Migraine Classification and Diagnosis
Migraine Types
- Migraines are classified into three main types: migraine without aura, migraine with aura, and chronic migraine, each with distinct diagnostic criteria and clinical presentations 1, 2
- The American Academy of Otolaryngology-Head and Neck Surgery states that migraine without aura is formerly called "common migraine" or "hemicrania simplex" 3
- Migraine without aura is characterized by recurrent headache attacks lasting 4-72 hours (untreated or unsuccessfully treated) 3, 2
- The International Headache Society recommends that diagnostic criteria for migraine without aura require at least 5 attacks fulfilling specific characteristics 3
- Migraine with aura is characterized by recurrent attacks with fully reversible neurological symptoms that usually develop gradually and are followed by headache 3, 2
- The American Academy of Neurology states that migraine with aura is formerly called "classic migraine," "ophthalmic migraine," or "complicated migraine" 3
- Aura symptoms may include visual, sensory, speech/language disturbances, motor symptoms, brainstem symptoms, and retinal symptoms 1, 2, 5
- Chronic migraine is defined as headache (migraine-like or tension-type-like) occurring on ≥15 days per month for >3 months 2, 6
Special Migraine Types
- Vestibular migraine is characterized by vestibular symptoms of moderate to severe intensity 5, 3
- The American Academy of Otolaryngology-Head and Neck Surgery recommends that diagnostic criteria for vestibular migraine include at least 5 episodes with vestibular symptoms lasting 5 minutes to 72 hours 5
- Probable migraine is defined as migraine-like attacks missing one feature required to fulfill all criteria for a specific migraine type 7
Medication-Overuse Headache
- Medication-overuse headache often complicates chronic migraine 2, 6
- The International Headache Society states that medication-overuse headache is characterized by headache on ≥15 days/month in a patient with pre-existing headache disorder 2, 6