Diagnosis

Anyone, including children, with recurring or persistent headaches should consult a doctor. There are no blood tests or imaging techniques that can be used to diagnose migraine headaches. A diagnosis will be made on the basis of medical history and physical exam, and, if necessary, tests may be necessary to rule out other diseases or conditions that may be causing the headaches. It is important to choose a doctor who is sensitive to the needs of headache sufferers and aware of the latest advances in treatment.

Diagnostic Criteria for Migraine

A diagnosis of migraine is usually made on the basis of repeated attacks (at least 5) that meet the following criteria:

• Headache attacks that last 4 - 72 hours
• Headache has at least two of the following characteristics: Location on one side of the head; throbbing pain; moderate or severe pain intensity; pain worsened by normal physical activity (such as walking or climbing stairs)
• During the headache, the patient has one or both of the following characteristics: Nausea or vomiting; extreme sensitivity to light or sound
• The headache cannot be attributed to another disorder

Headache Diary

The patient should try to recall what seems to bring on the headache and anything that relieves it. Keeping a headache diary is a useful way to identify triggers that bring on headaches, as well as to track the duration and frequency of headache attacks. Some tips include:

• Note all conditions, including any foods eaten, preceding an attack. Often two or more triggers interact to produce a headache. For example, a combination of weather changes and fatigue can make headaches more likely than the presence of just one of these events.
• Keep a migraine record for at least three menstrual cycles. For women, this can help to confirm a diagnosis of menstrual migraine.
• Track medications. This is important for identifying possible medication-overuse (rebound) headache or chronic (transformed) migraine.
• Attempt to define the intensity of the headache using a number system, such as:

1 = Mild, barely noticeable

2 = Noticeable, but does not interfere with work/activities

3 = Distracts from work/activities

4 = Makes work/activities very difficult

5 = Incapacitating

Medical and Personal History

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Review Date: 11/04/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)