How are migraine headaches diagnosed?

To get an accurate diagnosis, it's important to describe your migraine symptoms to your healthcare provider. It's helpful to track the dates, times, and other details linked to migraines. Keep a record of your symptoms to help identify the type of headache you have and any potential triggers. Use a calendar, notebook, or your phone to record the details.

Helpful information

Take note of the following:

• What time of day do the headaches happen?

• What is the specific location of the headaches?

• What do the headaches feel like?

• How long do the headaches last?

• Have there been changes in behavior or personality?

• Do you have any sensitivity to light, odors, or sounds?

• Do changes in position or any specific activity cause the headaches?

• Do weather changes cause headaches?

• Do you have trouble sleeping?

• Do you have a history of stress?

• Do you have an unusual amount of stress in your work, family, or personal life? 

• Have you had a head injury?

Procedures used to diagnose a migraine are generally used to rule out other possible causes of the symptoms. Your healthcare provider will ask about your health history and do a physical exam. You may also need one or more of these tests:

• Blood tests. Various blood chemistry and other lab tests may be run to check for underlying conditions.

• Sinus X-rays. This diagnostic imaging procedure looks for congestion or other problems that may be corrected.

• MRI. This diagnostic procedure uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body. It does not use X-rays.

• CT scan. This diagnostic imaging procedure uses a combination of X-rays and computer technology to make images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than standard X-rays but often not as detailed as MRI scans.

• Spinal tap (lumbar puncture). A special needle is placed into the lower back, into the spinal canal, which is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to find out if you have an infection or other problems. CSF is the fluid that surrounds the brain and spinal cord.

Treatment for migraines

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment may include:

• Medicine therapy

• Stress reduction

• Dietary evaluation

• Regular exercise

• Cold packs applied to the skin

• Pressure applied to the head

• Biofeedback training

The goal of treatment is to stop headaches from happening. Good headache management depends on knowing what type of headache you have. Treatment may include:

• Staying away from known triggers, such as certain foods and beverages, lack of sleep, and fasting

• Changing eating habits

• Exercising

• Resting in a quiet, dark environment

• Taking medicines, as advised by your healthcare provider

• Managing stress

Migraine headaches may need certain medicines. These include:

• Abortive medicines. These medicines act on specific receptors in blood vessels in the head and can stop a headache in progress.

• Rescue medicines. These are medicines such as pain relievers that stop the headache.

• Preventive medicines. These medicines are taken daily to reduce the onset or frequency of severe migraine headaches.

Some migraines may need to be evaluated right away. You may need to stay in the hospital for observation, diagnostic testing, or even surgery. Treatment depends on the person, how severe the symptoms are, and how often they happen.