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How Does A Neurologist Diagnose Migraines

Whats A Migraine Journal

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  • Keeping a migraine journal is not only beneficial to you, but it helps your healthcare provider with the diagnosis process. Your journal should be detailed and updated as much as possible before, during and after a migraine attack. Consider keeping track of the following:
  • The date and time of when the migraine began specifically when the prodrome started, if youre able to tell its happening. Track time passing. When did the aura phase begin? The headache? The postdrome? Do your best to tell what stage youre in and how long it lasts. If theres a pattern, that may help you anticipate what will happen in the future.
  • What are your symptoms? Be specific.
  • Note how many hours of sleep you got the night before it happened and your stress level. Whats causing your stress?
  • Note the weather.
  • Log your food and water intake. Did you eat something that triggered the migraine? Did you miss a meal?
  • Describe the type of pain and rate it on a one to 10 scale with 10 being the worst pain youve ever experienced.
  • Where is the pain located? One side of your head? Your jaw? Your eye?
  • List all of the medications you took. This includes any daily prescriptions, any supplements and any pain medication you took.
  • How did you try to treat your migraine, and did it work? What medicine did you take, at what dosage, at what time?
  • Consider other triggers. Maybe you played basketball in the sunlight? Maybe you watched a movie that had flashing lights? If youre a woman, are you on your period?

What Is The Difference Between A Headache And A Migraine

Headaches cause pain in the head, face, or upper neck, and can vary in frequency and intensity. A migraine is an extremely painful primary headache disorder. Migraines usually produce symptoms that are more intense and debilitating than headaches. Some types of migraines do not cause head pain, however.

How Severe Or Frequent Should My Headaches Be Before I Seek A Diagnosis

For people who experience migraine once or twice a month and are able to manage it with an over-the-counter medication such as ibuprofen, its really up to the individual if they want to seek further treatment, says Sandhya Kumar, MD, a neurologist and headache specialist at Wake Forest Baptist Health in Winston-Salem, North Carolina.

If you have headaches more than four times a month and theyre impacting your quality of life, you should consider seeking a diagnosis and further treatment that is specific for migraine, she says.

Even for people who have more infrequent attacks, say once or twice a month, but they are debilitating, and they have to take the whole day off work or stay in bed all day, that person should seek a diagnosis and medical treatment for migraine, says Dr. Kumar.

We have a lot of medications we can use not only rescue medications when they have a headache, but also preventive medications to decrease the severity and frequency of their headaches, she adds.

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Whats The Outlook For People With Migraine

Although migraine is a chronic condition, there can be periods of remission.

There are also a variety of treatments to help prevent migraine attacks and mitigate symptoms when they start to occur. Knowing the triggers of migraine can also help to minimize and prevent migraine attacks and help you manage your condition.

Seeing a neurologist regularly may help you maintain the best treatment for your migraine and to address any issues that might come up.

How To Know You’re Experiencing A Migraine

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Migraines are recurrent episodes that usually manifest with headaches, and they can be accompanied by other symptoms as well. The experience is often so distressing and similar to other neurological illnesses that it is not safe to assume that you are having a migraine before other serious conditions are ruled out.

Migraine diagnosis can take timewhile your medical history is the key to diagnosis, medical tests may confirm whether your recurrent episodes are actually migraines.

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Explanation Reassurance And Objectives

Patient satisfaction is a key management outcome and treatment success depends on it but most people with migraine report at least one perceived unmet treatment need. Unrealistic expectations constitute a major obstacle to achieving patient satisfaction a common misconception among patients is that effective treatment means cure of their migraine,. Clinicians must therefore disabuse patients of this belief without being overly negative. A realistic objective is a return of control from the disease to the patient with treatment that mitigates attack-related disability to an extent that the patient can continue with life with as little hindrance as possible.

Non-adherence is also an obstacle to effective treatment and requires management. Education is the solution clinicians must explain to the patient both the disease and the principles of managing it effectively, including instruction on the correct use of medication, potential adverse effects and what to do about them, and the importance of avoiding medication overuse. Such education can require time that is not available, but freely available patient information leaflets can support patient education.

Referral To A Specialist

A GP may decide to refer you to a neurologist, a specialist in conditions affecting the brain and nervous system, for further assessment and treatment if:

  • a diagnosis is unclear
  • you experience migraines on 15 days or more a month
  • treatment is not helping to control your symptoms

Page last reviewed: 10 May 2019 Next review due: 10 May 2022

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Diagnosis Of Migraine Without Aura

Most people with migraine have migraine without aura. To be diagnosed with migraine without aura, you doctor will look for:1

  • At least 5 attacks
  • Head pain that lasts 4 hours to 3 days, if untreated
  • Head pain on 1 side of the head that feels throbbing or pulsing, is moderate to severe, and gets worse with routine activity such as walking or climbing stairs
  • Nausea, vomiting, or both
  • Sensitivity to light and sound

Why Would I Be Referred To A Neurologist For Headaches

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Your doctor might refer you to a neurologist if you have unexplained headaches multiple times a week, especially if youve had the headaches for a while or if they dont get better with over-the-counter treatments. A neurologist can pinpoint the cause of your headaches and help you find effective treatments.

