Diagnosis of Migraine

Receiving an accurate diagnosis for migraines is the first step in getting you the treatment you need.

The more specific information you can give your doctor, the better.   It helps to keep a headache diary of your symptoms, any suspected triggers, what treatments you’ve tried (if any), and how effective they were. Otherwise, you may be giving your doctor incomplete information.

For example, if you’re asked how many headaches you get, a very specific answer of the number of days in the past month is much more helpful than a vague answer of “a lot.”

Questions your doctor may ask

Your doctor will ask you for some of the following information in order to help determine a diagnosis:   

  • How often do you have headaches?
  • Do they occur at a particular time?
  • How do they feel (a throbbing pain or a sharp pain)?
  • How long do they last?
  • Does your head hurt worse when you move?
  • Where is the pain located (back or front of head, one side only, or both sides)?
  • Do you have any accompanying symptoms, such as nausea or sensitivity to light or sound?
  • Are you under a great deal of stress?
  • Do you wake up with a headache in the morning, or does it wake you up at night?
  • Do you take any medication, including birth control pills?
  • If you take medicine to treat your headaches, what do you take, and how often? (Taking pain medication too often can worsen migraines.)
  • Have your headaches recently worsened?
  • Have you had any head trauma?

Common characteristics of migraines

Your doctor is looking for the following characteristic signs of a migraine:
  • Lasting for at least four hours
  • Pain that has at least two of the following characteristics: Is on one side of the head; feels like a throbbing type of pain; and is worsened by movement
  • Accompanied by nausea or vomiting and/or a sensitivity to light or sound

Tests to rule out other medical issues

After determining the answers to these questions, your doctor may order more tests based on your symptoms and any risk factors you may have.

For example, if you’re 50 or older and are having severe headaches for the first time, your doctor may need to rule out another cause, such as a stroke or low blood sugar. 

Additional testing is done to eliminate other possible issues that could be causing your headaches, since there’s not a test available to confirm a diagnosis of migraine.Your doctor may order some of the following tests to rule out other problems:
  • A CT scan or MRI, especially if you have additional symptoms such as a stiff neck or muscle weakness
  • Blood chemistry tests
  • Sinus X-rays
After ruling out other medical issues, your doctor may diagnosis you with migraines and proceed with the appropriate treatment.