How are migraines diagnosed?
Migraines are diagnosed based on your symptoms, type and location of headache, and headache frequency and triggers.
To make the diagnosis of migraine, your doctor will take your complete medical history. They will ask you about:
- Your headache symptoms
- The type and location of your headache
- The frequency of headaches
- Triggers for the headache
- Medication history
- Aura: How you felt before, during and after the headache
Your doctor may ask you for tests, such as magnetic resonance imaging (MRI) or electric encephalography (EEG), to rule out any other causes of headache (e.g., stroke or epilepsy)
How do you tell the difference between a migraine and a headache?
According to the International Classification of Headache Disorders 3 (ICHD) criteria for migraine without aura, you must have had at least five headache attacks fulfilling the following criteria:
Headache attacks lasting four to 72 hours (untreated or unsuccessfully treated)
The headache has at least two of the following characteristics:
- Unilateral location
- Pulsating quality
- Moderate or severe pain intensity
- Aggravation by or causing you to avoid routine physical activity (for example, walking or climbing stairs)
- In addition, during the headache, at least one of the following characteristics:
- Nausea and/or vomiting
- Photophobia (light intolerance) and/or phonophobia (noise intolerance)
Are there any migraine treatments?
There is no permanent cure for migraine headaches. However, with treatment, you can
- Prevent the attacks
- Get relief from the symptoms
- Decrease the severity and frequency of the attacks
These treatments include:
- Pain relievers: Over-the-counter (OTC) pain relievers, such as acetaminophen, aspirin, caffeine and ibuprofen, work well in relieving your headache temporarily. Be careful when you take OTC pain relievers because using them too much can give you rebound headaches.
- Triptans: You might get a pill to swallow, tablets you dissolve on your tongue, a nasal spray, an injection, or a skin patch.
- Dihydroergotamine: This can be used as an injection or as a nasal spray.
- Reyvow (Lasmiditan): This is a newly approved drug (2019) to relieve the signs and symptoms of migraine.
- Calcitonin gene-related peptide (CGRP) receptor antagonists: These are prescribed if other medicines fail to provide you relief.
If other treatments do not work and you have four or more migraine days a month, your doctor may suggest medicines to prevent them or reduce their severity. These include
- Anti-Seizure medicines
- Blood pressure medicines (like beta-blockers and calcium channel blockers)
- Some antidepressants
- Shots of Botox (botulinum toxin type a)
- CGRP antagonists
If you feel the aura of migraine or that a migraine attack is about to start, you can place a device known as transcranial magnetic stimulation (TMS), another migraine treatment option, on the back of your head. It sends waves of magnetic energy to part of your brain, which may stop or reduce pain.
What is the best thing to do for a migraine?
If you get migraines, you can ease the pain immediately by simple measures that include:
- Resting with your eyes closed in a dark, quiet room
- Putting an ice pack on your forehead
- Hydrating yourself by drinking plenty of liquids
You can talk with your doctor and try complementary or alternative treatments along with other medications. These include:
- Biofeedback: This method helps to identify stressful situations that could trigger migraines. By modifying your body’s reaction to stress, you can prevent migraine attacks.
- Cognitive behavioral therapy (CBT): A specialist can teach you changes people’s attitudes and their behavior.
- Progressive muscle relaxation (PMR): A therapist will teach how to tighten and relax your body muscles to relieve the stress that triggers your migraine.
- Supplements: These include riboflavin, coenzyme Q10 and melatonin.
- Physical therapies: These include chiropractic, massage, acupressure, acupuncture, and craniosacral therapy.
- Deep breathing
- Yoga
How can you prevent migraine?
Try these steps to prevent symptoms:
- Identify and avoid triggers
- Manage stress
- Eat on a regular schedule
- Drink lots of fluid
- Get plenty of rest
- Get regular moderate exercise
- Use devices (Cefaly and gammaCore) that prevent migraine