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Diagnostic criteria

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • the migrainous attacks are episodic and vary within and among patients
    • not all features are present in every attack or in every patient (1).
    • in other words migraine is heterogeneous in frequency, duration, and disability (2).
  • a combination of features is used for the diagnosis.
  • a diagnosis of migraine headache may be determined if the following criteria, which is based on the criteria outlined by the International Headache Society, are met with (3)

Type of Migraine

Diagnostic Criteria

Migraine without aura

At least five attacks that meet the following four criteria:
Headache lasting 4–72 hours (when untreated or unsuccessfully treated)


Headache with at least two of the following four characteristics:

- Unilateral location
- Pulsating quality
- Moderate or severe pain intensity
- Aggravation by or causing avoidance of routine physical activity (e.g., walking or climbing stairs)

Headache accompanied by at least one of the following symptoms:
- Nausea, vomiting, or both
- Photophobia and phonophobia

Not better accounted for by another ICHD-3 diagnosis

Migraine with aura

At least two attacks that meet the following three criteria:
One or more of the following fully reversible aura symptoms:


Visual
Sensory
Speech, language, or both
Motor
Brain stem
Retinal

At least three of the following six characteristics:

  • At least one aura symptom spreading gradually over a period >=5 minutes
  • Two or more aura symptoms occurring in succession
  • Each aura symptom lasting 5–60 minutes
  • At least one unilateral aura symptom
  • At least one positive aura symptom
  • Headache accompanying the aura or following the aura within 60 minutes

Not better accounted for by another ICHD-3 diagnosis

Chronic migraine

Headaches (suggestive of migraine or tension headaches) on >=15 days/month for >3 months that fulfill the following criteria:

Occurring in a patient who has had at least five attacks meeting the criteria for migraine without aura or the criteria for migraine with aura or both

On >=8 days/month for >3 months, features of migraine without aura or of migraine with aura or believed by the patient to be migraine at onset that is relieved by a triptan or ergot derivative


Not better accounted for by another ICHD-3 diagnosis

Reference:

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