A migraine is a neurological condition often confused with a severe tension headache, but it involves a distinct set of symptoms indicating a more complex biological process. Unlike a typical headache, a migraine is a disabling disease that frequently requires the person to stop daily activities. This self-assessment is based on established diagnostic criteria to help you understand your recurring head pain, but it is not a medical diagnosis and cannot replace a consultation with a qualified healthcare provider.
Core Migraine Symptoms: The Self-Assessment
To determine if your head pain aligns with the clinical definition of a migraine, consider the characteristics of your attacks. The International Classification of Headache Disorders (ICHD) defines specific criteria that differentiate migraine from other headache types.
Ask yourself if your headaches typically have at least two of the following four qualities:
- Is the pain typically located on only one side of your head (unilateral location)?
- Does the pain have a pulsating or throbbing quality?
- Is the pain intensity moderate or severe, meaning it significantly interferes with your daily functioning?
- Is the pain aggravated by, or does it cause you to avoid, routine physical activity like walking or climbing stairs?
In addition to the pain characteristics, a migraine attack is defined by accompanying symptoms. Do you experience nausea or vomiting? This is a common feature that often distinguishes migraine from tension-type headaches. Another element is an increased sensitivity to light (photophobia) and/or sound (phonophobia).
For a potential migraine diagnosis, the headache itself must last between four and 72 hours when untreated. If you answered yes to at least two of the four pain characteristic questions and yes to one of the associated symptom questions, your head pain may be a migraine. If your headaches have been so severe that they limit your ability to work, study, or function for at least one day in the past three months, this is a strong indicator of a disabling migraine attack.
Understanding Migraine Subtypes
Migraines are broadly classified based on their clinical presentation. The most common form is Migraine without Aura, which is characterized by the core symptoms described in the self-assessment. This subtype accounts for the majority of cases and does not involve neurological symptoms preceding the headache phase.
A distinct subtype is Migraine with Aura, where a collection of fully reversible neurological symptoms precedes the headache. These aura symptoms typically develop gradually over five minutes or more and last between five and 60 minutes. The most common aura is visual, involving temporary disturbances like flickering lights, zig-zag lines, or blind spots.
Other aura symptoms can involve sensory changes, such as tingling or numbness that spreads across the face or limb, or speech and language difficulties. The headache usually follows the aura within 60 minutes, though it can sometimes occur simultaneously or not at all.
A third category is Chronic Migraine, defined primarily by the frequency of head pain. A person has chronic migraine if they experience headache on 15 or more days per month for a period longer than three months. Of those headache days, at least eight days per month must meet the criteria for a full migraine attack. This high frequency indicates a more persistent form of the disorder that requires specialized management.
When Immediate Medical Consultation is Necessary
While most headaches are benign, certain symptoms, often referred to as “red flags,” signal a potentially serious underlying condition that requires immediate medical evaluation. Do not attempt to self-assess or manage your symptoms if they include any of these warning signs. The most urgent red flag is the “thunderclap” headache, which is pain that reaches its maximum intensity in less than one minute. This sudden onset can suggest conditions like a subarachnoid hemorrhage.
Any headache accompanied by new or changing neurological symptoms also requires urgent attention. These symptoms include:
- Weakness or numbness on one side of the body.
- Difficulty speaking.
- Vision loss.
- Confusion.
A headache that occurs following a recent head injury, even a minor one, should be evaluated immediately by a medical professional.
Other concerning signs are a headache accompanied by systemic symptoms, such as a fever, a stiff neck, or unexplained weight loss. A new-onset headache in a person over the age of 50, or a significant change in the pattern of a pre-existing headache disorder, warrants prompt medical investigation. The sudden appearance of a headache triggered by coughing, sneezing, or straining (Valsalva-induced) also requires a full diagnostic workup.
For routine management, maintaining a detailed headache diary is highly beneficial. Tracking the frequency, intensity, duration, and associated symptoms provides a healthcare provider with objective data. This information is a valuable tool for accurately diagnosing your condition and developing an effective, individualized treatment plan.