Migraine Criteria

By: Li Ming Wong

The Classification Subcommittee of the International Headache Society (IHS) publishes and revises the "International Classification of Headache Disorders", now in its second edition. This book offers specific diagnostic criteria for diagnosing migraines and is currently used worldwide.

According to IHS, a common migraine headache, also known as a migraine without aura, is defined by the specific criteria found below.

Frequency

The patient must have at least five of these headaches.

Duration

The headache, excluding attendant symptoms or prodromes, must last a minimum of four hours, up to seventy-two hours. Headaches that last over seventy-two hours generally require immediate medical attention in order to rule out other, more dangerous conditions.

Pain Descriptors

In order to be classed as a migraine a headache must include at least two of four different qualities of pain:

1) The pain is one-sided; the headache is primarily on one side of the head.
2) The pain is not constant; it throbs, pounds, or pulsates.
3) The pain must be of moderate or severe intensity, to the point where the sufferer is inhibited in daily activity, potentially to the point of being temporarily disabled.
4) The pain is increased, sometimes only slightly, by routine physical activity like bending over, climbing stairs, or moving quickly.

Side Effects

Headache pain must be accompanied at least one of four common side effects:

1) Nausea
2) Vomiting
3) Photophobia - sensitivity to light
4) Phonophobia - sensitivity to sound

Secondary Exclusions

Appropriate medical testing, such as a MRI or CAT scan, and/or a physician's exam must be conducted to rule out other conditions that may have caused the headache.

These criteria have helped simplify the diagnosis of migraine for many. However, because migraines are historically associated with extremely high levels of pain, people suffering from moderate migraine may not realize that is what they are experiencing.

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