Diagnosis

The importance of a diagnosis

It may sound obvious, but before you start any form of treatment you need to be sure that you are being treated for the right condition.  If you are getting regular headaches or other symptoms that you suspect could be migraine, it is important to see a doctor and get a proper diagnosis.

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.

How is a diagnosis made?

There is no actual test to diagnose migraine. Diagnosis will depend upon your doctor taking your medical history and ruling out other causes for the attacks.  To make a firm diagnosis, information from two sources will be used:

1. A detailed history of the headaches and/or other symptoms is taken. This history includes analysing:
   • The features of the headaches (for example, how often they happen, how severe the pain is, what symptoms go with them);
   • The effect the headaches have on your everyday activities;
   • The family history of headaches.
2. A thorough examination is carried out, including a complete neurological assessment.

When you visit your doctor to talk about your headaches, you should therefore expect to give quite detailed information about your attacks. Keeping a simple migraine diary can be very helpful. This might include details of treatment you have tried in the past which has not helped the attacks.

You may have heard of techniques such as CAT or MRI scans, where a picture is taken of your brain. Although these tests will help rule out other causes of headache, they cannot be used to diagnose migraine. Similarly, an EEG (electroencephalograph) will not help the doctor to make a correct diagnosis of migraine; nor do routine blood tests help.

Changing symptoms

A change in the pattern of your headaches or other symptoms might be the result of the naturally changing course of migraine. Symptoms can vary at each stage of a person’s life, especially in women where hormonal changes can influence attacks. Migraine mainly affects younger people, and the condition often improves with age. However, any change in the pattern of your headaches should be checked with your doctor. This can help rule out any other causes, especially if your migraine attacks get worse or develop unusual symptoms. See your doctor immediately if your headache patterns change while you are taking the contraceptive pill.

Mixed headaches

Are all your headaches migraine headaches? Many people with migraine also experience other types of headache, such as tension-type headache. These other headaches need to be identified so they can be treated appropriately. If you suspect that you are experiencing more than one type of headache disorder or are not sure, see your doctor.  Bringing other headaches under control can also lead to a drop in the number of migraine attacks you get.