Migraine headache

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Migraine Headache without Aura

  • At least 5 attacks of headache fulfilling the following criteria:
    • 1. HA attacks lasting 4–72 hr (untreated or unsuccessfully treated) (>1 h for children)
    • 2. HA has at least 2 of the following characteristics:
      • a. Unilateral location
      • b. Pulsating quality
      • c. Moderate or severe pain intensity
      • d. Aggravation by or causing avoidance of routine physical activity
    • 3. During HA at least one of the following occurs:
      • a. Nausea and/or vomiting
      • b. Photophobia and phonophobia (may be inferred from behavior)
    • 4. Not attributed to another disorder

Migraine Likelihood


  1. Pulsatile
  2. Duration of 4-72 hours
  3. Unilateral
  4. Nausea or vomiting
  5. Disabling in quality

Yes to 4 or more: LR 24 Yes to 3 or more: LR 3.5 Yes to 1-2: LR 0.41

See Also


Headache DDX

Headache Red Flags


International Headache Society Diagnostic Criteria

Detsky et. al, JAMA '06 Does this Patient with a Headache have a Migraine or need Neuroimaging?