There are two major types of migraines: migraines with aura and migraine without aura. Most migraine suffers, some two thirds, say they suffer from migraine without aura. Therefore, they don’t experience the visual or sensory warning signs sometimes called migraine prodrome or aura.
Migraine without aura, the most common type of migraine, and often is associated with women’s menstrual cycle. Typically, people with this type of migraine have more frequent attacks and the migraine attacks are more disabling than those who have migraine with aura.
Common symptoms of migraine without aura
- Pain on one side of head
- Pulsing or throbbing pain
- Sensitivity to light, photophobia
- Sensitivity to sound, phonophobia
- Nausea and/or vomiting
- Pain or discomfort is made worse by physical activities
Diagnosing migraine without aura
Often diagnosing any type of migraine—including migraine without aura—is difficult because of the wide range of symptoms that may occur. One way of determining if a patient has a migraine or a regular tension headache is to look at the symptoms. A migraine has head pain plus other symptoms, while a tension headache is usually just the head pain. Migraines without aura don’t have the warning symptoms that disturb the senses and occur before the head pain that are seen in migraine with aura.
To diagnose migraine without aura, doctors need to know information about current and past migraine attacks. Keeping a migraine journal to record each migraine episode and all of the migraine symptoms will be very helpful in diagnosing migraine.
Because migraines are diagnosed only after other causes of the symptoms have been ruled out, it is sometimes called a diagnosis of exclusion. There are several tests that can be conducted to make sure another disorder isn’t causing the symptoms.
The International Headache Society, developed its criteria for diagnosing migraines in 1988, and the most recent guidelines were published in 2013 (ICHD-III). Diagnostic criteria include:
A – At least five migraine attacks that fulfill criteria B through D
B – Each migraine attack, untreated or unsuccessfully treated, lasts from four to 72 hours
C – Head pain that has at least two of the following
- Pain on one side of the head, unilateral pain
- Pulsating quality
- Moderate to severe head pain
- Aggrivated by or causing avoidance of routine physical activity, such as walking or climbing stairs
D – During head pain, at least one of the following:
- Nausea and/or vomiting
- Photophobia, light sensitivity and phonophobia, sound sensitivity
E – Not due to any other disorder