencies and severities, and come with a wide range of symptoms. In a recent Facebook Live event hosted by the American Migraine Foundation, Dr. Nada Ahmad Hindiyeh, a neurologist and headache specialist at Stanford University, discussed the most common types of migraine attacks. By becoming aware of their symptoms, patients can work toward discovering the most effective treatment options for them. Read on to learn more:


Chronic Migraine vs. Episodic Migraine

Measuring the frequency of a patient’s migraine attacks allows medical professionals to determine whether they have a chronic or episodic migraine. According to Dr. Hindiyeh, “Episodic migraine occurs when you have less than 15 headache days a month, and chronic migraine occurs when you have 15 or more headache days a month.” For accurate tracking, Dr. Hindiyeh recommends that patients keep a headache diary or use a smartphone to log the frequency of their attacks.

When patients notice an increase in headache frequency or an elevated need for rescue medications, their migraine attacks may be progressing from episodic to chronic. Keeping an accurate log becomes even more important because symptoms don’t always tell the full story. “With chronic migraine, you may not have all of the same features you had before. That can be a typical pattern of chronic migraine, and it often happens if people are taking medications that may mask some of those symptoms,” said Dr. Hindiyeh.

Types of Headaches

Dr. Hindiyeh discussed specific sets of symptoms to help patients classify the type of headaches they are experiencing.

When patients become overly reliant on over-the-counter pain medications, they may experience rebound or medication overuse headache (MOH). According to Dr. Hindiyeh, MOH is a significant risk factor for migraine progression. “Generally, what I tell patients is the rule of 10. Limit the use of rescue medications to no more than 10 days a month to avoid rebound or MOH,” said Dr. Hindiyeh.

Another type of headache that people experience is tension-type headaches. These headaches are overall the most common, affecting 75% of people around the world. “They are not disabling and do not usually bring people into the doctor’s office,” said Dr. Hindiyeh. “Typically they feel like a tightness or squeezing sensation—like a vice grip is around the head.” Most patients classify the pain level of tension-type headaches as mild to moderate.

Although rare, another type of headache disorder patients may experience falls under the category of the Trigeminal Autonomic Cephalgias, or TACs, specifically cluster headaches and hemicrania continua. “Cluster headaches occur in about 0.1% of the population worldwide and affect more men than women,” Dr. Hindiyeh said. “These headaches occur in clusters, typically daily or a few times a day for a few weeks to months at a time, and then stop.” With cluster headaches, patients experience sharp, stabbing pain strictly on one side of their head, often behind one eye and occur in intense 15- to 180-minute bursts.

Cluster headaches and hemicrania continua can cause similar symptoms. However, hemicrania continua occurs more commonly in women than men and causes constant long-lasting pain. “It’s only on one side of the head, and the severity is usually a constant moderate pain with spikes of worsening pain that can last anywhere from 20 minutes to a few days,” said Dr. Hindiyeh. People who experience this type of headache are never pain-free, rather they have varying degrees of pain limited to one half of their head. Like cluster headache, the severe attacks of hemicrania continua are accompanied by droopiness of the eyelid, redness or tearing of the eye, or stuffiness or dripping of the nostril—only on the side of the head pain.

Developing a deeper awareness of the types and symptoms of migraine is essential to finding a treatment plan that works for you. For additional information, explore our comprehensive resource library full of doctor-verified fact sheets, toolkits and advice. To speak with a health care provider, use our find a doctor tool.