Migraine Headache

Migraine headache is an example of a primary headache.The diagnostic criteria are summarized below:-

Migraine without aura diagnostic criteria

A. At least five headache attacks lasting 4 - 72 hours (untreated or unsuccessfully treated), which has at least two of the four following characteristics:

1. Unilateral location

2. Pulsating quality

3. Moderate or severe intensity (inhibits or prohibits daily activities)

4. Aggravated by walking stairs or similar routine physical activity

B. During headache at least one of the two following symptoms occur:

1. Phonophobia and photophobia

2. Nausea and/or vomiting

Migraine with aura diagnostic criteria

A. At least two attacks fulfilling with at least three of the following:

1. One or more fully reversible aura symptoms indicating focal cerebral cortical and/or brain stem functions

2. At least one aura symptom develops gradually over more than four minutes, or two or more symptoms occur in succession

3. No aura symptom lasts more than 60 minutes; if more than one aura symptom is present, accepted duration is proportionally increased

4. Headache follows aura with free interval of at least 60 minutes (it may also simultaneously begin with the aura

B. At least one of thefollowing aura features establishes a diagnosis of migraine with typical aura:

1. Homonymous visual disturbance

2. Unilateral paresthesias and/or numbness

3. Unilateral weakness

4. Aphasia or unclassifiable speech difficulty

Drug treatment for prevention is sometimes necessary and includes propranolol, topiramate and valproic acid. Anxiety and stress along with sleep deprivation can often exacerbate migraines and therefore increasing sleep time to around 7 hours and decreasing stress often bring about a decrease in attack frequency.

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