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How Do I Choose A Good Neurologist

Board certification is one of the most important factors to consider when you are looking for a neurologist. It tells you that the doctor has the necessary training, skills and experience to provide healthcare in neurology. Also confirm that the neurologist has no history of malpractice claims or disciplinary actions.

How Does A Neurologist Diagnose Migraines

A migraine can cause a pulsing sensation on one side of your head. Other symptoms also include nausea, vomiting, and extreme sensitivity to sound and light. A migraine can last for several hours, and it can be so severe that it affects your life. Some people get warning signs. This is called aura, and it occurs before or with the headache. These symptoms include blind spots or flashes of light, difficulty speaking, tingling on one side of your arm, leg, or face. Did you know that a migraine is not just a headache but a neurological disorder? The effects of this condition differ from one person to another. It is important to educate both doctors and the public in the UAE about migraines because most tomes they are misdiagnosed as sinuses.

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Family History Of Migraine

Migraine has a strong genetic component and its prevalence is higher among people with directly affected first-degree relatives than among the general population,. Family history is, therefore, an important part of the medical history and is often positive in patients with migraine, although it might be under-reported by patients.

What Are The Symptoms Of Migraines

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The primary symptom of migraine is a headache. Pain is sometimes described as pounding or throbbing. It can begin as a dull ache that develops into pulsing pain that is mild, moderate or severe. If left untreated, your headache pain will become moderate to severe. Pain can shift from one side of your head to the other, or it can affect the front of your head, the back of your head or feel like its affecting your whole head. Some people feel pain around their eye or temple, and sometimes in their face, sinuses, jaw or neck.

Other symptoms of migraine headaches include:

  • Sensitivity to light, noise and odors.
  • Nausea and vomiting, upset stomach and abdominal pain.
  • Loss of appetite.
  • Feeling very warm or cold .
  • Pale skin color .
  • Euphoric mood.

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Whats A Migraine What Does A Migraine Feel Like

A migraine is a common neurological disease that causes a variety of symptoms, most notably a throbbing, pulsing headache on one side of your head. Your migraine will likely get worse with physical activity, lights, sounds or smells. It may last at least four hours or even days. About 12% of Americans have this genetic disorder. Research shows that its the sixth most disabling disease in the world.

When To Seek Emergency Care For A Headache

Warning signs that you need immediate medical attention for your headache or migraine include:

  • Your headache is accompanied by nausea, vomiting, dizziness, confusion, loss of consciousness, or blurry vision.
  • Your headache is accompanied by weakness or loss of control of part of your body, speech, or vision. This could signal a stroke.
  • Your headache is sudden and severe and is accompanied by a stiff neck or fever. This could be meningitis, an inflammation of the brain usually caused by a viral infection.
  • Your headache is the worst headache of your life. The abrupt onset of a very severe headache could mean bleeding or a clot in the brain, according to the American Migraine Foundation.

Additional reporting by Becky Upham.

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Proper Diagnosis Of Your Symptoms Can:

  • Give reassurance that the headaches or other symptoms are not a sign of a very serious illness
  • Allow you to get advice on stopping, managing and treating your symptoms.

If other medical conditions co-exist alongside your migraine this is important in terms of treatment. Certain drugs cannot be taken together for example.

A confirmed diagnosis of migraine and appropriate treatment can help prevent some attacks from occurring and help you to control the remaining attacks more effectively.

What Is A Migraine

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No single test can diagnose migraines. But The International Headache Society publishes criteria for what a migraine is . For instance, the IHS describes migraines without aura as recurring headaches that last up to 72 hours, with characteristics like pain on one side of the head, a pulsating quality, and moderate or severe pain intensity. Migraine symptoms may include nausea or photophobia .1

Although theyre less common, migraines with aura have visual symptoms like seeing geometric patterns, flashing lights or possibly a shimmering effect prior to a migraine striking. Less than one quarter of migraine patients will experience aura. Those who do often have visual impairment starting five to 60 minutes before a migraine strikes.1

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How Long Does A Benign Exertional Migraine Last

Benign Exertional Headache: Benign external headaches are migraines that are brought on by running, lifting, sneezing, or bending. The headache normally subsides after several minutes. Status Migrainosus: Status migrainosus is a severe migraine that can last 72 hours or longer and often results in hospitalization.

