What Happens During a Migraine Diagnosis?

The steps of migraine diagnosis will depend on your overall health, family history, and a few other factors.

You can start by seeing a primary care doctor. In some cases, you might need to see a neurologist (a doctor who treats diseases and disorders of the nervous system) for further testing and treatment. During your migraine diagnosis, a doctor will:

• gather your medical history
• perform an exam
• order scans to rule out other conditions

You can read more about each step below.

Gathering your medical history

Your doctor will need to gather a lot of information about your personal medical history and your family medical history to diagnose migraine.

They’ll ask you to provide as many details as you can about your symptoms. They’ll also want to know about any other medical conditions you’ve been diagnosed with and about any other symptoms you’ve been having recently.

You’ll be asked about your diet, stress levels, activity levels, and other aspects of your lifestyle.

Your doctor might ask you to keep a migraine journal until your next appointment. In the journal, you’ll record every time you have pain and describe what that pain feels like.

You can also record anything you do for the pain at home and whether it helps at all. For example, you might want to make note of whether certain over-the-counter (OTC) medications help.

You’ll need to provide as much family health history as you can. Since migraine tends to run in families, it’s important for the doctor to know whether you have any relatives who’ve been diagnosed with migraine. It’s also important to let them know about any other conditions that run in your family.

Performing a medical exam

During your exam, the doctor will do neurological tests to check your reflexes and see how you respond to sensations. They might also test your short-term memory. You’ll have your blood pressure and pulse taken. A doctor will also check your head, shoulders, and neck.

For many people, this is enough to diagnose migraine. Generally, you’ll be diagnosed with migraine if you’ve had at least five headaches that have lasted between 4 and 72 hours and your headaches have at least two of these four characteristics:

• are located primarily on one side of the head
• cause pain that’s pulsing or throbbing
• cause pain that’s moderate to severe
• are made worse by normal physical activity

Your headaches will also need to cause you nausea or sensitivity to light and sound to be categorized as migraine. A physical exam and thorough medical history allow a doctor to make the migraine diagnosis.

However, in some cases, the doctor might not be certain that your symptoms aren’t being caused by something else. In this case, you might need to move on to the next step.

Ordering scans to rule out other conditions

If your pain came on suddenly or if you’re having other symptoms that aren’t typically caused by migraine, your doctor might order more testing.

This testing isn’t for identifying migraine. It’s for identifying other things that might be causing your pain, such as brain aneurysms or tumors. Testing might include:

• Magnetic resonance imaging (MRI). An MRI uses magnetic waves to create a detailed image of your brain. The MRI will look for infections tumors, bleeding, and other abnormalities in your brain that could be causing your head pain.
• Computed tomography (CT scan). A CT scan creates a detailed image of your brain. Just like an MRI, a CT scan can be used to look for medical problems that could be the source of your pain.

Your doctor might also order blood work to help pinpoint other conditions that might be behind your pain and symptoms.

Keep in mind that these tests are for identifying causes that aren’t migraine. However, if no infections, tumors, or other possible causes are found, those causes can be ruled out. Ruling out other causes can allow your doctor to make a migraine diagnosis.

It’s common for people to think of migraine attacks as simply bad headaches, but that’s not actually the case.

Migraine is a neurological condition that causes severe pain. It can make it difficult to complete your daily activities or even get out of bed. Untreated, a migraine can last for several days. In addition to the pain, migraine episodes can cause nausea, vomiting, and other symptoms.

Some people also experience warning symptoms before a migraine episode strikes. This is called an aura. An aura can cause a variety of sensory disruptions. However, not everyone with migraine experiences auras.

Migraine can begin at any age but is most often diagnosed in people in their teens, twenties, or thirties.

Migraine tends to run in families and is diagnosed more often in women than in men. The frequency of migraine attacks can vary from person to person. Some people might experience a few episodes a year, while others might have several in a single week.

The symptoms of migraine can be very painful. Many people need to rest in a dark, quiet place during their migraine episodes to help manage their symptoms. Migraine symptoms often include:

• pain on one side of the head
• throbbing or pulsing pain
• sensitivity to lights
• sensitivity to sounds
• sensitivity to smells
• nausea and vomiting

Some people also experience warning periods before a migraine. These warning periods have their own symptoms. The two warning periods are known as prodrome and aura.

