Materiały źródłowe

• #1 Diagnosis and management of migraine in ten steps

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8321897/

  Migraine is a disabling primary headache disorder that directly affects more than one billion people worldwide. Despite its widespread prevalence, migraine remains under-diagnosed and under-treated. […] In this Consensus Statement, we introduce typical clinical features, diagnostic criteria and differential diagnoses of migraine. […] The medical history is the mainstay of migraine diagnosis; with the assistance of a range of published aids, a full history should enable systematic application of the criteria set out in the ICHD-3. […] The ICHD-3 criteria, which were developed by the International Headache Society, set out the clinical features that establish the diagnosis of migraine and its types and subtypes. […] Diagnosis of migraine can also be facilitated by use of screening instruments that evaluate whether a patient’s clinical features suggest migraine.

• #1 Diagnosis & Treatment – American Migraine Foundation

  https://americanmigrainefoundation.org/migraine-diagnosis-treatment/

  We understand that searching for answers about your migraine symptoms is often confusing and intimidating—all while living in a state of uncertainty. The good news is you are not alone, and the help you need is closer than you may think. Set yourself up for success by understanding migraine diagnosis and treatment. […] There is no test to diagnose migraine. Instead, your doctor will gather your symptoms, conduct a physical examination and review your personal and family medical history to reach a conclusion. Your doctor may also order a magnetic resonance imaging (MRI) or computed tomography (CT) scan to rule out any other conditions. […] Receiving a formal migraine diagnosis is the first milestone when working with your doctor to identify a personalized and effective treatment plan. Continuing to talk with your doctor throughout the course of your treatment is important for determining the strategies that prove beneficial and those that may not be as effective. […] Treatment options vary, from acute treatment to relieve symptoms to preventive treatment to reduce the number of attacks you experience. There are also behavioral treatment options and lifestyle changes that can help.

• #1 Migraine Headache – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560787/

  Migraine is a genetically influenced complex neurological disorder characterized by episodes of moderate-to-severe headaches, typically unilateral and frequently accompanied by nausea and heightened sensitivity to light and sound. […] Diagnosis involves patient history, physical examination, and meeting specific diagnostic criteria. […] The diagnosis of migraine is based on patient history, physical examination, and fulfillment of diagnostic criteria. […] The International Classification of Headache Disorders (ICHD-3) describes the below-mentioned diagnostic criteria for migraine. […] Criterion B1. Migraine without aura: B1a: Headache attacks lasting 4 to 72 hours (untreated or unsuccessfully treated). […] Criterion B2. Migraine with aura: B2a: 1 or more of the fully reversible aura symptoms mentioned below.

• #1 1. Migraine – ICHD-3

  https://ichd-3.org/1-migraine/

  Migraine is a common disabling primary headache disorder. Many epidemiological studies have documented its high prevalence and socio-economic and personal impacts. In the Global Burden of Disease Study2010 (GBD2010), it was ranked as the third most prevalent disorder in the world. In GBD2015, it was ranked third–highest cause of disability worldwide in both males and females under the age of 50 years. […] Migraine has two major types. 1.1 Migraine without aura is a clinical syndrome characterized by headache with specific features and associated symptoms. 1.2 Migraine with aura is primarily characterized by the transient focal neurological symptoms that usually precede or sometimes accompany the headache. Some patients also experience a prodromal phase, occurring hours or days before the headache, and/or a postdromal phase following headache resolution. Prodromal and postdromal symptoms include hyperactivity, hypoactivity, depression, cravings for particular foods, repetitive yawning, fatigue and neck stiffness and/or pain.

• #1 Migraine Diagnosis – Migraine Association of Ireland

  https://migraine.ie/hcp/migraine-diagnosis/

  Criteria for Diagnosing Migraine Without Aura […] A. At least five attacks fulfilling B-D B. Attacks lasting 4-72 hours if untreated or unsuccessfully treated C. Headache has at least two of the following characteristics […] – Unilateral location […] – Pulsating quality […] – Moderate or severe pain intensity […] – Aggravation by or causing avoidance of routine physical activity […] D. During headache, at least one of the following […] – Nausea and / or vomiting […] – Photophobia / Phonophobia […] E. Headache not attributable to any other disorder […] […] Criteria for Diagnosing Migraine With Aura […] A. At least two attacks fulfilling criteria B-D B. Aura consisting of at least one of the following, but no motor weakness: […] – Fully reversible visual symptoms including positive features (e.g. flickering lights, spots or lines) and /or negative features (i.e. loss of vision)

• #1 How to diagnose migraine headaches | Medmastery

  https://www.medmastery.com/guides/headaches-clinical-guide/how-diagnose-migraine-headaches?srsltid=AfmBOoq_UJ5g8C2JudaPJ0uoebzn2M1tIiuNiaEecxvZNd_23xw6sX3R

  For migraine that occurs with an aura, there are several other criteria that must be met for a diagnosis. […] In addition to all of the basic migraine criteria, there are several others that must be fulfilled to diagnose migraine with aura: There must be at least two attacks that have any of the symptoms of aura above. Aura symptoms must have at least three of the following six characteristics: At least one aura symptom spreads gradually over five minutes, Two or more aura symptoms occur in succession, Each individual aura symptom lasts 560 minutes, At least one aura symptom is unilateral, At least one aura symptom is positive, meaning a symptom of an added sensory perceptive phenomena such as scintillating lights or pins and needles, The aura is accompanied, or followed within 60 minutes, by a headache.

• #1 Chronic Migraine: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9638-chronic-migraine

  Chronic migraine is a condition where you have frequent or long-lasting episodes of headaches and migraines. […] To receive this diagnosis, you must have: At least 15 days in a month where you experience a headache or migraine. This must happen for at least three months. […] A healthcare provider can diagnose migraines using a combination of approaches. A neurological exam is usually one of the first steps. […] Your provider may recommend certain tests, especially diagnostic imaging scans, such as a computed tomography (CT) scan, to rule out life-threatening conditions like stroke. […] Chronic migraine treatments are similar to migraine treatments in general. Medications are the main form of treatment, and there are two main treatment approaches: Preventive and Rescue. […] Chronic migraine is a condition that can shift and change throughout your lifetime. Between 26% and 70% of chronic migraine cases will transform back into episodic migraine. […] Chronic migraine isn’t dangerous (except in rare cases), but it is serious. Migraines can be disruptive and make it difficult or impossible to go about your usual activities.

