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Is it Migraine or Something Else?

Is it Migraine or Something Else?

Living with a chronic illness tends to make us believe that every physical symptom we experience is related to that illness. This is especially true for something as symptomatically varied as migraine. Nauseated? Migraine. Dizzy? Migraine. Neck pain? Migraine. Fatigue? Migraine. Blurred vision? Mood swings? Feel like you’re three times the size of your car? Migraine. Migraine. Migraine.

It’s all migraine, unless it’s not.

And, sometimes, it isn’t.

What if it’s not migraine?

Sometimes, it’s something else. Something small and simple like a cold or a bad night’s sleep. Something more serious—a stroke, meningitis.

So how do we know? When just about every common symptom of every major illness could be caused by migraine, perhaps has been caused by migraine in the past, how are we to judge if this time a symptom could be indicative of something else?

Most of us tend to err on the side of migraine. At least, I know I do. It’s easier to write any symptom off as one of the strange and ever-changing ways migraine disease presents itself than have to face a medical professional and try to convince them that a symptom they can’t see suddenly feels “different.”

Different is important, though. In fact, when living with chronic migraine, a small change in symptom presentation may be the only clue we’re given that something else is wrong.

We have another article here at that expertly discusses how to know when a migraine attack is an emergency. It’s essential reading, and I hope everyone on this site has read it at least once. But this is about something else. When you live with chronic migraine, knowing when something isn’t a migraine attack can be just as essential.

There’s no clear cut way to know

Unfortunately, the presentation of migraine is too varied for there to be hard guidelines for these scenarios. When researching the issue, then, what seems to be of most concern is that word “different.”

Are you experiencing an attack that came on at a different time than normal (e.g. in the middle of the night compared to mid-day)?

Is the pain more intense or of a different nature (stabbing instead of pulsating, for instance) than usual?

Are you experiencing an unusual symptom along with your usual symptoms?

Is a usual symptom more intense or longer lasting than normal?

Are you feeling more disabled by a symptom than normal?

Is the symptom timeline unusual? For example, are symptoms presenting one after the other instead of all at once or vice versa?

Do you have a fever in addition to your usual symptoms?

Trust your instincts

If the answer to any of the above is yes or you’re experiencing some other unusual presentation of your usual symptoms, you should call your doctor or go into a medical facility for evaluation immediately. Many serious illnesses, like meningitis, present with migraine-like symptoms, such as photophobia, intense head pain, and nausea. Many of these illnesses also are time-sensitive, meaning the more time that passes between symptom onset and evaluation may mean more serious risks and poorer outcomes for you.

If you’re experiencing anything unusual, or if something feels “off” to you, don’t write it off to migraine. Trust your instincts. You live with this disease day in and day out. You know what is normal for you, even if that may not be normal for someone else. If you’re concerned, call your doctor, go to urgent care, or visit the ER. You’ll be glad you did.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • sysad
    3 years ago

    Sarah, Thank you for the great article. Only 7 months in to Chronic Migraines and apparently cluster headaches. I have not got a handle on what is and what isn’t a migraine yet. Three weeks ago I was taken to the E/R because I was too nauseous, dizzy and throwing up, along with nasal pain, terrible headaches. They diagnosed it as sinus infection, gave me anti-biotics and sent me on my way. Not much help. Last week a worse bout with the same symptoms, diagnosed as migraine, IV, pain medication and nausea medication. Only difference was a CAT scan and blood tests. My sister was scaring me telling me I had spinal meningitis because three months ago she was admitted for it. My instincts aren’t there yet, my migraines seem to change and I’m often too late with my rescue medication.

  • Sarah Hackley moderator author
    3 years ago

    Thank you for your response. You’ll get better at recognizing the different ways migraine disease presents for you, but it is always changing. At least, that’s been my experience. So, really, we’re all learning as we go. That’s why it’s always a good idea to get checked out if you’re worried.

  • mrst53
    3 years ago

    I had the same experience with viral meningitis. I have fibro and another disease that causes a lot of muscle and joint pain. After 2 weeks I went to the doctor and they treated me for something totally unrelated. After 10 days, I was still sick. The headaches were the worst. I went back and my doctor gave me a stronger antibiotic. 10 days later, I was still feeling sick. Luckily I had an appointment with my neuro doc. He listened to me and and examined me and then told me I had meningitis. I was lucky I had not died. He gave me a different med and a shot in the back of the head to treat the headache pain. I thought all my pain and headache pain was due to to other things. boy was I wrong.

  • Sarah Hackley moderator author
    3 years ago

    I’m so glad your doctor listened to you and helped you figure out a reason and a solution. Thank you for sharing your story!

  • Candy Meacham
    3 years ago

    I’ve had this experience many times, trying to distinguish between migraine and ? Once I put off going to the doctor because of a lot of ongoing fatigue, a very frequent, almost constant symptom since I have chronic migraine. Eventually, when it got worse, I went to the doc and was diagnosed w/ pneumonia. Another time I had a sudden onset of light flashes at the periphery of my vision. I was in Mexico at the time. I couldn’t figure what else it might be and w/ no family doc around, I waited until I got home and weeks later went to the optometrist. It was actually an eye problem, which might have (but didn’t) progressed to detached retina, which can cause blindness in one eye if not treated immediately. I was lucky.

  • Sarah Hackley moderator author
    3 years ago


    Thank you for sharing your story. I recently had an experience with viral meningitis, which is what inspired this article, so I completely understand. I’m glad you eventually went in and got treatment.

    Warm regards,


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