Diagnosing Migraine and Headache

Be prepared for your first appointment to discuss your migraine

Obtaining a proper diagnosis of your migraine and headache is all about establishing a clear communication channel with your doctor, as well as what steps your doctor can take to test for the severity of your headache pain and condition. For the patient, getting better educated on the type of migraine you may have could be a good start to researching and finding common threads. Assessing your symptoms, the frequency of attacks, and your individual pain level are good tools to track and ultimately discuss with your doctor.

Not only is a proper diagnosis important for determining what type of migraine you may have, but it may also be reassuring to find that your migraine is not the cause of a much larger, serious illness or condition. In addition, if you have other complications that you take medication for, it is good to know what treatments you can and cannot take, as certain drugs cannot be taken together.

Questions to Answer for Your Next Appointment

John Hopkins Medicine suggests the following list of questions that you can start answering yourself during the tracking process:

  • 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 your behavior or personality?
  • Does movement cause the headaches, or exacerbate it during attacks?
  • 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?

A detailed medical history report (do migraines run in your family?), as well as a full neurological assessment (testing motor, senses, and reflexes), will most likely also occur during the initial assessment. Going to your family physician, who may then refer you to a neurologist (especially if your migraine and comorbid symptoms get worse), will ensure that you are getting the best help for your condition.

Therefore, expect to be giving a lot of information to your doctor or specialist. Have you used any treatments before the appointment, and did they work? Tracking details such as this will pay dividends when you make your first appointment with your doctor to talk about the condition.

Confirming a diagnosis as soon as possible will allow you the relief of starting to prevent further attacks, or trying to curb comorbid symptoms that may occur.

Diagnostic Tests

A doctor may perform numerous tests to rule out any other possible serious conditions. Or, these tests may be applied later if your migraine is showing signs of severity or unusual tendencies. Therefore, these tests are not specifically designed to diagnose migraines, but instead are used to ensure that your migraine is not the cause of a much deeper illness or condition. According to the Mayo Clinic, as well as John Hopkins Medicine, these include:

  • Blood tests to check for blood vessel problems, infections in your spinal cord or brain, and toxins in your system.
  • Magnetic resonance imaging (MRI), a powerful magnetic field and radio wave to produce detailed images of the brain and blood vessels. MRI scans help doctors diagnose bleeding in the brain, infections, and other brain and nervous system conditions.
  • Computerized tomography (CT) scan, a series of X-rays to create detailed cross-sectional images of the brain. This helps doctors diagnose infections, brain damage, bleeding in the brain and other possible medical problems that may be causing headaches.
  • Spinal tap (lumbar puncture), a thin needle inserted between two vertebrae in the lower back to remove a sample of cerebrospinal fluid for analysis in a lab. A spinal tap is given if your doctor suspects infections, bleeding in the brain or any other underlying condition.
  • EEG (electroencephalograph), a test during which electrodes, or sensors, record the electrical signals of the brain placed on the one’s scalp, and transmitted to an amplifier that records the activity. According to the Cleveland Clinic, this procedure usually isn’t necessary unless you have passed out from a migraine.
  • Sinus x-rays, a diagnostic imaging procedure to evaluate for congestion or other problems that may be corrected.

Take our Headache and Migraine Quiz to see what type you may be experiencing.

What if My Symptoms Change?

Don’t worry, says the Migraine Trust. According to the research organization, a change in the pattern of your headaches or other symptoms might be the result of the naturally changing course of migraine; symptoms vary over time as well. Women, for example, may have different patterns of attacks when hormonal changes (from birth control, for example) occur. However, these pattern changes should still be checked by your doctor, as this can help rule out any other causes, especially if your migraine attacks get worse or develop unusual symptoms.

In addition, many migraine sufferers also experience other types of headache, such as tension-type headache, which means that they need to be identified, treated, and prevented appropriately. Putting other headaches under control can drop the number of frequent migraine attacks one may suffer.

-Additional reporting by Steven Aliano

Updated on: 06/19/19
Continue Reading:
The Empowered Patient's Guide to Migraine and Headache