Migraine is considered a diagnosis of exclusion. That means in order to diagnose migraine, other possible causes of the symptoms must be ruled out or excluded. Therefore many people ask, can you diagnose migraines with certainty?
Doctors have a range of criteria and tests for diagnosing migraine. Migraine diagnosis typically centers around a description of the different migraine symptoms, how long they occur and how long they last. That’s why it’s key to keep a record of your symptoms—their intensity and frequency—in your migraine symptoms journal. This will help your migraine specialist determine what tests to run to rule out other reasons for your discomfort.
Some tests than can be conducted to exclude other causes of the attacks:
- MRI, Magnetic resonance imaging
- CT/Cat SCAN for Migraine, Computed Tomography
- Blood Chemistry and Urinalysis
- Sinus X-Ray
- EEG, Electroencephalogram
- Eye Exam
- Spinal Tap/ lumbar puncture
Commonly used guides for determining if a migraine is the culprit come from the International Headache Society. Because they are typically divided into two groups—migraines with aura and migraines without aura—the information for diagnosing migraine is also divided into those two groups.
Diagnosing migraine without aura
If patients have attacks that meet the following
A. Patient experienced at least five attacks that meet the criteria, B through D, listed below
B. Head pain lasting four to 72 hours (untreated or unsuccessfully treated)
C. Head pain with at least two of the following four characteristics:
1. Unilateral location (pain on one side of the head)
2. Pulsating quality (head throbs)
3. Moderate or severe intensity (inhibits or prohibits daily activities).
4. Pain is intensified with walking up or down stairs or performing similar physical activity
D. During headache, at least 1 of the following must occur:
E. At least 1 of the following must apply:
1. History, physical, and neurologic examinations do not suggest another disorder
2. History, physical, and neurologic examinations do suggest another disorder, but it is ruled out by appropriate investigations
3. Another disorder is present, but attacks do not occur for the first time, soon after the disorder
Diagnosing migraine with aura
Diagnosing migraine with aura uses the same criteria as migraine without aura, with the addition of aura symptoms. Aura can cause visual symptoms as well as lead to disturbances in other senses.
Visual aura symptoms include
- Seeing flashes or flickering light
- Seeing zigzag lines or waves, also called fortification illusions
- Seeing spots, stars, halos, circles, lines, other shapes or colors
- Blurry vision
- Loss of vision
- Cloudy vision
- Other vision changes
- Seeing three-dimensional effects
- Seeing dark areas
Sensory aura can cause the following symptoms, in the face, tongue, hand, arm, foot, leg or throughout the body:
Diagnosing migraines can be tricky, particularly since there’s no specific blood or saliva test for it. Keeping a record of your symptoms and finding a doctor who specializing in treating migraines is the best course of action.