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Headache, Migraine

Karly Pippitt, MD and Seniha Ozudogru, MD Reviewed 06/2020
 


BASICS

DESCRIPTION

Recurrent headache disorder manifesting in attacks lasting 4 to 72 hours. Typical characteristics are unilateral location, pulsating quality, moderate to severe intensity, aggravatio...

DIAGNOSIS

Migraine is a clinical diagnosis; thorough history and neuro examination are usually all that are necessary. 

HISTORY

  • Validated migraine screening tool: ID MigraineTM (2)

  • In the last 3 months d...

TREATMENT

GENERAL MEASURES

  • Most patients manage attacks with self-care.

  • Cold compresses to area of pain

  • Withdrawal from stressful surroundings.

  • Consistent sleep hours desirable

  • See also “General Prevention...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Early intervention is key at the onset of an attack.

  • Preventive treatment to decrease frequency and severity of attacks, make acute treatments more efficacious, an...

REFERENCES

1
Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders, 3rd edition. Cephalalgia.  2018;38(1):1–211.
2
Sacco S, ...

ADDITIONAL READING

  • International Headache Society. The International Classification of Headache Disorders 3rd edition. IHS Classification ICHD-3 Web site. https://ichd-3.org/. Updated 2019. Accessed A...

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 headaches that may be associated with additional neurologic symptoms.

  • Consider n...

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