Last reviewed: June 2018
Last updated: February  2018

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
  • childhood motion sickness
  • caffeine intake
  • exposure to change in barometric pressure
  • female sex
  • menstruation
  • divorced, widowed, or separated
  • obesity
  • habitual snoring
  • stressful life events
  • overuse of headache medications
  • low socioeconomic status
  • allergies or asthma
  • hypertension
  • hypothyroidism
  • lack of sleep

Diagnostic investigations

Investigations to consider

  • erythrocyte sedimentation rate
  • lumbar puncture
  • CSF culture
  • CT head
  • MRI brain
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Associate Professor of Neurology

Chief

Headache Division

Department of Neurology

Duke University Medical Center

Durham

NC

Disclosures

TAC was an unpaid site PI for the Alder study ALD403-CLIN-011 (monoclonal Ab against CGRP as treatment for chronic migraine), which ended in July 2017. TAC served as a paid consultant for Eli Lilly Co. in November 2016. In 2017 he served as a paid consultant for Alphasights, a global healthcare consulting organization, regarding migraine headache diagnosis and treatment. He has provided expert testimony regarding headache disorders for a legal case in 2015, and expects to be paid to provide expert testimony on headache disorders in 2018 for a legal case relating to the diagnosis, treatment, and standard of care for headache disorders.

Dr Timothy Collins would like to gratefully acknowledge Dr Ann Donnelly, the previous contributor to this monograph. AD declares that she has no competing interests.

Peer reviewers VIEW ALL

Professor

Family and Community Medicine

University of Kansas School of Medicine

Wichita

KS

Disclosures

AW declares that she has no competing interests.

Director

Walton Headache Center

Augusta

GA

Disclosures

MSH declares that he has no competing interests.

Use of this content is subject to our disclaimer