How Do I Know if My Headache is a Migraine?

Answer

Doctors diagnose migraines clinically based on patient history and symptoms; there is no single diagnostic test.

The Science

What is a Migraine?

• Migraine is much more than a simple headache and is a neurological disorder with throbbing pain, dizziness, vomiting, and vision disturbances.
• Migraine is an electrical and inflammatory chemical problem in the brain neuron cells.

Triggers for a Migraine Attack

• A migraine attack could be initiated by physical activity, flashing lights, emotional stress, irregular sleeping patterns, skipping meals, dehydration, certain foods like MSG, chocolate, red wine, fermented foods like cheese and pickles, and caffeine.
• The attack may start 6 to 48 hours after the trigger. Note down the specific triggers in your case, so you may try to avoid them in the future.

A Typical Migraine Attack

A migraine attack has four stages:

• Prodome (Pre-headache) phase: Some people develop mood swings, food cravings, neck stiffness, fatigue, yawning episodes, or feel a strange taste or smell a few hours or a day before the attack.
• Aura phase: Some people see flashing lights or blurry vision an hour before or during a migraine attack. They may also get slurred speech and hand numbness. An abnormal electrical wave in the brain causes this, but not everyone sees aura.
• Headache phase: The attack releases inflammatory chemicals near the arteries and membranes surrounding the brain, which causes pain in the eyes, temples, forehead, and neck. Some chemicals dilate blood vessels, also causing pain. Extra activity, sound, lights or smells may aggravate the pain. But some attacks may not have a headache.
• Postdromal phase: The attack is over and the pain subsides, but the person is tired and confused.

Learn what happens in a migraine attack and keep a diary of your disease history and what happens before, during and after your headaches. This will help in diagnosis.

Diagnosing Migraines

• Migraine has specific treatments and preventive measures compared to regular headaches. So it should be diagnosed early and correctly.
• Your doctor can diagnose migraines based on your family history and headache patterns. CT or MRI scans cannot interpret it and are done only to rule out other headache causes such as brain tumours.

Diagnostic Criteria for Migraines

A migraine headache shows a symptom pattern different from a regular headache and the diagnosis is made based on three clinical criteria:

1. At least five prior episodes lasting from four hours to three days;
2. At least two of the following characteristics:
   • Only on one side of the head;
   • Throbbing type of pain;
   • Moderate or severe pain; or
   • Worsens by routine physical activity.
3. At least one of the following symptoms:
   • Nausea or vomiting;
   • Sensitivity to light; or
   • Sensitivity to noise.

To Read More

• Migraine Canada: The cause of migraine: it’s all in your brain! The electrical and chemical sides of migraine
• EveryDayHealth: How Is Migraine Diagnosed?
• WebMD: Slideshow: A Visual Guide to Migraine Headaches
• Penn Medicine: Migraine vs. Headache: How to Tell the Difference
• The Migraine Trust: Migraine attack triggers
• MedicineNet: Migraine vs. Headache: How to Tell the Difference
• MedicalNewsToday: What is the difference between a headache and migraine?
• On this Website: How vitamin B₂ helps in migraine

First Published on: 19th May 2023
Image Credit: yanalya on Freepik