The term “complicated migraine” is no longer used. It commonly referred to attacks of prolonged aura symptoms that could last hours to days or opthalmoplegic migraine where patients developed a partial or complete paralysis of the nerves that are needed for eye movement.
Other unusual types of migraine with aura include hemiplegic migraine and basilar type migraine. Familial hemiplegic migraine can be inherited and has been linked to one of several chromosomes. During attacks, patients develop stroke-like symptoms with sensory and/or loss of strength of muscles. Rarely, this type of migraine occurs without a family history. In basilar-type migraine, patients have migraine aura with neurological symptoms related to the base of the brain called the brainstem, including dizziness, hearing changes and visual disturbance. Unlike migraine with typical aura where numbness can occur on one side of the body, in this form both sides are affected. Sometimes, patients will loose consciousness or pass out with these headaches.
Another form of migraine is retinal migraine where the patient’s visual symptoms occur in only one eye, stemming from the retina itself versus the portion of the brain involved in vision, as is the case for the typical migraine aura.
Migraine can also be associated with serious results such as aura lasting longer than a week with or without brain infarction (stroke), and migraine-triggered seizures.
Patients with these types of unusual migraines should be evaluated and treated by a specialist. Because the cause of these migraine types is not fully understood, patients with these symptoms should not use triptans for acute treatment.