Migraine headache in Adult
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Synopsis

Migraine headaches are recurrent moderate to severe headaches, typically unilateral in location, pounding or pulsating in quality of pain, and lasting 4-72 hours. Nausea and/or vomiting, photophobia, and/or phonophobia may accompany the headaches. Symptoms are usually worse with activity. Headaches may or may not be preceded by an aura, which is a transient visual, language, sensory, or motor disturbance. The International Classification of Headache Disorders, 3rd edition (ICHD-3), identifies 3 main categories: migraine without aura, migraine with aura, and chronic migraine.
A small percentage of patients may experience migraine attacks without any associated head pain, typically characterized by migrainous aura and/or other migrainous symptoms such as photophobia or nausea.
Patients may identify triggers that induce headaches. There may also be a positive family history of migraine headache. Age of onset varies, and migraine headaches can start in childhood, although they most commonly begin between the ages of 15 and 25, with onset in girls often starting around menarche. Migraines are 3 times more common in women than in men.
Related topic: basilar migraine headache
A small percentage of patients may experience migraine attacks without any associated head pain, typically characterized by migrainous aura and/or other migrainous symptoms such as photophobia or nausea.
Patients may identify triggers that induce headaches. There may also be a positive family history of migraine headache. Age of onset varies, and migraine headaches can start in childhood, although they most commonly begin between the ages of 15 and 25, with onset in girls often starting around menarche. Migraines are 3 times more common in women than in men.
Related topic: basilar migraine headache
Codes
ICD10CM:
G43.909 – Migraine, unspecified, not intractable, without status migrainosus
SNOMEDCT:
37796009 – Migraine
G43.909 – Migraine, unspecified, not intractable, without status migrainosus
SNOMEDCT:
37796009 – Migraine
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Tension headache
- Cluster headache
- Paroxysmal hemicrania continua
- Hemicrania continua
- SUNCT syndrome (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing)
- LASH syndrome (long-lasting autonomic symptoms with hemicrania)
- Trigeminal neuralgia
- Postherpetic neuralgia
- Occipital neuralgia
- Cervicalgia
- Sinusitis
- Cerebral venous sinus thrombosis (see cerebral stroke)
- Arteriovenous malformation
- Brain tumor
- Seizure
- Transient ischemic attack / stroke
- Subarachnoid hemorrhage
- Reversible posterior leukoencephalopathy syndrome
- Reversible cerebral vasoconstriction syndrome
- Aseptic meningitis
- Analgesic rebound headache
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
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References
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Last Reviewed:03/05/2018
Last Updated:08/31/2023
Last Updated:08/31/2023

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