• #1 Migraine Diagnosis | Science of Migraine

  https://www.scienceofmigraine.com/management/migraine-diagnosis-criteria

  Key distinctive features of migraine are: Unilateral location, Long duration (4-72 hours), Frequency, Associated symptoms such as nausea and/or vomiting, Sensitivity to light and sound or to touch. […] Diagnoses of migraine can be refined based on the frequency of monthly migraine days (MMDs) and monthly headache days (MHDs). […] Approximately 50% of patients with chronic migraine have MOH that may revert to episodic headache after drug withdrawal. […] The ICHD-3 criteria for acute medication overuse differ based on the drug class.

• #1 Diagnosis and management of migraine in ten steps | Nature Reviews Neurology

  https://www.nature.com/articles/s41582-021-00509-5

  The ICHD-3 criteria, which were developed by the International Headache Society, set out the clinical features that establish the diagnosis of migraine and its types and subtypes. These criteria prioritize specificity over sensitivity, so an additional set of criteria are given for a diagnosis of probable migraine, which is defined as migraine-like attacks missing one of the features required to fulfil all criteria for a type or subtype of migraine. Probable migraine is a diagnosis pending confirmation during early follow-up. […] Diagnosis of migraine can also be facilitated by use of screening instruments that evaluate whether a patient’s clinical features suggest migraine. After use of such screening instruments, diagnosis should be confirmed by a review of the medical history and/or use of a diagnostic headache diary. Validated screening instruments include the three-item ID-Migraine questionnaire and the five-item Migraine Screen Questionnaire. […] A conclusion that treatment has failed should be made with caution and must always be preceded by a thorough review of the underlying reasons. In some cases, apparent failures might be remediable, such as when failure is due to poor adherence or suboptimal dosing.

• #1 Self-Assessment Questions – Course #90073: Migraine: Diagnosis and Therapeutic Advances – NetCE

  https://www.netce.com/studypoints.php?courseid=2835&printable=yes&page=printquestions

  Useful evidence-based clinical guidelines for the diagnosis of migraine have been developed and are summarized in the mnemonic POUND: pulsatile headache; one-day duration (4 to 72 hours); unilateral location; nausea or vomiting; and disabling intensity. […] Chronic migraine is defined as headaches that occur on 15 or more days per month for more than three months, which have the features of migraine headache on at least eight days per month. […] The pattern of migraine presented by a patient changes over the lifetime, and its assessment determines the combination of clinical management with patient education, pharmacologic treatment, and behavioral interventions. […] The most common cause of symptoms suggestive of chronic migraine is medication overuse, and in at least 50% of these patients, the condition is reversed after discontinuation of medications.

• #1 Diagnosis – The Migraine TrustVisualV1 – SearchVisualV1 – CrossVisualV1 – Home VisualV1 – CrossVisualV1 – Arrow

  https://migrainetrust.org/live-with-migraine/healthcare/diagnosis/

  Getting your migraine diagnosed […] If you are getting regular headaches or other symptoms that you suspect could be migraine, it is important to see a doctor and get a proper diagnosis. […] Diagnosis will therefore depend upon your doctor taking your medical history and ruling out other causes for the attacks. […] To make a firm diagnosis, information from two approaches will be used. […] A detailed history of the headaches and/or other symptoms will be taken. […] A thorough examination will be carried out, including a necessary neurological assessment. […] When you visit your doctor to talk about your headaches, you should therefore expect to give quite detailed information about your attacks. […] A change in the pattern of your headaches or other symptoms might be the result of the naturally changing course of migraine. […] However, any change in the pattern of your headaches should be checked with your doctor. […] If you suspect that you are experiencing more than one type of headache disorder or are not sure, see your doctor.

• #1 How Is Migraine Diagnosed?

  https://www.healthline.com/health/migraine/migraine-diagnosis

  Your doctor will need to gather a lot of information about your personal medical history and your family medical history to diagnose migraine. […] Generally, youll be diagnosed with migraine if youve had at least five headaches that have lasted between 4 and 72 hours and your headaches have at least two of these four characteristics: are located primarily on one side of the head, cause pain thats pulsing or throbbing, cause pain thats moderate to severe, are made worse by normal physical activity. […] A physical exam and thorough medical history allow a doctor to make the migraine diagnosis. […] However, in some cases, the doctor might not be certain that your symptoms arent being caused by something else. In this case, you might need to move on to the next step. […] If your pain came on suddenly or if youre having other symptoms that arent typically caused by migraine, your doctor might order more testing.

• #1 How Migraines Are Diagnosed

  https://www.verywellhealth.com/migraine-diagnosis-4583064

  Your physical examination, which will include a neurological exam, is a vital part of your migraine evaluation. […] Your healthcare provider may decide to run some tests to rule out other conditions besides migraines if your symptoms are new, changing, or if they dont completely fit into what would be expected to accompany a migraine. […] Medical tests, including imaging and blood tests, can’t detect a migraine, but your healthcare provider may order these tests to help rule out other causes for your headaches. Your healthcare provider will diagnose your migraine based on your medical history as well as a physical examination and testing to look for any other problems. […] Migraine symptoms are similar to symptoms of several other conditions, and your healthcare provider will need to confirm whether you have migraines—the treatment for migraines differs from that of other neurological problems.

• #1 Migraine Mimics

  https://practicalneurology.com/articles/2019-may/migraine-mimics

  A careful history is followed by general medical and neurologic examinations to search for red flags, ie, clinical features that suggest the possibility of a secondary headache disorder. […] When red flags are present, a targeted diagnostic evaluation is undertaken to support or exclude suspected secondary headache disorders. […] Migraine is both a diagnosis of inclusion and exclusion. […] It is a diagnosis of inclusion in that certain clinical features must be present. […] It is a diagnosis of exclusion in that alternative primary and secondary disorders must be excluded. […] Once migraine is diagnosed, the goals of treatment are reducing headache frequency and severity, leading to an overall improvement in quality of life. […] If headaches do not respond to treatment as expected, the possibility of alternative diagnoses should be reconsidered.

