Migraines are primary headaches and a part of life for nearly 10% of the Canadian population. They can be debilitating and vary in presentation. These headaches can last a day or more and can present with nausea, vomiting, sensitivity to light or sound among other symptoms. In clinic, I arrive at a migraine diagnosis after performing an appropriate history and physical using the following guidelines (The following is for reference only and is not meant to be used by you to self-diagnose a condition)
- Recurrent headaches
- 4-72 hours in duration
- One sided pain
- Pulsating pain type
- Moderate and severe in intensity
- Aggravated by routine activity
- Possible neurological aura with at least one of the following: fully reversible visual symptoms such as flickering lights, spots in vision, or lines, reversible loss of vision, fully reversible sensory symptoms that includes symptoms like pins and needles or numbness. Fully reversible difficulty in swallowing or speech.
- During the headache, one or more of nausea, vomiting, light or noise sensitivity are present
- Neurological signs are reversible and do not last more than 60 minutes.
- No neurological deficits outside of typical symptoms including NO motor weakness.
- Aura symptoms that come on about 5 or so minutes followed by another for 5 or more minutes but none more than 60 minutes.
Source: Hainder et al. 2013. American Family Physician. “Approach to acute Headaches in adults” http://www.aafp.org/afp/2013/0515/p682.html
Source: “Clinical Practice Guidelines for the Management of Headache Disorders in Adults”