A prodrome normally occurs 1 or 2 days before a migraine. If you have a prodrome period, you might experience:

• mood changes
• irritability
• food cravings
• increased thirst
• neck pain or stiffness
• constipation

An aura generally occurs right before a migraine. Some people also have aura symptoms during their migraine. Aura symptoms buildup gradually and can last as long as 1 hour. Symptoms include:

• vision loss
• visual hallucinations, such as flashes of light or bright spots
• seeing shapes
• difficulty speaking
• weakness on one side of the body
• tingling sensation on one side of the body
• uncontrollable jerks or tremors
• auditory hallucinations, such as sounds or music

Some people experience further symptoms once a migraine episode has passed. This is known as post-drome and lasts for about a day. During post-drome, some people report feeling:

• drained
• confused
• exhausted
• elated or other mood changes
• a dull headache

There are generally two parts to migraine treatment. The first part is stopping the pain and symptoms of migraine when they occur. The second is preventing migraine from occurring. Your treatment will include both of these parts.

Treatments for stopping migraine symptoms include these medications:

• OTC pain relievers. OTC medications, such as Tylenol, Advil, and Excedrin, might help relieve mild migraine pain. They’re often not enough to stop moderate or severe pain. Long-term use of these medications can also cause damage to your stomach lining.
• Triptans. Triptans are a class of medications that block pain pathways in your brain. They’re available in pills, nasal sprays, or injections. For many people, they’re an effective way to treat migraine.
• Dihydroergotamines. These medications are taken as nasal spray or injection. They’re often useful for people whose migraine attacks last longer than 24 hours. In some people, they can cause migraine symptoms to worsen.
• Opioids. Opioids such as codeine can be effective in treating migraine. However, these medications are very strong and highly addictive. You’ll generally only be prescribed opioids if no other treatment has worked to stop your migraine symptoms.
• Anti-nausea medications. People who have nausea and vomiting with migraine might benefit from taking anti-nausea medication along with a pain medication.

Treatments for preventing migraine include:

• Identifying and avoiding triggers. You might be asked to keep a migraine journal to identify triggers that cause or worsen your migraine. Triggers can vary from person to person and might include weather, smells, hormonal changes, stress, certain foods, and more. Avoiding your migraine triggers can help prevent a migraine attack from occurring.
• Beta-blockers. Beta-blockers are often prescribed to people with high blood pressure, but they’ve been proven to be effective in treating migraine, as well. Your doctor might prescribe a daily beta-blocker to help prevent migraine, especially if you have frequent or severe attacks.
• Calcium channel blockers. Just like beta-blockers, calcium channel blockers are generally used for high blood pressure. They’ve been found to be effective at preventing migraine, especially in people who have an aura with their migraine.
• Antidepressants. Antidepressants can be used to prevent migraine. Some antidepressants can have unwanted side effects or interactions with other medications.
• Antiseizure medications. Some medications that prevent seizures can also prevent migraine attacks. Like antidepressants, these medications can cause unwanted side effects in some people.
• Botox injections. Botox is most often associated with cosmetic procedures, but it can actually be used in migraine prevention as well. You’ll need an injection every 12 weeks or so if you go this route.

It can take a while to figure out the right combination of treatments for you. Tell your doctor what’s effective and what isn’t. They can help you try other options until you find something that works.

If you’ve already been diagnosed with migraine, your doctor can help you figure out the best prevention methods. Often, your first step will be keeping a migraine journal so that you can figure out what triggers your attacks and avoid them.

Many migraine triggers are related to everyday health habits. This includes:

• not getting enough sleep
• not eating regular meals
• not exercising enough
• being under stress

For some people, managing those things can help you prevent or lessen migraine. You can also avoid common trigger foods and drinks, such as:

• chocolate
• red wine
• cultured dairy
• foods with added MSG
• processed foods or smoked meats

You can try eliminating these foods from your diet for a week and seeing whether you have fewer headaches. Some people are also helped by natural remedies that aren’t medications.

Using these treatments in combination with avoiding migraine triggers can be very effective in preventing migraine. This might include yoga, massage therapy, or biofeedback.

Migraine causes pain and can be a major disruption to your everyday life.

If you’re having symptoms that might be migraine, talk with your doctor. They can help you figure out whether it’s migraine, another type of headache, or an underlying condition.

Having a diagnosis can help you get the care you need to treat migraine attacks when they strike and to help prevent future ones.