Rare Types of Migraine

Medically Reviewed by Arefa Cassoobhoy, MD, MPH on March 24, 2023
4 min read

Most people with migraine -- about 70%-75% -- get migraine without aura. That usually comes with the things most associated with the disorder: head pain, nausea, diarrhea, and sensitivity to light and sound.

But there are less common kinds of migraine that show up in other ways. If you have new symptoms like the ones discussed here, see your doctor.

One of the most common symptoms of this very rare but serious type of migraine is weakness on one side of your body. This one-sided weakness is very similar to what happens to your body during a stroke. That similarity can make it hard to diagnose.

If these types of migraine run in your family, they’re called familial hemiplegic migraine, and they're caused by a mutated gene you get from your parents. If it doesn’t run in your family, it’s called a sporadic hemiplegic migraine. It’s also caused by gene mutation.

Most times, you start having hemiplegic migraines when you’re a child. Other symptoms include:

  • Head pain
  • Vision changes, like seeing stars or zigzags, or having blind spots
  • Trouble speaking
  • Confusion
  • Trouble with muscle coordination, called ataxia
  • Nausea or vomiting
  • Sensitivity to light and sound

If your migraine is severe, you may have seizures, fever, or fall into a coma. You can have these symptoms for hours, days, or weeks. Call 911 for any of these symptoms (except headache, nausea, vomiting, or sensitivity to light or sound) if they are new or have not been diagnosed.

Doctors used to call these basilar-type migraines because they thought narrowing or spasming of the basilar artery in your brain caused them. But scientists now know it’s nerves, not vessels, that bring them.

The symptoms of migraine with brainstem aura are a lot like those of hemiplegic migraines without muscle weakness. They usually come on slowly, and head pain follows.

They include:

  • Sparkling lights on one side of your vision
  • Numbness or tingling that moves up your arm into your face
  • Trouble understanding what others are saying
  • Problems hearing
  • Slurred speech
  • Vertigo (feeling like you’re spinning)
  • Ringing ears
  • Double vision
  • Ataxia

This rare form of migraine can mimic other conditions like transient ischemic attacks (TIA), stroke, seizures, and vertigo, so call 911 for any new or troubling symptoms.

Although anyone can get abdominal migraines, they mostly affect children ages 5-9. Most kids grow out of them by the time they’re 16. You usually feel the pain from these right behind the belly button. It might feel like mild soreness, or it could be severe. Along with abdominal pain, you typically feel nauseous and throw up.

You may not feel like eating. Your skin may also look paler than usual.

Abdominal migraines can last anywhere from 2 to 72 hours. Kids who get them usually go on to have migraine headaches as adults. Your doctor will probably rule out other gastrointestinal and kidney conditions before deciding that the pain is from abdominal migraine.

You don’t often have head pain with these vision-related migraines. Experts think ocular migraine comes from unusual electrical activity in the brain. If this happens in the outer surface of your brain, it’s called a migraine with aura. If it happens in the back of your eye in your retina, it’s called an ocular migraine. Ocular migraine can also come from a lack of blood flow to your retina.

Light that comes from electronic screens can be a trigger for these. Ocular migraines usually happen in just one of your eyes, and they can have severe symptoms, like temporary loss of vision.

Migraine with aura may cause vision problems like:

• Flashes of light
• Blind spots
• Seeing stars

You may also have problems with your speech and motor skills. All these symptoms tend to be short-lived, but any vision or speech disturbance or trouble with motor skills need to be checked out immediately in the ER.

This form of migraine causes vertigo. Vestibular refers to the inner ear, which is where your sense of balance is housed. You may or may not have a headache.

Between a third to a half of people with migraine may have a vestibular migraine at some point in their lives. You’re most likely to have one after you’ve had migraine for years.

Vertigo can make you feel like the room is spinning or like you’re moving when you’re not. You may feel dizzy or lose your balance a lot. A vestibular migraine may also cause ringing in your ears or make you feel extra sensitive to sound. Call 911 if you have a new onset of vertigo to be sure that it is not a stroke.