Migraines are commonly diagnosed based on symptoms, since there are no specific tests to detect and confirm this condition.

To be satisfied that a person suffers from migraines, a doctor needs to establish a pattern of recurring headaches. These headaches may be accompanied by symptoms such as nausea and vomiting or preceded by warning signs (called aura) such as vision problems or stiffness in the neck.

On the other hand, migraines can occur unpredictably and in the absence of any other symptoms, which can make diagnosis difficult to confirm. Migraines can also occur on an infrequent basis, sometimes even years apart, which can complicate or delay diagnosis. Furthermore, a person can suffer from a silent headache which is characterized by symptoms of migraine such as nausea and aura but no actual headache. This can also be a challenge to diagnose.

Some of the steps taken in the diagnosis of migraine include:

• A detailed history of the patient’s symptoms is obtained along with any family history of the condition.
• A physical examination may be carried out to check the patient’s coordination, reflexes and vision which can help the doctor to decide whether any other conditions may be causing the headaches.
• Patients may be asked to maintain a diary recording the date and time of migraines along with the symptoms that developed. Patients are also asked to keep a note of any food eaten. Together, this information can help the doctor establish any potential factors that may be triggering migraine in the patient.

When to see the doctor

People should see their doctor if they feel they cannot manage their migraines with over-the-counter pain relief. People should also arrange an appointment with their doctor if any of the following apply:

• Aura symptoms occur on same side of body in each case of attack
• There is an increase in the frequency of attacks
• The first attack is occurring beyond the age of 50 years
• There is a change in the usual migraine symptoms