Migraine Diagnosis and Tests | How Do You Know You Have Migraine?

There are no specific tests to diagnose migraine. The diagnosis is based purely on its symptoms and signs. Tests are done to rule out other causes of a headache.

We will elaborate the typical migraine symptoms again here, which will tell the doctor and you that you are suffering from migraine.

Chart showing how migraine is diagnosed
Migraine diagnosis

Symptoms That Help Diagnose Migraine

How do you know when you have migraine?  The following symptoms, which are typical will help you know that you have a migraine headache.

  • Occurrence of recurrent five or more headaches over a period
  • If you have migraine with aura, two such attacks are enough to confirm the diagnosis.
  • Symptoms of migraine aura are also described in the post on migraine symptoms.
  • The duration of a headache can be between four to seventy-two hours.
  • The migraine headache is usually unilateral, of throbbing nature, moderate to severe in intensity and is aggravated or triggered by physical activity. All these symptoms may not be present but presence of any two of these can lead to a fairly confirmed diagnosis.
  • Presence of vomiting and/or nausea or photophobia (sensitivity to light) and phonophobia (sensitivity to sound) is a fairly good indicator.
  • Presence of risk factors

If the migraine sufferer is associated with any risk factor that makes him prone, the doctor will immediately suspect this as the cause of the headache. Risk factors include family history, age, and gender.

Tests to diagnose migraine

If your headache is sudden, severe or unusual, certain tests will have to be carried out to rule out other causes of your headache. Remember, that these tests are not done to diagnose migraine but to rule out other causes of the headache, which will help your doctor in the diagnosis through the elimination method.

Computerized Tomography(CT scan)

This imaging procedure provides cross-section images of the brain, which help to rule out any brain tumor or infection, which may be causing your headache.

MRI (Magnetic resonance Images)

MRI provides more detailed cross-section images with the help of magnetic waves, which help to detect tumors, infections, aneurysm, neurological disease, stroke, etc.

Lumbar puncture or spinal tap

The spinal tap involves inserting a needle between two vertebrae (usually the lumbar vertebrae L3/L 4 or L 4/L5). The cerebrospinal fluid (CSF) is withdrawn for laboratory analysis.  CSF is the fluid, which surrounds the brain and the spinal cord. Infection of the brain meninges (meningitis) can be diagnosed through this method.

Erythrocyte Sedimentation Test (ESR)

Though not conclusive,  ESR is a simple blood test that helps to detect any infection in the body, which could be causing your headache.

X-ray of the cervical spine

A cervical x-ray will help to rule out cervical spondylosis, which can cause a headache.

Angiography of the head and neck

This angiography is done to check for the potency of the blood vessels in the head and neck region. X-rays are taken as an injected dye travels through the arteries and veins in the head and neck. This procedure helps to detect any bulge in a blood vessel such as that caused by an aneurysm or narrowing such as that caused by a growth in the neighboring area.