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Conditions That Can Look Like Migraines

Medically Reviewed by Michael W. Smith, MD on November 03, 2020

When you think of migraine, you probably think of a bad headache. While head pain is the most common (and sometimes the most intense) sign of migraine, you can also have other symptoms. You might confuse some signs of migraine with other conditions, including scary ones like stroke or epilepsy.

Migraine often causes:

  • Pain that throbs or pulses, on one or both sides of your head
  • Pain that gets worse when you're active or around lights, sounds, or smells
  • Nausea
  • Vomiting

You might have other symptoms that are basically warning signs a migraine attack is about to start. Doctors call this prodrome. Signs can include:

  • Mood changes
  • Neck stiffness and pain
  • Cravings for certain foods or drinks

Some people have migraine symptoms that affect their vision and other senses. This is aura, and it can happen before, after, or at the same time as a headache. You can also have an aura without a headache. You might:

  • See patterns, shapes, or streaks or flashes of light
  • Have blind spots
  • Feel tingling in your arm or leg
  • Go numb or weak in your face or on one side of your body
  • Struggle to talk
  • Hear sounds like ringing or music
  • Move uncontrollably

Other Types of Headaches

It's not always easy to tell the difference between migraine and another type of headache. Here are how symptoms of two common types of headaches may differ from migraine:

Tension headache. People with migraine can get this kind, too. But the pain often feels different than that of migraine. It's usually more like a dull ache. Your forehead or sides and back of your head may feel tight. Migraine pain often throbs or pulses and is more intense. A tension headache may not get worse when you move. And it doesn’t usually cause stomach problems or affect your vision like a migraine can.

Sinus headache. With a sinus headache, you often have a stuffy nose and feel pain or pressure in your face or forehead. Migraine can cause the same symptoms. But migraine causes throbbing pain, while sinus headache pain is a constant dull pain. Some people with a sinus headache may also have a fever, trouble smelling, or bad breath. Migraine doesn't cause these symptoms.

Other Migraine Mimics

Like tension and sinus headaches, migraine is common. Serious conditions that look like it are much less likely. Here are some conditions that can mimic migraine, and how you can tell the difference

Stroke. You have a stroke when blood and oxygen can’t reach an area of your brain. That happens when a blood vessel bursts or gets blocked by a clot. The symptoms come on quickly and can resemble those of migraine with aura. There are three major signs:

  • Your face droops or goes numb on one side
  • One of your arms is weak or numb
  • You can’t talk or your words aren’t clear

Some people who have strokes also:

  • Have an intense headache
  • Throw up or feel nauseated
  • Are confused
  • Can’t see well
  • Struggle to walk
  • Feel numb or weak in one of their legs

A major difference is that aura symptoms often build up over time. A headache caused by migraine also often develops slowly. But stroke symptoms are sudden. Migraine with aura can actually raise your risk for a common type of stroke called an ischemic stroke. If you suspect a stroke, get medical help at once.

Brain aneurysm. This happens when part of a blood vessel in your brain bulges out. If the vessel leaks or breaks (ruptures), blood can get into your brain. This is called a hemorrhagic stroke, and it's dangerous.

Some symptoms of a ruptured brain aneurysm are similar to migraine: headache, nausea, vomiting, and sensitivity to light. The main difference between the two conditions is how quickly they happen and the intensity of the pain. A migraine headache is painful. But a ruptured brain aneurysm headache comes out of nowhere and is the worst you’ve ever felt.

Seek medical help immediately if you think you or someone around you has an aneurysm.

Brain tumor. Brain tumors can cause headaches. But the pattern of these headaches tends to change more over time than that of migraine. With a brain tumor, your headache might be strongest when you wake up and weaken during the day. Other symptoms also show up when you have a brain tumor. Your mood may go down, your mind may be less sharp, and you may have personality changes. You might have weakness or seizures.

Epilepsy. You may get a bad headache before or after an epileptic seizure. Some symptoms of migraine aura can look like a seizure, including vision problems, nausea, and uncontrolled movements. But during a seizure, you could be confused, feel depressed or fearful, or even lose consciousness. Seizures usually last 30 seconds to 2 minutes. Migraine aura, though, can last up to an hour. The two conditions are linked. People with migraines are more likely to have epilepsy and vice versa.

Meningitis. This infection can cause an intense headache. You might feel nauseous and throw up. Your neck might be stiff, and light could bother you. But with meningitis, you can have flu-like symptoms early on. You likely have a high fever, which doesn’t usually happen with migraine. And with migraine, neck stiffness often happens before the headache starts.

If you suspect you or someone around you may have meningitis, seek medical help right away.

Glaucoma. Certain types of glaucoma can cause a headache when the pressure inside your eye increases quickly. As with migraine, your head hurts, you feel queasy, and you may have blurry vision. But you may also have red eyes and extreme eye pain, which are not symptoms of migraine. Get immediate medical care if you think you have this.

Reversible cerebral vasoconstriction syndrome (RCVS). This is a narrowing of your brain arteries that most often affects women ages 20-50. Many people who get it have had migraine in the past. A migraine headache usually starts slowly, but this condition brings sudden, strong head pain. You might have vision changes, stroke-like symptoms, and seizures, too. Make an appointment with your doctor if you suspect RCVS. Treatment can prevent serious problems like a stroke.

Idiopathic intracranial hypertension (IIH). You get this when the pressure of the fluid around your brain gets too high. That leads to an intense or repeated headache. You may also have vision loss, nausea, and vomiting. One sign that you have IIH instead of migraine is a whooshing sound in your ears. Instead of easing after a half hour or so, the vision problems are long-lasting. Also, if you have IIH, medicine doesn’t help your nausea.

Cerebrospinal fluid (CSF) leak. In rare cases, the tissue that contains your brain and spinal cord fluid gets a tear or hole, allowing some of the fluid to leak out. This leads to a headache that may get better when you lie down. You can have other symptoms similar to migraine like nausea, vomiting, and light and noise sensitivity. But with CSF leaks, you sometimes have pain between your shoulder blades. You may also feel off balance and hear ringing in your ears.

WebMD Medical Reference

Sources

SOURCES:

Cleveland Clinic: “Chronic Migraine,” “Migraine Headaches,” “Headaches,” “Cerebrospinal Fluid (CSF) Leak.”

Merck Manual Consumer Version: “Overview of Brain Tumors,” “Migraines.”

Practical Neurology: “Migraine Mimics.”

Mayo Clinic: “Brain aneurysm,” “Migraine,” “Headache,” “Tension headache,” “Meningitis,” “Seizures.”

Johns Hopkins Medicine: “Types of Seizures,” “Evaluation of a First-Time Seizure,” “Focal Seizures.”

American Stroke Association: “Ischemic Stroke (Clots),” “Learn More Stroke Warning Signs and Symptoms,” “Stroke Symptoms,” “About Stroke,” “What migraine sufferers need to know about stroke risk.”

Stroke Association: “Migraine and stroke.”

American Academy of Ophthalmology: “Flashes of Light.”

American Migraine Foundation: “Understanding Ocular Migraine,” “Silent Migraine: A Guide,” “Sinus Headaches.”

Cedars Sinai: “Cerebrospinal Fluid Leak,” “Reversible Cerebral Vasoconstriction Syndrome (RCVS).”

National Eye Institute: “Idiopathic Intracranial Hypertension,” “Types of Glaucoma,” “Glaucoma.”

National Organization for Rare Disorders: “Idiopathic Intracranial Hypertension.”

BrightFocus Foundation: “Does Glaucoma Cause Headaches?”

Intracranial Hypertension Research Foundation: "Headache."

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