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Complex Migraine

Harvard Health Publications
2007 Copyright Harvard Health Publications


What is a "complex" migraine headache?


There are several types of migraine headaches. A "complex migraine" is one in which there are neurological symptoms such as weakness, loss of vision, or difficulty speaking in addition to the headache. In fact, a complex migraine may be mistaken for a stroke.

One theory about the cause of migraine headaches is that blood vessels in the brain suddenly narrow (or spasm) and then dilate; when the blood vessels dilate, the headache develops. During the spasm phase, certain parts of the brain may receive too little blood, and this may cause the stroke-like symptoms. However, unlike a stroke, blood flow is not permanently interrupted during migraine headaches, and the neurological symptoms are nearly always temporary.

Other types of migraines include:

  • Common migraine – Causes a severe, throbbing headache associated with nausea and sensitivity to light and sound; this is the most common and characteristic type.

  • Classic migraine – With this type, there is an "aura," a set of warning symptoms such as flashing lights or blurry vision, that comes and goes over 10 to 30 minutes just before the headache begins.

These terms (common, classic and complex) to describe migraine headaches have fallen out of favor in recent years, as many people have features of more than one type and the options for treatment are the same for all three types.

There are more treatments than ever before to prevent or treat migraine headaches. So, if you have bothersome headaches (with or without symptoms of complex migraine), see your doctor for evaluation and treatment.

Robert Shmerling, M.D., is associate physician and clinical chief of rheumatology at Beth Israel Deaconess Medical Center and an associate professor in medicine at Harvard Medical School. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program and has been a practicing rheumatologist for over 25 years.

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Harvard Health Publications Source: from the Harvard Health Publications Family Health Guide, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved.

Used with permission of StayWell.

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