Migraine diagnosis

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:

Commonly used guides for determining if a migraine is the culprit come from the International Headache Society. Because migraines 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:

1. Nausea with or without vomiting

2. Photophobia (sensitivity to light) or phonophobia (sensitivity to sound)

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 migraine 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:

Tingling or numbness
The feeling of pins and needles
Odd sensation in a body part

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.

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References

Guidelines for the diagnosis and management of migraine Canadian Med Assoc Pryse-Phillips 1997
Diagnostic criteria of pediatric migraine without aura The Turkish Journal of Pediatrics _enbil 2006
Gallagher Migraine Diagnosis Management and Treatment Options