Understanding Complicated Migraine

Complicated migraine?  If you are someone who deals with migraine attacks on a regular basis or if you care about someone who does, you'll find that this term is one that used to get shunted around a great deal.  The truth is that although various forms of migraine share some qualities, there are actually quite a few different ways to classify them.

Confused about Complicated Migraine?
Getting mixed messages
about complicated migraine?
Different types of migraine have different causes, different effects, and while they are all to a certain extent debilitating, there is a lot that might separate the migraine that one person has from the migraine that is suffered by another.

If the causes and effects are dissimilar, you will find that the solution is going to be dissimilar as well, and this is where the phrase "complicated migraine" does migraine sufferers a disservice.  It essentially allowed migraine to be treated as one simple condition, and if you have ever been given a migraine treatment that did not work well, this may well have been why.  (read a summary of complicated migraine here)

There are a wide range of migraine types that have been covered under the umbrella term complicated migraine in the past, so take a look at the most common ones.

Migraine with aura

If you suffer from migraine with aura, you'll find that you not only experiencing the standard migraine symptoms, but that you are also encountering visual disturbances like blind spots, zigzagging patterns or flashes of light.  Some other common symptoms that come with this type of migraine include brief speech impediment, tingling or numbness.

The symptoms that often go along with this type of migraine (including headache and nausea) can often be eliminated through medication, supplements and natural treatment, avoiding known migraine triggers, and self care.

This is probably the disease most commonly diagnosed as complicated migraine.

Ophthalmoplegic 'migraine'

In what is called an opthalmoplegic migraine, the sufferer will develop complete or partial paralysis of nerves that are related to the movement of the eye.  There may be a weakness in the eye muscles, and some common effects include temporary double vision, a drooping eyelid, an overly dilated pupil.  This is accompanied by (or preceded by) a headache similar to headaches in other types of migraine.

There is the current suspicion that migraine attacks of this type is not migraine at all (partly because the headache can last for a week or more, and there can be no symptoms for several days before the other symptoms show up).  This disorder, probably not migraine at all, has been diagnosed in the past as "complicated migraine", and sometimes eye migraine.

Hemiplegic migraine

With hemiplegic migraine, you will find that you are looking at migraine with aura artifacts that last for 24 hours (though sometimes for weeks), and possible paralysis on one side of the body.  Symptoms that resemble meningitis might be a part of this type of migraine, as is poor muscle coordination, along with nausea or vomiting.

Hemiplegic migraine is usually broken down into two categories:  Familial Hemiplegic Migraine and Sporadic Hemiplegic Migraine.  Read more about headache and hemiplegic migraine here.

Basilar-type migraine

One more type of migraine that is frequently misdiagnosed is basilar-type migraine.  These are often confused with other diseases as well, and some of the things that accompany them include vertigo, slurred speech, tinnitus, impaired hearing, and decreased consciousness.  It does mimic some rather alarming conditions, but good diagnosis can dismiss many of them.

Read more about what used to be called basilar artery migraine, and why the names are changing.


If your doctor has given you a diagnosis of complicated migraine, show her this page and ask for a more specific diagnosis.  If she's not sure, you can also direct her to the International Headache Society classification website.  If your doctor is not helpful, you might want to consider getting a qualified specialist (usually a neurologist) who has more experience treating migraine.