Last reviewed: 5 Jan 2023
Last updated: 30 Aug 2022

Summary

Definition

History and exam

Key diagnostic factors

  • prolonged headache
  • nausea
  • decreased ability to function
  • headache worse with activity
  • sensitivity to light
  • sensitivity to noise
  • aura

Other diagnostic factors

  • vomiting
  • unilateral
  • throbbing sensation

Risk factors

  • family history of migraine
  • female sex
  • obesity
  • stressful life events
  • medication overuse
  • sleep disorders
  • low socioeconomic status
  • allergies or asthma
  • hypothyroidism

Diagnostic investigations

Investigations to consider

  • erythrocyte sedimentation rate (ESR)
  • lumbar puncture (LP)
  • cerebrospinal fluid (CSF) culture
  • MRI brain
  • CT head
  • angiography

Treatment algorithm

Contributors

Authors

Timothy A. Collins, MD

Associate Professor of Neurology

Chief

Headache Division

Department of Neurology

Duke University Medical Center

Durham

NC

Disclosures

TAC served as a paid consultant for Alphasights (a global healthcare consulting organization) in 2017 and 2018 regarding migraine headache diagnosis and treatment. He provides expert testimony for legal cases regarding headache disorders and treatment (approximately one case per year). TAC is an author of several references cited in this topic.

Acknowledgements

Dr Timothy Collins would like to gratefully acknowledge Dr Ann Donnelly, the previous contributor to this topic.

Disclosures

AD declares that she has no competing interests.

Peer reviewers

Anne Walling, MD

Professor

Family and Community Medicine

University of Kansas School of Medicine

Wichita

KS

Disclosures

AW declares that she has no competing interests.

Marc S. Husid, MD

Director

Walton Headache Center

Augusta

GA

Disclosures

MSH declares that he has no competing interests.

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