Migraine Tests And Diagnosis

If you've ever had a migraine, you know how debilitating it can be. While many people assume that migraines are nothing more than bad headaches, they are much more severe. Along with lasting for extended periods, migraine pain is often recurring and can include other symptoms, including sensitivity to light and sound. 

Before scheduling an appointment with your healthcare provider to address your migraine symptoms, here's what you should know about the testing and diagnosis of migraine pain.

What is a migraine?

A migraine is a recurring headache that causes pulsating or throbbing pain. Typically, migraine pain is located on one side of your head, although this can vary from person to person. Along with head pain that is sometimes difficult to bear, migraines can also include muscle weakness, nausea, and sensitivity to light, sound, and smell. 

Migraines¹ usually begin around puberty and most frequently affect people between 35 and 45. Women are twice as likely to suffer from migraines than men due to hormonal factors. Most people with recurring migraine attacks will experience them throughout their lives. 

What are the symptoms of a migraine?

Migraines can affect people differently. While one person may have some symptoms, you may experience unique symptoms. Here are some of the most common:

Head pain:

• On one side or all around, in the front or back of your head, or behind or around your eyes or cheeks

• Ranging from moderate to severe

• Throbbing, pulsing or pounding

• That gets worse when you exercise or physically exert yourself

• That can last 4 hours or as long as several days

Nausea and vomiting:

• Sensitivity to light, sound, and smells

• An inability to perform your routine tasks, such as going to work or school

If you experience one or more of these symptoms, don't wait to schedule an appointment with your healthcare provider. Seeking professional assistance as soon as possible is the best way to receive a diagnosis and find a treatment plan that works for you.

How are migraines diagnosed?

When it comes to diagnosing migraines, your healthcare provider will consider several factors:

Your symptoms

They will discuss your symptoms with you. It's vital to provide as much detail as possible when describing your symptoms, including factors that you think may be unrelated to your head pain. 

Writing down what occurs before, during, and after a migraine attack can assist your healthcare provider in making an accurate diagnosis. 

Here are some factors worth recording and mentioning to your doctor during your appointment:

• How severe is your head pain?

• How often do you experience symptoms?

• Is there a pattern to when they occur, such as right before you start your menstrual cycle?

• Where is the pain located on your head, and how would you describe it? Is it throbbing, pulsating, or pounding?

• Have you noticed anything that makes your head pain better or worse?

• What foods, activities, or other triggers do you suspect could be causing the pain?

• What medications do you take to treat your symptoms, and how often do you take them?

• How do you feel after your symptoms subside?

Medical history

They will likely ask you about your family's medical history and review your medical history. 

Tests

Your doctor will perform a physical and neurological exam. Tests may include blood tests, magnetic resonance imaging (MRI), and computerized tomography (CT) to rule out other health conditions that could cause your symptoms.

How are migraines treated?

Because there is no cure for migraines, treatment manages your symptoms and prevents another attack from occurring in the future. There are two primary types of migraine medications:

• Acute or abortive medications: You take these during a migraine attack to stop symptoms and relieve pain.

• Preventive medications: You take these regularly to decrease the severity and frequency of migraine attacks.

Your healthcare provider can help you determine which type of treatment would be best for you. They will decide based on the severity of your condition, what other medications you're taking, and your medical history.

Pain-relieving medications

When taking a medication to treat migraine pain, it's best to do so at the first sign of the migraine. The medicine can work quicker and more effectively than if you wait for the migraine to progress. Medications that commonly treat migraine pain include:

Over-the-counter pain relievers

These medications, such as Advil or Motrin IB, typically work against mild migraine symptoms but can cause other health concerns if used for an extended period, including gastrointestinal problems.

Triptans

These prescription pills, nasal sprays, or shots combat migraine pain by blocking specific pathways in your brain. While they effectively relieve migraine symptoms in many people, they may not be the best option for people at risk of a heart attack or stroke.

Dihydroergotamine

This medication comes as a nasal spray or an injection. It's best to take it soon after migraine symptoms begin, especially in migraines that last longer than 24 hours. Dihydroergotamine can make you dizzy, so avoid using heavy machinery or driving until you know how it affects you.

Lasmiditan

You take lasmiditan orally, and it can treat migraines with or without aura. It is very effective at reducing migraine pain, but it can cause drowsiness, so you shouldn't drive for at least eight hours after taking it.

Opioid medications

Doctors sometimes prescribe narcotics when other migraine medications are ineffective or not an option. Your doctor will only recommend opioids when other treatments aren't an option because they are very addictive.

Preventive medications

If you experience frequent migraines or more than 15 migraines in one month, you may benefit from a preventive migraine medication. There are currently three types that are FDA-approved:

Beta-blockers

While these drugs are for high blood pressure, they can also reduce migraine pain by relaxing your blood vessels. Inderal and Timolol have been FDA-approved to prevent migraine symptoms.

Anticonvulsants

These medications prevent seizures by blocking the channels that bring impulses to your nerves, muscles, and brain cells. The FDA has approved Depakote and Topamax for migraine.

Calcitonin gene-related peptide (CGRP) inhibitors

These specifically prevent migraines with and without aura. These drugs target a protein in the nervous system and brain that contributes to migraine progression and pain. You can take them by injection, intravenous (IV), or orally. There are five types approved by the FDA: Aimovig, Ajovy, Emgality, Vyepti, and Nurtec ODT.

Additional migraine treatment and prevention

Along with taking medications prescribed by your doctor to treat and prevent migraine symptoms, there are steps you can take at home. Drinking plenty of fluids, resting in a dark, quiet place, and placing a cool cloth on your forehead may help you feel better during a migraine attack. 

Making changes to your lifestyle could prevent a migraine attack in the future. These include:

• Reducing stress

• Losing weight if you're overweight

• Hormonal therapy (if your migraines occur around your menstrual cycle)

• Practicing meditation

When to see your healthcare provider

If you're experiencing migraine symptoms, it's worth scheduling an appointment with your healthcare provider. Be sure to write down your symptoms, current medications, and any other details that may be beneficial in diagnosing and treating your condition. 

Working closely with your doctor can help you find the best treatment plan for your needs and manage your symptoms quickly and effectively.

The lowdown

Migraines are a serious health condition that affects as many as 39 million Americans. While there is no cure for migraines, you can take steps to treat and prevent migraine pain. 

After scheduling an appointment with your healthcare provider, they will review your symptoms and medical history. By performing a physical exam and running tests, they can determine if your head pain is from migraines or another source. 

If you are diagnosed with migraines, you can manage your condition with lifestyle changes and prescription medications to treat and prevent your symptoms.