Age Migraines begin? Diagnosing without imaging?

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  • Full Question:

    I've two questions, actually. I was always given to understand that migraines can "hit" anyone, but are relatively rare prior to age fifteen or so (onset of puberty). Does the research support this?


    Also, can one be absolutely diagnosed as "having migraines" without some sort of "imaging" test (MRI or CT scan), and based solely on their description of their sensations/symptoms?


    I've a good friend whose child is suffering severe headaches, which they call "migraines", and I am concerned that the diagnosis might be premature and overly severe.... should I be concerned? Barry.

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    Full Answer:

    Dear Barry;


    To your first question, no, it is not rare for Migraines to begin prior to puberty. Migraines can begin when children are very young, even before they're able to talk, and it's not unusual for children to begin having Migraines during grade school, or even earlier.


    Diagnosis of Migraine is a diagnosis of exclusion. It's diagnosed by reviewing the medical history of the patient and their family, discussing their symptoms, conducting an examination, and ruling out other possible causes of the symptoms. With Migraine, there's nothing to show up on an imaging study, so when they're utilized, it's to rule out other conditions. When the symptoms clearly fit Migraine, especially if there's a family history of Migraine, some doctors feel imaging studies are unnecesary.


    If your friend is uncomfortable with the diagnosis, he or she is well within his or her rights to seek a second opinion.


    Good luck,
    John Claude Krusz and Teri Robert



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    About Ask the Clinician:

    Dr. Krusz is a recognized expert in the fields of headache and  Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and  Migraines. You can read more about Dr. Krusz or more about Teri Robert.


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    Last updated October 23, 2012.

Published On: November 05, 2012