Headache, Migraine

Karly Pippitt, MD and Seniha Ozudogru, MD Reviewed 04/2024

BASICS

DESCRIPTION

Recurrent headache disorder manifesting in attacks lasting 4–72 hours. Typically: unilateral location, pulsating quality, moderate to severe intensity, and associated nausea and/or p...

DIAGNOSIS

Clinical diagnosis; recommend thorough history and neurologic examination

HISTORY

Validated migraine screening tool: ID Migraine (2)
In the last 3 months did you have the following symptoms w...

TREATMENT

GENERAL MEASURES

Consistent sleep hours and eating habits
Cold compresses to area of pain

MEDICATION

First-line abortive treatments

Mild to moderate attacks:
- Acetaminophen is effective; when comb...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Quarterly or more frequent appointments when headaches not well controlled
Monitor frequency of attacks and medication usage via headache diary.
M...

REFERENCES

Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1211.

Sacco S, M...

CODES

ICD10

G43.909 Migraine, unsp, not intractable, without status migrainosus
G43.109 Migraine with aura, not intractable, w/o status migrainosus
G43.409 Hemiplegic migraine, not intractable, w/o statu...

CLINICAL PEARLS

Migraine is a chronic headache disorder of unclear etiology often characterized by unilateral, throbbing pain that may be associated with additional neurologic symptoms.
Consider OTC an...

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