How Doctors Determine If You Have Migraine
An overview of the various tools health care providers use to aid in diagnosing migraine.
Article Summary
Diagnosing migraine is a comprehensive, multi-step process.
- Doctors look at your medical history, including headache history, triggers, and migraine symptoms
- Tests may be used to rule out other conditions
- Open conversations with your doctor can help
Understanding whether your headaches are a symptom of migraine is an important step in managing your health. While there isn’t a scan or biomarker—like a CT scan, MRI, blood test, or EEG—that confirms a migraine diagnosis, doctors have a well-established and comprehensive process to determine if you have migraine.
Doctors diagnose migraine through a clinical assessment of symptoms, migraine history, and physical exam.
To learn more about how to prepare for this appointment, review Might Have Migraine? What to Expect During a Headache Visit With Your Doctor for more information.
How Doctors Diagnose Migraine
Let’s explore how doctors diagnose migraine and what you can expect from the process. Since no single test can diagnose migraine, doctors take a holistic approach by gathering information about your health. The more information you can provide, the better equipped your doctor will be to make an accurate diagnosis.
Patient Medical and Headache History
One of the first things a doctor reviews is your patient history. They may ask you questions about the duration, frequency, location, type, and intensity of your headache pain. They may ask if you experience any sensory changes, known as “auras,” before a headache begins. These auras could involve visual disturbances like seeing flashes of light or experiencing sensory changes such as tingling sensations. While auras affect a portion of people with migraine disease, not everyone with migraine will experience them. They may also ask if you experience any photophobia (abnormal sensitivity to light), phonophobia (abnormal sensitivity to sound), nausea, and/or vomiting.
Doctors will also consider your family history because migraine can be genetic. Research suggests that a genetic link is present in about 42% of cases. If a close family member, such as one or both parents, have migraine, this information can help in the diagnostic process as it may indicate a genetic predisposition.
Physical and Neurological Examinations
To rule out other possible causes of your headaches, doctors conduct physical and neurological exams. These assessments help rule out conditions that might mimic migraine symptoms, like infections.
Ruling Out Secondary Conditions
Part of diagnosing migraine involves differential diagnosis. This is a process where doctors rule out secondary causes that are underlying to the migraine attack. By ruling out other potential conditions, doctors can more accurately identify migraine.
Understanding whether your headaches are a symptom of migraine is an important step in managing your health.
When Imaging or Tests Are Necessary
Imaging tests like MRIs or CT scans are usually reserved for cases where doctors need to rule out other underlying health issues. These tests are used to help ensure that there are no other underlying causes for these symptoms.
Diagnostic Criteria
Doctors use guidelines like the International Classification of Headache Disorders (ICHD-3) to help accurately diagnose and differentiate between different headache disorders, including migraine. The ICHD-3 is a comprehensive guide and provides specific diagnostic criteria.
To help with diagnosing migraine, many doctors utilize ID Migraine, a brief, self-administered migraine screener that asks about nausea, sensitivity to light, and the impact of headaches on your daily life.
If you have questions about your treatment—or think it’s time for a change—connect with a doctor online, from wherever you are.
Trigger Identification
Identifying potential triggers is another essential part of diagnosing migraine. Triggers might include but are not limited to stress, hormonal changes, lack of sleep, certain foods, or even weather changes. Learn more about potential triggers at What Can Trigger a Migraine Attack? An Overview of Common Triggers.
Recognizing these triggers can be crucial in diagnosing migraine. Doctors may recommend keeping a headache diary, where you note the frequency and timing of your headaches, what you ate, what you were doing before it started, how severe it was, and accompanying symptoms (for example, nausea as well as sensitivity to light and sound). This diary can help identify patterns and trends of migraine attacks versus other types of headaches.
Symptom Pattern Analysis
Doctors also conduct a detailed analysis of symptom patterns. This helps them distinguish migraine from other types of headaches, such as tension headaches or cluster headaches. Your doctor may also ask you some questions about your symptoms so they can have a better understanding of how headaches impact your daily life.
The extent to which headaches interfere with your life often provides crucial information for diagnosing migraine.
Ruling Out Secondary Conditions
To rule out other possible causes of your headaches, doctors conduct physical and neurological exams. These assessments help rule out other conditions that might mimic migraine symptoms, like infections. By ruling out other potential conditions, doctors can more accurately identify migraine.
Imaging tests like MRIs or CT scans are usually reserved for cases where doctors need to rule out other underlying health issues. These tests are used to aid in diagnosing migraine, to help ensure that there are no other causes for these symptoms.
Challenges in Diagnosing Migraine
Varying, Overlapping, or Atypical Symptoms
Diagnosing migraine can sometimes be complex because every person is different and symptoms may not always follow typical patterns. For example, “silent migraine” refers to instances where the aura, or sensory disruptions, occur without the headache itself. Similarly, vestibular migraine, where dizziness is the main symptom, can be mistaken for other balance-related conditions.
In addition, there can be symptoms that overlap with other headache disorders, which can make diagnosis difficult.
Lastly, because many different symptoms can be associated with migraine, it can be difficult for doctors to obtain an accurate patient history.
Comorbid Conditions
Migraine can exist alongside other conditions, making migraine treatment and determining the primary cause difficult. When conditions share overlapping symptoms, it can lead to under-diagnosis or misdiagnosis, which can delay appropriate migraine treatment.
Downplaying Impact
Unfortunately, stigma around migraine can cause people to downplay how much it affects their lives. Because migraine can be an invisible illness, people might feel pressure to minimize their symptoms when talking to others, even their doctors.
It’s important to be honest and open about how migraine impacts daily activities, social interactions, and emotional well-being. Sharing the full extent of migraine’s impact helps doctors understand the severity of migraine. Remember, your doctor is there to help you. The more they know, the more they can support you with managing your migraine.
Recap of Learnings
While there is not a specific lab test, scan, or biomarker, doctors have a well-established approach to diagnosing migraine. They look at your headache and medical history, use a comprehensive guide to help them differentiate between different headache disorders, even if your symptoms are not typical, and use testing and imaging to help rule out other conditions when necessary. Remember, talk openly with your doctors about your symptoms and any impact on your daily life so they can have a better understanding of how to best support you with managing your migraine.
Visit https://www.pfizerforall.com/migraine/talk-to-a-doctor to connect with a doctor.
This article is just the beginning. Dive deeper into how this condition is treated and what might be right for you.
Poll
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- Stress
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- Certain foods
- Sleep disruption
- Screen time / eye strain
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“text” a common trigger for migraine attacks. Learn about other triggers and how you can manage them.
References
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