• #1 Migraine Headache – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560787/

  Neuroimaging, such as computed tomography (CT) scan, magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), or magnetic resonance venography (MRV), is indicated in the following cases: Acute severe headache, especially if it is the first or worst episode (to exclude subarachnoid hemorrhage). […] The commonly used acronym „SNOOP” can be used to aid in the determination of neuroimaging indications as follows: „S” for systemic signs or symptoms and secondary risk factors.

• #1 Diagnosis and management of migraine in ten steps

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8321897/

  Differential diagnoses for migraine include other primary headache disorders and some secondary headache disorders. […] The only role for neuroimaging in the diagnosis of headache is to confirm or exclude causes of secondary headache that are suspected on the basis of red flags in the medical history and/or physical examination. […] A conclusion that treatment has failed should be made with caution and must always be preceded by a thorough review of the underlying reasons. […] Medication overuse headache is a chronic headache disorder characterized by headache on 15 days per month. […] Recognition of comorbid conditions in migraine is important because they can influence drug choice. […] Long-term management of migraine should be the responsibility of primary care.

• #1 Diagnosing Migraine | NYU Langone Health

  https://nyulangone.org/conditions/migraine/diagnosis

  Migraines are debilitating, recurrent headaches that cause moderate to severe throbbing pain. […] To determine if migraines are causing your pain, neurologists at NYU Langone ask about your symptoms, focusing on the frequency, intensity, duration, location, and any known triggers. […] A careful review of your symptoms can help your doctor to determine the type of migraine you’re experiencing and if an underlying condition could be the cause. […] The neurological examination is done to help determine whether the migraines originate from a brain tumor or blood clot in the brain, or to rule out the possibility that another condition may be causing your symptoms. […] A doctor may order an MRI scan to look for other conditions that can cause headaches, such as a tumor or abscess, which is a collection of pus that has formed in response to an infection. […] Similar to an MRI, a magnetic resonance angiogram (MRA) is an imaging technique used to check for an abnormality, such as an aneurysm, in the blood vessels of the brain.

• #1 Migraine: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/neuro/headache/migraine/treatment

  How is Migraine Diagnosed? Diagnosis Migraine diagnosis is typically based on medical signs and the symptoms the patient describes, rather than tests. To diagnose a migraine, the neurologist will ask about the patients history and family history, review the specific symptoms, and perform a physical examination. The doctor may order tests to rule out other possible causes of severe headaches. […] Additional tests to rule out other medical conditions may include: Blood tests, Imaging tests, including computed tomography (CT) or magnetic resonance imaging (MRI) brain scans, to rule out other causes for the headache such as a brain tumor, Electroencephalogram (EEG) may be ordered to rule out seizures.

• #1 Challenges of Migraine Diagnosis

  https://www.neurologylive.com/view/challenges-of-migraine-diagnosis

  Unfortunately, we have a very suboptimal diagnosis of migraine. […] There are certain data showing that the United States had consortium therapies and migraine-specific pharmacology therapies. […] Two-thirds of patients have consulted a health care professional in the past year before having a diagnosis of migraine. […] Unfortunately, they didnt have a diagnosis of migraine at that time. […] Predictors for potential migraine consultation includeit seems obvioushaving health insurance. […] Other studies, like the CaMEO study, show that among subjects with migraine, about 40% who have chronic migraine end up seeing a physician at the time of enrollment. […] They also identified 3 obstacles for care: having a consultative health care professional for migraine, having received an accurate diagnosis, and having been prescribed minimum acute and preventive pharmacological treatments. […] Most of the time, when were collecting our data, we use the ICHD-3 criteria to ask all the questions that our questionnaires usually collect.

• #1 Defining and Diagnosing Migraine

  https://www.ajmc.com/view/defining-and-diagnosing-migraine

  A migraine is more than a headache. The headache itself can be 1 or both sided, throbbing, and it keeps you from moving. In addition to which there can be sensitivity to light, sound, and odors and nausea. […] If you have headache days, more than 15 a month, the majority of which are migraine, thats called chronic migraine. If you have less than 15 headache days per month, by definition its called episodic migraine. […] Well, 1 study showed at least 44% of patients [who] have migraine are undiagnosed, and the other research study has shown that from the onset of symptoms to the diagnosis can be 5 years in about a majority of migraineurs. […] People think that they have tension headaches, [that] they have sinus headaches, when in fact those are migraine headaches. […] The few people [who] actually get diagnosed quickly are the fortunate ones.

• #1 Defining and Diagnosing Migraine

  https://www.ajmc.com/view/defining-and-diagnosing-migraine

  The ramifications of that are huge because if you are misdiagnosed or if you are not diagnosed at all, then patients tend to self-medicate. […] It depends on what the patient believes. […] I would suspect with adequate treatment, [fewer] than 1 in 10 patients today are uncontrolled. […] the diagnostic odyssey sometimes is an interesting one. Well see patients [who] are presenting to the emergency [department] multiple times. Theyll end up on opioids. They will have MRIs [magnetic resonance imaging] or diagnostic imaging [exams]. And so many times it really does help to have a member, if you will, referred to a treating specialist who can confirm the diagnosis and establish the right treatment pattern.

• #1

  https://link.springer.com/article/10.1007/s40122-022-00387-9

  A timely and accurate diagnosis is important for the management of CM; unfortunately, many patients receive a delayed or incorrect diagnosis (most commonly chronic tension-type headache [cTTH]), potentially because screening tools have lower sensitivity and specificity compared to direct interviews. […] An accurate diagnosis is a key step in providing good medical care for individuals with migraine (especially CM), in addition to a consultation with a medical professional and prescription of appropriate medications. […] Patients who present to PCPs with recurrent disabling headaches nearly always have migraine, so the presumptive diagnosis should be migraine until other types of headache diagnoses have been eliminated. […] Patients who meet the ICHD 3 criteria for CM should be diagnosed with CM whether or not they experience tension-like headaches or other milder headaches during this period.

