A migraine is a complex neurological event that is far more than a typical headache and can be severely debilitating. This self-assessment helps you recognize symptom patterns, which is the first step toward understanding your condition. While this guide uses established clinical criteria, it is not a substitute for a professional medical diagnosis. A definitive diagnosis requires a comprehensive evaluation by a physician.
Defining the Migraine Condition
A migraine is classified as a primary headache disorder, meaning the headache itself is the disease rather than a symptom of another underlying condition. It is characterized by recurrent attacks that vary widely in frequency and severity. The disorder involves a cascade of changes in the brain that progress through distinct phases.
The migraine process can be divided into four potential stages, though not everyone experiences all of them during every attack. The Prodrome phase can begin hours or days before pain onset, marked by subtle symptoms like neck stiffness, mood changes, food cravings, or excessive yawning. Approximately 25% to 30% of sufferers experience an Aura, involving transient neurological symptoms such as visual disturbances (flashing lights or zigzag lines) or sensory changes (tingling).
The Attack phase is when the headache pain is at its peak, usually lasting between four and 72 hours if untreated. After the pain subsides, the Postdrome phase, often called a “migraine hangover,” leaves the individual feeling drained, confused, or washed out for up to a day or more. Understanding these distinct phases helps recognize that the migraine disorder affects the entire nervous system.
Self-Assessment: Recognizing Key Symptom Criteria
The criteria used by neurologists to diagnose migraine are specific and form the basis of this self-assessment. To be classified as a migraine, an individual must have experienced at least five attacks lasting between four and 72 hours. The pain must exhibit at least two of the following four characteristics:
- It is felt on only one side of the head (unilateral).
- It has a pulsating or throbbing quality.
- Its intensity is moderate or severe.
- It is aggravated by routine physical activity (e.g., walking or climbing stairs).
A true migraine attack must also be accompanied by at least one other non-headache symptom. These include nausea and/or vomiting, or increased sensitivity to both light (photophobia) and sound (phonophobia). The presence of these associated symptoms, particularly the combination of nausea or vomiting with light and sound sensitivity, strongly points toward a migraine diagnosis. If an attack meets the duration and pain criteria but lacks one of the sensory or gastrointestinal symptoms, it is often classified as a probable migraine. Answering these questions about pain quality, intensity, location, and associated sensory symptoms provides a strong indication of whether your headaches align with clinical migraine definitions.
Distinguishing Migraine from Other Headache Types
Differentiating a migraine from the two other most common primary headaches—tension-type and cluster headaches—is a significant challenge in self-assessment. Tension headaches are the most common type, usually presenting as a constant, dull ache or a feeling of a tight band wrapped around the head. Unlike migraines, tension headaches are typically felt on both sides of the head (bilateral), and the pain is mild to moderate, usually allowing for daily activities.
Tension headaches are defined largely by the absence of migraine features. They do not include the severe nausea, vomiting, or simultaneous sensitivity to both light and sound that characterize a migraine attack. While mild sensitivity to light or sound may occur, tension headaches are not typically throbbing pain that worsens with movement.
Cluster headaches represent the other end of the spectrum, characterized by excruciating, sharp, or piercing pain. This pain is strictly unilateral and concentrated around or behind one eye. Attacks are short, lasting from 15 minutes to three hours, but can occur multiple times daily during a cluster period. Cluster headaches are distinct because they include specific autonomic symptoms on the pain side, such as a droopy eyelid, a blocked or runny nose, or a watery eye.
Beyond the Quiz: When Professional Diagnosis is Necessary
While this self-assessment is useful, it cannot replace the diagnostic expertise of a healthcare professional. A formal medical diagnosis is the only way to confirm a migraine disorder and gain access to appropriate, specialized treatment options. A physician will determine the severity and frequency of your attacks to prescribe abortive medications, such as triptans, designed to stop an attack once it has started.
Seeking a medical diagnosis is also crucial for exploring preventative therapies, which are medications taken regularly to reduce the frequency and severity of attacks. A physician can also help you begin keeping a headache diary—a detailed record of your attacks, duration, and triggers—which is a useful tool for long-term management.
Seek immediate medical attention if you experience any “red flag” symptoms that suggest a more serious underlying condition. These warning signs are often summarized by the SNOOP criteria:
- Systemic symptoms (fever, weight loss).
- Neurologic symptoms (weakness, confusion, double vision).
- Onset that is sudden and severe (a “thunderclap” headache).
- Older age of onset (a new headache after age 50).
- Pattern change (a dramatically different or worsening headache).
The presence of any of these symptoms warrants an urgent evaluation to rule out conditions like stroke, meningitis, or aneurysm.