Diagnosis and Treatment for Migraines

How are migraine headaches diagnosed?

In order to get an accurate diagnosis it is important to be able to describe your migraine symptoms to your healthcare provider. It is helpful to track migraine occurrences (dates and times) and the details associated with migraines.

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 changes in position cause the headaches?

• Do you have trouble sleeping?

• Do you have a history of stress?

• Are you currently experiencing an unusual amount of stress in your work, family, or personal life? 

• Is there a history of head trauma?

Procedures used to diagnose a migraine are generally used to rule out other possible causes of the symptoms. In addition to a complete medical history and physical examination, some procedures that may be used include:

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

• Sinus X-rays. A diagnostic imaging procedure to evaluate for congestion or other problems that may be corrected.

• Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

• Computed tomography scan (also called a CT or CAT scan). A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than standard X-rays.

• Spinal tap (also called a 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 determine if there is 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. Adequate headache management depends on the accurate identification of the type of headache and may include:

• Avoiding known triggers, such as certain foods and beverages, lack of sleep, and fasting

• Changing eating habits

• Exercise

• Resting in a quiet, dark environment

• Medicines, as recommended by your healthcare provider

• Stress management

Migraine headaches may need specific medicine management including:

• Abortive medicines. Medicines, prescribed by your healthcare provider, act on specific receptors in blood vessels in the head and can stop a headache in progress.

• Rescue medicines. Medicines purchased over-the-counter, such as analgesics (pain relievers), stop the headache.

• Preventive medicines. Medicines, prescribed by your healthcare provider, taken daily to reduce the onset or frequency of severe migraine headaches.

Some migraines may need immediate medical attention, including hospitalization for observation, diagnostic testing, or even surgery. Treatment is individualized, depending on the severity and frequency of symptoms.