• #1 How Is Migraine Diagnosed?

  https://www.everydayhealth.com/migraine/diagnosis/

  Many people try to deal with migraine on their own, which can mean lots of hours in a dark, quiet room trying to manage pain and other symptoms with over-the-counter medications. The condition can go undiagnosed for years, meaning the person who has it may miss out on effective treatment. […] If you regularly experience headaches and other symptoms of migraine, it may be time to seek a diagnosis. Your primary care doctor can usually evaluate your symptoms and decide what treatment will work best for you, but in some cases, you may be referred to a neurologist. […] Once you have a migraine diagnosis, you can begin the treatment you need. […] A proper diagnosis will make a difference in how its managed. […] For people who experience migraine once or twice a month and are able to manage it with an over-the-counter medication such as ibuprofen, its really up to the individual if they want to seek further treatment.

• #1 Diagnosis and Treatment for Migraines

  https://healthlibrary.osfhealthcare.org/Conditions/Neuroscience/Headaches/Migraines/85,P00812

  To get an accurate diagnosis, it’s important to clearly describe your migraine symptoms to your doctor. […] Procedures used to diagnose a migraine are generally used to rule out other possible causes of the symptoms. Your doctor will ask about your health history and do a physical exam. You may also need one or more of these tests: […] Migraine headaches may need certain medicines. These include: […] Some migraines may need to be evaluated right away. You may need to stay in the hospital for observation, diagnostic testing, or even surgery. Treatment depends on the person, how severe the symptoms are, and how often they happen.

• #2 Migraine Diagnosis | Science of Migraine

  https://www.scienceofmigraine.com/management/migraine-diagnosis-criteria

  Find International Headache Society (IHS) migraine diagnosis guidelines and key considerations that can help differentiate migraine from other headache disorders […] Although migraine is a common disease with substantial impact, it is underdiagnosed and undertreated. […] In the American Migraine Prevalence and Prevention Study (N = 18,968), a substantial proportion of people who met the International Classification of Headache Disorders, second edition (ICHD-2) criteria for migraine reported never having received a medical diagnosis of migraine. […] Migraine diagnosis is described in the third edition of the ICHD (ICHD-3), developed by the IHS. […] An accurate diagnosis of migraine depends on obtaining an accurate patient history. […] Characteristic symptoms of migraine facilitate differential diagnosis from other primary headache disorders, including tension-type and cluster headache.

• #2 Migraine – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201

  Migraine is a clinical diagnosis. That means the diagnosis is based on the symptoms reported by the patient. There is no lab test or imaging study that can rule in or rule out migraine. Based on screening diagnostic criteria, if you have the symptoms of headache associated with sensitivity to light, a decrease in function and nausea, you likely have migraine. Please see your healthcare professional for the possible diagnosis of migraine and migraine specific treatment. […] If you regularly have signs and symptoms of migraine, keep a record of your attacks and how you treated them. Then make an appointment with your health care provider to discuss your headaches. […] Even if you have a history of headaches, see your health care provider if the pattern changes or your headaches suddenly feel different.

• #2 Diagnosis and management of migraine in ten steps | Nature Reviews Neurology

  https://www.nature.com/articles/s41582-021-00509-5

  The ICHD-3 criteria, which were developed by the International Headache Society, set out the clinical features that establish the diagnosis of migraine and its types and subtypes. These criteria prioritize specificity over sensitivity, so an additional set of criteria are given for a diagnosis of probable migraine, which is defined as migraine-like attacks missing one of the features required to fulfil all criteria for a type or subtype of migraine. Probable migraine is a diagnosis pending confirmation during early follow-up. […] Diagnosis of migraine can also be facilitated by use of screening instruments that evaluate whether a patient’s clinical features suggest migraine. After use of such screening instruments, diagnosis should be confirmed by a review of the medical history and/or use of a diagnostic headache diary. Validated screening instruments include the three-item ID-Migraine questionnaire and the five-item Migraine Screen Questionnaire. […] A conclusion that treatment has failed should be made with caution and must always be preceded by a thorough review of the underlying reasons. In some cases, apparent failures might be remediable, such as when failure is due to poor adherence or suboptimal dosing.

• #2 1.1 Migraine without aura – ICHD-3

  https://ichd-3.org/1-migraine/1-1-migraine-without-aura/

  1. Migraine without aura is a recurrent headache disorder manifesting in attacks lasting 4-72 hours. Typical characteristics of the headache are unilateral location, pulsating quality, moderate or severe intensity, aggravation by routine physical activity and association with nausea and/or photophobia and phonophobia. […] Diagnostic criteria include at least five attacks fulfilling specific criteria, with headache attacks lasting 4-72 hours, and at least two of the following four characteristics: unilateral location, pulsating quality, moderate or severe pain intensity, and aggravation by or causing avoidance of routine physical activity. […] Migraine without aura often has a menstrual relationship. […] Very frequent migraine attacks are now distinguished as Chronic migraine. […] Regional cerebral blood flow imaging shows no changes suggestive of cortical spreading depression during attacks of migraine without aura, although blood flow changes in the brainstem may occur. […] It is now clear that migraine without aura is a neurobiological disorder; clinical as well as basic neuroscience has advanced our knowledge of migraine mechanisms, and continues to do so.

• #2 Understanding Migraine Tests and Diagnosis Doctor Q&A — Migraine Again

  https://www.migraineagain.com/migraine-tests-diagnosis/

  Migraine is a disease that is characterized by attacks or episodes. Individual attacks may themselves be diagnosed as migraine, and referred to as migraine attacks, but to receive a formal diagnosis of migraine disease requires at least five attacks. […] A migraine diagnosis is a clinical diagnosis, meaning it is made based upon characteristics rather than any specific tests, scans, or biomarkers. […] The criteria used to diagnose migraine in the ICHD-3 are: At least five episodes lasting 4 to 72 hours that include at least one of the following: Nausea and/or vomiting, Photophobia (light sensitivity), Phonophobia (noise sensitivity), Head pain with at least two of these characteristics: Unilateral location (occurring on only one side), Pulsating quality, At least moderate severity, Aggravated by routine physical activity.

