About this condition
Migraine headaches may be throbbing, interfere with everyday activity and be accompanied by nausea, sensitivity to light or intolerance of noise. Some people have an aura with gradually developing, reversible visual, sensory or language symptoms. Migraine can also occur without aura.
Clinical features
Attacks often last from several hours to about three days, although patterns vary. Pain does not have to be one-sided. A recurrent history should not be used to dismiss a new unusual symptom. A clinician distinguishes migraine from other primary headaches, medication-overuse headache and potentially dangerous secondary causes.
Important differences and warning signs
Diagnosis is mainly clinical, using the attack pattern and neurological examination. MRI is not routinely necessary for every person with a typical stable migraine pattern and no red flags. A headache diary can record attack days, duration, missed activities, sleep, medication use and response.
Assessment and individual care
Management may include treatment for acute attacks, preventive treatment when appropriate and practical changes to sleep and meal routines. Choice of medicine depends on contraindications, other conditions and frequency of painkiller use. Frequent unsupervised analgesics can contribute to medication-overuse headache.
Related information: Headaches in adults; Speech difficulties.
Signs and symptoms
- Recurring moderate or severe headache attacks, sometimes throbbing or one-sided.
- Nausea, light or sound sensitivity and reduced ability to continue activities.
- In some people, a gradually developing, reversible aura before or during a headache.
Diagnosis and tests
A clinician reviews headache history, aura and neurological findings. Imaging is reserved for situations in which symptoms or warning signs justify it.
Care and treatment approaches
An individual plan addresses acute attacks and possible prevention, taking account of contraindications and the risks of medication overuse.
When to seek urgent care
A sudden thunderclap or worst-ever headache, new weakness or difficulty speaking, an unusual prolonged aura, altered consciousness or fever requires urgent assessment. Call 103 if stroke is suspected.
Frequently asked questions
Can migraine occur without aura?
Yes. Many migraine attacks occur without aura; diagnosis is based on the overall pattern and clinical assessment.
Does every migraine attack require an MRI?
No. Imaging is not routine in stable typical migraine; the need depends on examination and red flags.
Why keep a headache diary?
It helps track attack frequency, disability and medication use, which can inform treatment and prevention decisions.
Information sources
Medical source links used when preparing this article.
Important information
A medical consultation is needed for diagnosis and treatment recommendations.
Self-treatment can be harmful to your health.
