Migraine without Aura - The Basics

by Teri Robert, Lead Health Guide

Migraine is a common disabling primary headache disorder. Epidemiological studies have documented its high prevalence and high socioeconomic and personal impacts. It is now ranked by the World Health Organization as number 19 among all diseases world-wide causing disability.

Migraine is a genetic neurological disease. Because there are several different types of Migraine, and some forms involve different genetic markers, some researchers theorize that it may actually be more than one disease. For now, however, Migraine is divided into two major subtypes, Migraine without aura (MWOA) and Migraine with aura (MWA). There is a single classification under Migraine without aura. MWOA is the most common form of Migraine.

For consistency in diagnosing and classifying head pain disorders, the International Headache Society’s International Classification of Headache Disorders, 3rd Edition (ICHD-3), is generally accepted as the “gold standard.” The ICHD-3 classification criteria for Migraine without aura is:

1.1 Migraine without aura

Previously used terms: Common migraine, hemicrania simplex

Recurrent headache disorder manifesting in attacks lasting 4–72 hours. Typical characteristics of the headache are unilateral (one-sided) location, pulsating quality (throbbing or varying with the heartbeat), moderate or severe intensity, aggravation by routine physical activity and association with nausea and/or photophobia (increased sensitivity to light) and phonophobia (increased sensitivity to sound).

Diagnostic criteria:

  1. At least 5 attacks fulfilling criteria B–D
  2. Headache attacks lasting 4–72 hours (untreated or unsuccessfully treated)
  3. Headache has at least two of the following characteristics:
    1. unilateral location
    2. pulsating quality
    3. moderate or severe pain intensity
    4. aggravation by or causing avoidance of routine physical activity (e.g., walking or climbing stairs)
  4. During headache at least one of the following:
    1. nausea and/or vomiting
    2. photophobia and phonophobia
  5. Not better accounted for by another ICHD-3 diagnosis.

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