• #2 Migraine Diagnosis – Migraine Association of Ireland

  https://migraine.ie/hcp/migraine-diagnosis/

  – Fully reversible sensory symptoms including positive features (i.e. pins and needles) and / or negative features (i.e. numbness) […] – Fully reversible dysphasic speech disturbance […] C. At least two of the following: […] – Homonymous visual symptoms and / or unilateral sensory symptoms […] – At least one aura symptom develops gradually over ≥5 minutes and / or different aura symptoms occur in succession over ≥5 minutes. […] – Each symptom lasts ≥5 and ≤60 minutes […] D. Headache fulfilling criteria B-D for Migraine without Aura begins during the aura or follows aura within 60 minutes E. Headache not attributed to another disorder […] […] 1-3% of all migraine does not fit the standard diagnostic criteria for ‘Migraine with Aura’ or ‘Migraine without Aura’.

• #2 Migraine Headache: Diagnosis and Current and Emerging Preventive Treatments

  https://www.psychiatrist.com/pcc/migraine-headache-diagnosis-current-emerging-preventive/

  Migraine is not static. Some individuals will cease experiencing symptoms over a prolonged period; their migraine diagnosis should be considered to be in remission. […] The ICHD-3 diagnosis of chronic migraine requires that a patient experience headache on 15 or more days per month for 3 or more months, and the headaches on at least 8 of those days must have the features of a migraine. […] Risk factors that can be targeted to reduce a patients likelihood of developing chronic migraine include high caffeine consumption, psychiatric disorders such as depression and anxiety, and medical conditions such as obesity, arthritis, diabetes, and sleep disorders. […] The ultimate goal of headache treatment is to provide relief from the headache. […] Not every patient is a candidate for preventive treatment. Guidelines are available to assist clinicians in selecting patients who are likely to benefit from this type of treatment.

• #2 Overview of Migraine Diagnosis | American Headache Society

  https://americanheadachesociety.org/research/library/overview-of-migraine-diagnosis

  Migraine is by far the most common headache type for which patients seek help from providers. […] In addition, migraine is frequently underdiagnosed and undertreated. This makes it extremely important for primary care providers to understand how to diagnose migraine. […] Clinical history, family history and physical/neurologic examination findings are usually sufficient to make a diagnosis of migraine. […] Patients seeking help for bilateral headaches that interfere with daily activities are likely to have migraine rather than tension-type headache and might require migraine-specific medication. […] Medication overuse headache (a secondary headache disorder) should be considered present in patients with migraine (or tension-type headache) using combination analgesics, opioids or triptans 10 or more days a month, or acetaminophen/NSAIDs 15 or more days a month.

• #2 Diagnosis of Migraine Headache | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/1215/p2087.html

  In a more recent U.S. study, researchers developed the three-item Identification of Migraine (ID Migraine) clinical decision rule for the diagnosis of migraine. […] Although the methodology for both rules is strong, the ID Migraine rule has the advantage of being prospectively validated and can be used confidently as a self-administered tool. […] It is important to remember that some of the features that make migraine more likely (e.g., photophobia, aura) also make it more likely that the patient will have a significant abnormality on an imaging study. […] Imaging is recommended for patients with high-risk features such as acute thunderclap headache; abnormal neurologic examination findings; aura; vomiting, if not part of the patients usual migraine pattern; headache aggravated by exertion or Valsalva maneuver; or a nonclassic pattern of migraine, cluster, or tension headache. […] The patient has four out of five clinical features of migraine and, therefore, has a 92 percent probability of migraine. She also has a 62 percent probability (the highest possible) using the ID Migraine rule.

• #2 Improving Diagnosis of Migraine in Primary Care

  https://www.stfm.org/publicationsresearch/publications/educationcolumns/2014/july/

  Headache is a common complaint in primary care, and migraines affect approximately 12% of the US population; however, most medical schools offer only about 3 hours of education on headache. This distinction between headache and migraine is important, as correct diagnosis makes correct treatment more likely. […] In our review of patients in our community clinics, we found the predominant diagnosis was of headache, not migraine, and the corresponding prescription for this diagnosis was an opiate pain medication, which is known to make migraine headaches worse. […] The ID Migraine tool consists of three short questions: In the last 3 months, did you feel nauseated or sick with a headache? In the last 3 months, did light bother you with a headache? In the last 3 months, have your headaches limited your ability to work, study, or do your daily activities for at least a day? Answering yes to two out of three questions yields 80% probability of a diagnosis of migraine.

• #2 Diagnosis, Treatment & Management of Migraines | Banner

  https://www.bannerhealth.com/services/neurology/programs-care/headaches/migraines/diagnosis-and-treatment

  If you think you have migraine headaches, youll want to see a neurologist or another health care provider who can check your symptoms and medical history. Theres no specific test that can diagnose migraines. Your doctor will consider factors such as: […] Your doctor will want to know how often you have headaches, what they feel like, what other symptoms you have and whether youve noticed any triggers or patterns. […] Your doctor will ask where you feel the pain, how intense it is, how long it lasts and whether you noticed symptoms like sensitivity to light or sound, nausea or aura. […] This exam can help rule out other possible causes of headaches. […] Your doctor will consider if you have other health problems that may be causing your headaches or adding to your symptoms. […] Your doctor will also ask other questions like how long the headache lasts, what the pain feels like and what other symptoms you have. With this information, they can decide if you have a specific type of migraine such as chronic migraine, hemiplegic migraine or vestibular migraine, or if it could be a different condition.

• #2 Diagnosis and Treatment for Migraines

  https://healthlibrary.brighamandwomens.org/Conditions/Heart/85,P00812

  How are migraine headaches diagnosed? To get an accurate diagnosis, it’s important to clearly describe your migraine symptoms to your doctor. It’s helpful to track the dates, times, and other details linked to migraines. Keep a record of your symptoms to help identify the type of headache you have and any potential triggers. Use a calendar, notebook, or your phone to record the details. […] Procedures used to diagnose a migraine are generally used to rule out other possible causes of the symptoms. Your doctor will ask about your health history and do a physical exam. You may also need one or more of these tests: […] Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is. […] The goal of treatment is to stop headaches from happening. Good headache management depends on knowing what type of headache you have. Treatment may include: […] Migraine headaches may need certain medicines. These include: […] Some migraines may need to be evaluated right away. You may need to stay in the hospital for observation, diagnostic testing, or even surgery. Treatment depends on the person, how severe the symptoms are, and how often they happen.

