Fact-sheet: Migraine
Updated on 09/17/2021 at 12:16 PM
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Definition
Characteristic headache episodes separated by symptom-free intervals. No further work-up is required when the presentation is typical. Two types: migraine without aura and migraine with aura.
Clinical features
1/ Migraine without Aura - Typically pulsatile, tends to worsen with physical exertion or concentration - Features: location, onset, duration (4-72h) +/- nausea and vomiting, vasomotor signs (changes in facial color), photophobia, phonophobia - Complete recovery after the attack. 2/ Migraine with Aura - Presence of focal neurological manifestations preceding or accompanying the migraine headache, classically contralateral to it. - Gradual onset of the aura (> 5 min). - Complete resolution within one hour, before or alongside the headache; - Types: most common = visual aura and sensory aura. Others = word-finding difficulty or paraphasia, balance disorders. Exceptionally = ophthalmoplegia, hemiplegia. Rarely, the migraine aura is not followed by headache --> diagnostic challenge.
MRI
Indicated only in cases of atypical clinical presentation.