Migraine is a neurological condition that can cause multiple symptoms. Its frequently characterized by intense, debilitating headaches. Symptoms may include nausea, vomiting, difficulty speaking, numbness or tingling, and sensitivity to light and sound .

How To Prepare For Your Visit With A Headache Doctor

Many people living with migraine understand the value of a doctor who understands what they are going through and who is willing to help them find relief. But, with waiting lists up to six months or longer to be seen, that first appointment becomes even more criticalwhich is exactly why its essential to effectively prepare for your first visit.

We spoke with Dr. Cynthia Armand, a Headache Fellow at New Yorks Montefiore Headache Center, about how to prepare for a first-time visit with a headache specialist.

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What Is The Prognosis For People With Migraines

Migraines are unique to each individual. Likewise, how migraines are managed is also unique. The best outcomes are usually achieved by learning and avoiding personal migraine triggers, managing symptoms, practicing preventive methods, following the advice of your healthcare provider and reporting any significant changes as soon as they occur.

Migraine Is Much More Than Just A Headache

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There are different types of migraine that involve different symptoms. There are many features or symptoms that are a part of migraine. There are also differences in how severe a symptom might be.

The most common symptoms of a migraine attack include:

  • throbbing headache
  • sensitivity to light, noise and smell
  • nausea
  • lethargy

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Is It Time To See A Neurologist For Your Headaches

Your family doctor is a great starting point for headache relief. But for chronic headaches that dont respond to treatment, you may need to enlist the help of a neurologist.

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The average headache doesnt require a call to a neurologist or even your family doctor. But if you’re experiencing frequent headaches and using medication for them on the regular, thats a different story.

If you have a history of headaches that come once or twice a month and go away when you take an over-the-counter medication such as acetaminophen or ibuprofen, you may not need to seek further treatment, says Sandhya Kumar, MD, a neurologist and headache specialist at Wake Forest Baptist Health in Winston-Salem, North Carolina.

If youre having headaches more than four times a month, especially if they are debilitating and keeping you home from work, you should see a provider for diagnosis and medication, says Dr. Kumar.

Do I Need A Formal Diagnosis Of Migraine To Receive Treatment

If you meet most, but not all, of the ICHD criteria, your doctor may diagnose you with probable migraine, according to the American Headache Society. You may be asked to continue to track your symptoms and the frequency and severity of your headaches to receive a formal diagnosis of migraine.

In the meantime, depending on which symptoms you have, your care provider will develop a treatment plan for how best to manage your attacks.

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Stages Of A Migraine Attack

It is often difficult to know when a migraine attack is going to happen. However, you can often tell the pattern of each attack as there are well defined stages.

It is these stages and their symptoms that distinguish a migraine from a headache.

However, not everyone will experience all of the symptoms of each stage and the stages can overlap. In adults, we can divide a migraine attack into four or five stages that lead on from each other.

Learning to recognise the different stages of a migraine attack can be useful. You might get one, all, or a combination of these stages, and the combination of stages may vary from attack to attack. Each stage can vary in how long and how bad it is. Recognising different symptoms at different times during your attack can give your doctor information which may help them make a diagnosis. Taking medication as soon as you notice the pain may stop or shorten an attack.

Migraine attacks in children are often much shorter than in an adult. It may be easier to tell the different headache stages in a child.

Are There Any Physical Examinations In The First Appointment

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A detailed neurological examination is always carried out during the first consultation to look for any signs or symptoms of an illness that might be causing the headaches. This includes feeling the temporal arteries, checking the blood pressure, checking the patients vision and seeing if a fever is present. Also, a full neurological examination will include fundoscopy to look at the back of the eyes for evidence of raised pressure or swelling due to tumours. The neurological exam also will look for any abnormalities that point to a focus of malfunction in any part of the brain.

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Which Painkiller Is Best For Migraine

Many people who have migraines find that over-the-counter painkillers, such as paracetamol, aspirin and ibuprofen, can help to reduce their symptoms. They tend to be most effective if taken at the first signs of a migraine attack, as this gives them time to absorb into your bloodstream and ease your symptoms.

What Questions Should I Ask My Healthcare Provider

  • Will my child grow out of their migraines?
  • What medications do you recommend for me?
  • What should I change about my lifestyle to prevent my migraine headaches?
  • Should I get tested?
  • What type of migraine do I have?
  • What can my friends and family do to help?
  • Are my migraines considered chronic?

A note from Cleveland Clinic

Migraine headaches can be devastating and make it impossible to go to work, school or experience other daily activities. Fortunately, there are some ways to possibly prevent a migraine and other ways to help you manage and endure the symptoms. Work with your healthcare provider to keep migraines from ruling your life.

Last reviewed by a Cleveland Clinic medical professional on 03/03/2021.

References

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