• #2

  https://www2.hse.ie/conditions/migraine/diagnosis/

  There is no specific test to diagnose migraine. Your GP will ask about your symptoms and if they have a pattern. […] Migraine attacks can be unpredictable. It can take time to get an accurate diagnosis. […] Your GP may check your: vision, coordination, reflexes, sensations. This helps to rule out some other causes of your symptoms. […] They may ask if your headaches: are on 1 side of your head, feel like a pulsing pain, stop you from doing daily activities, get worse when you move or do physical activity, happen with other symptoms such as feeling and being sick, make you more sensitive to light and noise. […] Your GP may decide to refer you to a neurologist. This is a specialist in the brain and nervous system. […] The specialist may recommend other tests and treatment if: a diagnosis is unclear, you have migraine attacks on 15 days or more a month (chronic migraine), treatment does not control your symptoms, you have new symptoms.

• #2 Migraine Mimics

  https://practicalneurology.com/diseases-diagnoses/headache-pain/migraine-mimics/31510/

  A careful history is followed by general medical and neurologic examinations to search for red flags, ie, clinical features that suggest the possibility of a secondary headache disorder. […] When red flags are present, a targeted diagnostic evaluation is undertaken to support or exclude suspected secondary headache disorders. […] Migraine is both a diagnosis of inclusion and exclusion. It is a diagnosis of inclusion in that certain clinical features must be present. It is a diagnosis of exclusion in that alternative primary and secondary disorders must be excluded. […] Once migraine is diagnosed, the goals of treatment are reducing headache frequency and severity, leading to an overall improvement in quality of life. […] If headaches do not respond to treatment as expected, the possibility of alternative diagnoses should be reconsidered.

• #2 Migraine – Diagnosis : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/migraine-diagnosis/

  The following “red flags” may warrant head CT without contrast (contrast or MRI may be indicated): The “first or worst” headache. […] Patients presenting with thunderclap (sudden onset, maximal intensity instantly) headache require CT without contrast to rule out medical emergencies such as subarachnoid hemorrhage. […] A lumbar puncture (LP) is indicated for the diagnosis of an infectious CNS process, subarachnoid hemorrhage not detected by CT without contrast (> 6hrs post onset), or idiopathic intracranial hypertension. […] Differential diagnosis beyond migraine includes cluster headache: Severe, throbbing, unilateral pain occurring over the orbitotemporal region. […] Tension-type headache: Bilateral, squeezing or band-like pain. […] Medication overuse headache: Occurs in conjunction with 15 or more days per month of medication overuse (overuse of at least 1 acute treatment drug for more than 3 months).

• #2 Migraine – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/migraine-headache/diagnosis-treatment/drc-20360207

  If you have migraines or a family history of migraines, a specialist trained in treating headaches, known as a neurologist, will likely diagnose migraines based on your medical history, symptoms, and a physical and neurological examination. […] If your condition is unusual, complex or suddenly becomes severe, tests to rule out other causes for your pain might include: […] An MRI scan. A magnetic resonance imaging (MRI) scan uses a powerful magnetic field and radio waves to produce detailed images of the brain and blood vessels. MRI scans help diagnose tumors, strokes, bleeding in the brain, infections, and other brain and nervous system, known as neurological, conditions. […] A CT scan. A computerized tomography (CT) scan uses a series of X-rays to create detailed cross-sectional images of the brain. This helps diagnose tumors, infections, brain damage, bleeding in the brain and other possible medical problems that may be causing headaches.

• #2 Diagnosis, Treatment & Management of Migraines | Banner

  https://www.bannerhealth.com/services/neurology/programs-care/headaches/migraines/diagnosis-and-treatment

  Even though no test can diagnose migraines, your provider may suggest certain tests or imaging studies to rule out other conditions or identify issues that might contribute to your headaches. […] Your doctor may recommend: […] Imaging studies (such as magnetic resonance imaging (MRI) or computed tomography (CT) scans) to check brain structure and rule out any underlying causes of the headaches. […] Sleep studies (polysomnography), to find out if sleep disorders such as sleep apnea could be adding to your headaches. […] Blood tests, which can look for inflammatory markers, hormonal imbalances, vitamin deficiencies and thyroid function issues. […] Lumbar puncture (spinal tap) to analyze the cerebrospinal fluid for signs of infection, inflammation or other problems. […] Electroencephalogram (EEG), which measures the brain’s electrical activity. […] Allergy testing, such as skin prick tests or blood tests, to see if allergies might be triggering your headaches.

• #2 Headache Tests | National Headache Foundation

  https://headaches.org/resources/headache-tests/

  These tests can help you communicate the severity of your headache pain to your doctor and/or help you identify a migraine. […] Answering yes to two out of three of these questions means theres a 81% chance you have migraine. […] Answering yes to all three means theres at least a 93% chance you have migraine. […] Healthcare providers should evaluate the following symptoms to determine if a patient has migraine: […] By measuring the number of days missed in these activity areas due to migraine, the MIDAS tool can improve migraine care by getting treatment right the first time a patient consults with his or her healthcare provider. […] The MIDAS score looks at the patients medical needs and helps the healthcare provider to determine the appropriate treatment at the first consultation.

• #2

  https://link.springer.com/article/10.1007/s40122-022-00387-9

  Chronic migraine (CM) is one of the most disabling diseases, and it is commonly misdiagnosed and mistreated. […] Despite the importance of a timely and accurate diagnosis for the effective management of CM, recent surveys have shown that only 20-25% of individuals with CM receive a correct diagnosis. […] Ideally, a diagnosis of CM should be made in the primary care setting, based on a thorough medical history including detailed descriptions of headaches occurring earlier in life as well as current headaches, and the range of headaches (not just the worst headaches). […] A headache day is defined as more than 4 h a day of headache. […] Every CM patient should be offered a preventive migraine treatment. […] Our key message to physicians for a patient who comes to the clinic with frequent disabling headaches having features of migraine is to assume CM until proven otherwise.

