8
Diagnosis
Table 5. International Classification of Headache Disorders
(ICHD) Diagnostic Criteria for Migraine
1.1 Migraine without aura
Previously used terms:
Common migraine; hemicrania simplex.
Description:
Recurrent headache disorder manifesting in attacks lasting 4–72 hours. Typical
characteristics of the headache are unilateral location, pulsating quality, moderate or
severe intensity, aggravation by routine physical activity and association with nausea
and/or photophobia and phonophobia.
Diagnostic criteria:
a. At least five attacks
1
fulfilling criteria B–D
b. Headache attacks lasting 4–72 hours (when untreated or unsuccessfully treated)
2,3
c. Headache has at least two of the following four characteristics:
1. unilateral location
2. pulsating quality
3. moderate or severe pain intensity
4. aggravation by or causing avoidance of routine physical activity (e.g., walking or
climbing stairs)
d. During headache, at least one of the following :
1. nausea and/or vomiting
2. photophobia and phonophobia
e. Not better accounted for by another ICHD-3 diagnosis.
Notes:
1. One or a few migraine attacks may be difficult to distinguish from symptomatic migraine-like
attacks. Furthermore, the nature of a single or a few attacks may be difficult to understand.
erefore, at least five attacks are required. Individuals who otherwise meet criteria for 1.1
Migraine without aura but have had fewer than five attacks should be coded 1.5.1 Probable
migraine without aura.
2. When the patient falls asleep during a migraine attack and wakes up without it, duration of the
attack is reckoned until the time of awakening.
3. In children and adolescents (aged under 18 years), attacks may last 2–72 hours (the evidence for
untreated durations of less than two hours in children has not been substantiated).
