A migraine is a specific neurological event, not simply a severe headache. Understanding its distinct features helps you evaluate your symptoms based on clinical criteria used for diagnosis. This self-assessment is not a substitute for a professional medical evaluation. Use this information to prepare for a discussion with a doctor, who can provide a definitive diagnosis and treatment plan.
Characteristics of Migraine Pain
Identifying a migraine involves assessing the quality and location of the head pain, which often distinguishes it from common tension headaches. To meet the clinical criteria for migraine without aura, an attack must include at least two specific pain characteristics. The pain is frequently unilateral, meaning it affects only one side of the head, though this can shift sides or become bilateral during an attack.
The sensation is commonly described as having a pulsating or throbbing quality. The pain intensity is moderate to severe, meaning it is disruptive to daily life. A defining characteristic is that the pain is often aggravated by, or causes the avoidance of, routine physical activity, such as walking or climbing stairs. If untreated, a migraine attack typically lasts between four and 72 hours.
Non-Pain Symptoms and Aura
Migraines are often accompanied by other neurological symptoms. Attacks usually include at least one of two specific sensory sensitivities: photophobia (increased sensitivity to light) and phonophobia (increased sensitivity to sound). Many individuals also experience digestive symptoms, most commonly nausea, which may or may not lead to vomiting.
Approximately one-third of people who experience migraines also have an aura, which involves temporary, fully reversible neurological symptoms that usually precede the headache. The most common form is a visual aura, manifesting as flickering lights, zigzag lines, or blind spots that spread gradually across the field of vision. Sensory auras are also possible, causing tingling or numbness that slowly moves from one part of the body to another. Each aura symptom typically lasts from five to 60 minutes.
Assessing Frequency and Disability
Evaluating the impact of your headaches on your life helps determine the severity of your condition. Healthcare providers often use tools like the Migraine Disability Assessment (MIDAS) questionnaire to quantify lost time and productivity due to attacks. This assessment considers the number of days missed from work, school, or household chores, as well as days where productivity was significantly reduced over a three-month period.
A high level of disability suggests a need for comprehensive management. Chronic migraine is diagnosed when a person experiences headaches on 15 or more days per month for at least three months, with at least eight of those days having migrainous features. Understanding frequency and disability level helps a clinician determine if preventive treatments are appropriate.
Consulting a Healthcare Provider
While this self-assessment can help you prepare for a medical discussion, a definitive diagnosis requires consultation with a qualified healthcare professional. You should seek immediate medical attention if you experience any “red flag” symptoms, as these may indicate a more serious underlying condition. One such symptom is a “thunderclap” headache, which reaches its maximum, severe intensity within seconds to a minute of onset.
Other warning signs include:
- A new headache that occurs after the age of 50.
- A headache accompanied by a fever, a stiff neck, or changes in mental status.
- A headache that is progressive and worsens over time.
- A headache associated with new, unexplained neurological deficits.
These symptoms suggest the need for further testing to rule out causes other than primary migraine disorders.