• #2 Differing Definitions of Symptoms Might Delay Migraine Diagnosis – U.S. Medicine

  https://www.usmedicine.com/clinical-topics/pain-management/differing-definitions-of-symptoms-might-delay-migraine-diagnosis/

  BETHESDA, MD Headaches are an almost universal experience, affecting approximately 96% of people globally at some point in their lives. Migraines, with a lifetime prevalence of 12.9% to 15.2%, consistently rank among the top three leading causes of disability for both men and women. Yet, despite guidelines that define clear diagnostic criteria for migraines and several migraine subtypes, diagnosis remains difficult. […] Up to 53% of patients experience a delay from symptom onset to diagnosis of more than 5 yearsa delay which a new study attributes in part to a phenomenon known as health literacy. […] Because the diagnosis of migraine relies heavily on patient reporting of subjective symptoms, many patients experience substantial delays in the diagnosis and treatment of migraine, the researchers stated. This delay in diagnosis may be in part attributable to these differences in interpretation of the symptoms associated with migraine. […] Understanding migraine and being able to communicate with patients regarding the symptoms associated with migraine is critically important to the otolaryngologist, they concluded.

• #2

  https://link.springer.com/article/10.1007/s40122-022-00387-9

  A timely and accurate diagnosis is important for the management of CM; unfortunately, many patients receive a delayed or incorrect diagnosis (most commonly chronic tension-type headache [cTTH]), potentially because screening tools have lower sensitivity and specificity compared to direct interviews. […] An accurate diagnosis is a key step in providing good medical care for individuals with migraine (especially CM), in addition to a consultation with a medical professional and prescription of appropriate medications. […] Patients who present to PCPs with recurrent disabling headaches nearly always have migraine, so the presumptive diagnosis should be migraine until other types of headache diagnoses have been eliminated. […] Patients who meet the ICHD 3 criteria for CM should be diagnosed with CM whether or not they experience tension-like headaches or other milder headaches during this period.

• #2 Testing for Migraine: Getting a Migraine Diagnosis

  https://www.health.com/migraine-diagnosis-6950986

  There is no one sole examination that tests for migraine, so providers can use a combination of tests to detect migraine and help you figure out a treatment plan. […] Migraine is often underdiagnosed, so it’s important to know the symptoms and visit a healthcare provider if you think you’re experiencing migraine. During your appointment, a provider will ask you about your medical history and perform a routine physical exam. They may also use neurological and imaging tests to confirm a diagnosis or rule out other headache-related conditions. […] The primary healthcare provider or a neurologist—a doctor who specializes in the brain—can diagnose you with migraine. At your appointment, the provider will usually start with an oral medical history to learn more about your symptoms. […] A provider can generally use your medical history and physical exams to diagnose your migraine. Imaging tests are not typically necessary for migraine, but similar to a neurological exam, imaging tests can detect various brain conditions.

• #2 Neurologist for Migraines: What to Expect

  https://www.webmd.com/migraines-headaches/first-neurology-appointment-for-migraines

  Everyone gets a headache from time to time. But if you start to notice other symptoms along with your head pain, it may be a migraine. Your primary care doctor is probably your first appointment to help figure out whats going on. They may refer you to a neurologist if they think your head pain could be from something more serious than just a regular headache. […] Your primary care doctor may refer you to a neurologist for migraine. […] During your first appointment with your neurologist, they will ask about your medical history, your symptoms, and if any of your relatives have migraines. […] Afterwards, they might do a physical exam or neurological tests to rule out other causes of your pain. […] Your health care team will be on the lookout for telltale signs and symptoms like: […] There are a few types of tests, and the one you get will depend on your symptoms:

• #2 Do I Need an MRI for My Migraine? | American Migraine Foundation

  https://americanmigrainefoundation.org/resource-library/do-i-need-an-mri-for-my-migraine/

  Receiving a formal migraine diagnosis is the first milestone when working with your doctor to identify a personalized and effective treatment plan. Continuing to talk with your doctor throughout the course of your treatment is important for determining the strategies that prove beneficial and those that may not be as effective. […] Your doctor will likely diagnose migraine based on your symptoms, medical history and a physical and neurological examination. […] While many people with migraine don’t need an MRI, your doctor might recommend it if you have any headache red flags. […] Contact your doctor right away if you have these symptoms; they can help determine if you need imaging. […] A normal MRI shouldn’t prevent your healthcare provider from diagnosing and treating your migraine.

• #3 Overview of Migraine Diagnosis | American Headache Society

  https://americanheadachesociety.org/research/library/overview-of-migraine-diagnosis

  Migraine is by far the most common headache type for which patients seek help from providers. […] In addition, migraine is frequently underdiagnosed and undertreated. This makes it extremely important for primary care providers to understand how to diagnose migraine. […] Clinical history, family history and physical/neurologic examination findings are usually sufficient to make a diagnosis of migraine. […] Patients seeking help for bilateral headaches that interfere with daily activities are likely to have migraine rather than tension-type headache and might require migraine-specific medication. […] Medication overuse headache (a secondary headache disorder) should be considered present in patients with migraine (or tension-type headache) using combination analgesics, opioids or triptans 10 or more days a month, or acetaminophen/NSAIDs 15 or more days a month.

• #3 Migraine headache in adults – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/10

  Migraine is a chronic, episodic, neurological disorder that has a strong genetic component and usually presents in early-to-mid life. […] Diagnosis is based on history and physical examination. No laboratory or imaging tests are essential for diagnosis. […] Key features in the history that support a diagnosis of migraine are nausea, photophobia, and reduced ability to function, along with headache. […] Clinical diagnosis.

• #3 Migraine Diagnosis – Migraine Association of Ireland

  https://migraine.ie/hcp/migraine-diagnosis/

  Criteria for Diagnosing Migraine Without Aura […] A. At least five attacks fulfilling B-D B. Attacks lasting 4-72 hours if untreated or unsuccessfully treated C. Headache has at least two of the following characteristics […] – Unilateral location […] – Pulsating quality […] – Moderate or severe pain intensity […] – Aggravation by or causing avoidance of routine physical activity […] D. During headache, at least one of the following […] – Nausea and / or vomiting […] – Photophobia / Phonophobia […] E. Headache not attributable to any other disorder […] […] Criteria for Diagnosing Migraine With Aura […] A. At least two attacks fulfilling criteria B-D B. Aura consisting of at least one of the following, but no motor weakness: […] – Fully reversible visual symptoms including positive features (e.g. flickering lights, spots or lines) and /or negative features (i.e. loss of vision)

• #3 How Is Migraine Diagnosed?

  https://www.everydayhealth.com/migraine/diagnosis/

  If youve been managing your headaches with over-the-counter medications frequently (more than once or twice a week), you should talk with your doctor about your symptoms, she says. […] A proper diagnosis will make a difference in how its managed. […] Your doctor will review your personal medical history, including any chronic illnesses you are managing or medications you take, and also ask you about migraine in your family. […] To get a formal diagnosis of migraine disease as specified by the International Classifications of Headache Disorders (ICHD-3), a person must have at least five episodes of symptoms that last from 4 to 72 hours, says Kumar. […] In addition, the migraine attacks must include at least two of the following characteristics: Unilateral location (occurring on only one side), Pulsating or throbbing quality, At least moderate severity, Aggravated by routine physical activity.

• #3 Self-Assessment Questions – Course #90073: Migraine: Diagnosis and Therapeutic Advances – NetCE

  https://www.netce.com/studypoints.php?courseid=2835&printable=yes&page=printquestions

  Useful evidence-based clinical guidelines for the diagnosis of migraine have been developed and are summarized in the mnemonic POUND: pulsatile headache; one-day duration (4 to 72 hours); unilateral location; nausea or vomiting; and disabling intensity. […] Chronic migraine is defined as headaches that occur on 15 or more days per month for more than three months, which have the features of migraine headache on at least eight days per month. […] The pattern of migraine presented by a patient changes over the lifetime, and its assessment determines the combination of clinical management with patient education, pharmacologic treatment, and behavioral interventions. […] The most common cause of symptoms suggestive of chronic migraine is medication overuse, and in at least 50% of these patients, the condition is reversed after discontinuation of medications.

• #3 How Does Someone Get a Migraine Diagnosis?Share to Facebookprint pageBookmark for latercaret iconFollow us on facebookFollow us on instagramFollow us on facebookFollow us on linkedincaret icon

  https://migraine.com/migraine-diagnosis

  A screening tool is a set of questions that doctors use to narrow down what your symptoms may be. For your headaches to be considered migraine attacks you must experience 2 out of 3 of these things: Disability – Do your migraine attacks stop you from doing your daily activities? Do they keep you from work or school? Nausea Photophobia – Is it painful to be in bright rooms when you have a headache? […] Your doctor may use a scoring system to better understand and treat your headaches. One widely used system is the Headache Impact Test-6 (HIT-6). The HIT-6 is made up of 6 questions. […] Another commonly used system is the Migraine Disability Assessment Score (MIDAS). The MIDAS questionnaire is made up of 5 questions. […] If the screening tool indicates that you might have migraine, your doctor will ask you more questions to see if your headaches meet the migraine definition. The International Classification of Headache Disorders (ICHD) explains how to diagnose any type of headache. According to the ICHD, migraine should include these 4 characteristics: 5 or more migraine attacks in your lifetime, Attacks that last 4 to 72 hours, 2 or more of the following features: Pain on only one side of the head, pulsing or throbbing pain, moderate to severe pain, pain made worse by – or that makes it difficult to complete – normal activities, 1 or more of the following: nausea, vomiting, pain that worsens with bright light, pain that worsens with loud noise.

• #3 Challenges of Migraine Diagnosis

  https://www.neurologylive.com/view/challenges-of-migraine-diagnosis

  In this segment, were going to be talking about migraine diagnosis, a challenge that many of us still face in clinic. […] The challenge is to be able to take an excellent history. […] Its important that we focus on a couple of key items and allow the patient space to tell us their history from the start, so we can pick up on key elements of the diagnosis. […] One challenge in making that diagnosis of migraine is that patients are not used to telling their stories. […] If we spend a little time up front letting the patient share her story, then afterward we can focus on specific questions we have. […] For a lot of providers, if theyre not specifically focused on migraine and headache, looking at the ICHD-3 classification, it can be daunting. […] Is there photophobia and phonophobia with your migraine? Is there impactare you missing work or school? Is there nausea? If patients answer yes to 2 of 3, theres a positive predictive value of over 90% that the patient has migraines.

• #3 Headaches | Migraines – Causes, Diagnostic Tests and Treatment

  https://www.radiologyinfo.org/en/info/headache

  Your doctor may order head MRI, head CT or lumbar puncture to help diagnose and evaluate your condition. […] To diagnose the cause of headaches and to rule out underlying medical conditions, physicians obtain a patient history and conduct a careful neurological examination. Diagnostic testing may include the following imaging tests: […] MRI of the head: Magnetic resonance imaging (MRI) uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures. Physicians use MRI of the brain to examine the anatomy of the brain and to assist in the diagnosis of tumors, developmental abnormalities, blood vessel problems (such as an aneurysm), disorders of the eyes and the inner ear, stroke, disease involving the pituitary gland and certain chronic disorders of the nervous system, such as multiple sclerosis.

• #3 Diagnosis and Treatment for Migraines

  https://healthlibrary.uwmedicine.org/library/Wellness/Behavior/85,P00812

  To get an accurate diagnosis, it’s important to clearly describe your migraine symptoms to your doctor. […] Procedures used to diagnose a migraine are generally used to rule out other possible causes of the symptoms. Your doctor will ask about your health history and do a physical exam. You may also need one or more of these tests: […] Various blood chemistry and other lab tests may be run to check for underlying conditions. […] This imaging procedure looks for congestion or other problems that may be corrected. […] This procedure uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body. It does not use X-rays. […] This procedure uses a combination of X-rays and computer technology to make images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than standard X-rays but often not as detailed as MRI scans.

• #3 How Is Migraine Diagnosed?

  https://www.healthline.com/health/migraine/migraine-diagnosis

  If youre having symptoms that might be migraine, talk with your doctor. They can help you figure out whether its migraine, another type of headache, or an underlying condition. […] Having a diagnosis can help you get the care you need to treat migraine attacks when they strike and to help prevent future ones.

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