{"id":12266,"date":"2022-10-24T18:33:19","date_gmt":"2022-10-24T16:33:19","guid":{"rendered":"https:\/\/www.physiotutors.com\/?post_type=wiki&amp;p=12266"},"modified":"2022-10-24T18:33:19","modified_gmt":"2022-10-24T16:33:19","slug":"migraine","status":"publish","type":"wiki","link":"https:\/\/www.physiotutors.com\/wiki\/migraine\/","title":{"rendered":"Migraine"},"featured_media":12267,"template":"","class_list":["post-12266","wiki","type-wiki","status-publish","has-post-thumbnail","hentry"],"acf":{"sections":[{"acf_fc_layout":"page-header-detail-page","background":{"background_image":12267,"background_image_alt_text":"Migraine Headache"},"heading":"Migraine Headache | Headache & Dizziness Assessment","subheading":"Headache","content_editor":"","button_type":"url","button_label":"Check our shop","button_style":"button-five","button_internal_link":null,"button_anchor":"","button_url":"https:\/\/study.physiotutors.com\/course\/headache-treatment-in-clinical-practice\/","button_file":null,"label":""},{"acf_fc_layout":"submenu","links":[{"button_type":"anchor","button_label":"Learn","button_internal_link":null,"button_anchor":"section-number-3","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Online Course","button_internal_link":null,"button_anchor":"section-number-4","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Reviews","button_internal_link":null,"button_anchor":"section-number-4","button_url":"","button_file":null}],"dropdown_label":"Go to","button_right":{"button_type":"internal_link","button_label":"Become a member","button_style":"button-three","button_internal_link":16662,"button_anchor":"","button_url":"","button_file":null},"button_description":"Find this wiki on the Physiotutors platform"},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h4>Learn<\/h4>"},"column_right":{"content_editor":"<h6>Migraine Headache | Headache &amp; Dizziness Assessment<\/h2>\n<span style=\"font-weight: 400;\">Headaches can manifest on their own but are also a very common symptom in neck pain patients as more than 60% of patients with a primary neck pain complaint report having concordant episodes of neck pain. Therefore it's essential to find out what kind of headache the patient is suffering from.\u00a0<\/span>\n\n<span style=\"font-weight: 400;\">To start off let\u2019s differentiate between primary and secondary types of headaches. But what does this mean? Simply put, primary headaches are a \u201cdisease themselves\u201d whereas, in secondary headaches, the headache is a symptom of another condition. <\/span><span style=\"font-weight: 400;\">So primary headaches would be migraines, tension-type headaches &amp; cluster headaches. Secondary-type headaches are headaches caused by tumors, hemorrhage, other trauma, TMJ dysfunction, substance overdose, or neck pain aka the Cervicogenic headache.<\/span>\n\n<span style=\"font-weight: 400;\">Now let\u2019s take a closer look at migraines, which are primary types of headaches.\n<\/span><span style=\"font-weight: 400;\">Migraines have a mean 1-year prevalence of 11.2% around the world with women being more often affected than men in an age range between 20-50. Migraines exist in two distinct forms: That is either With or without the presence of a phenomenon called Aura. But we will get to that later.\u00a0<\/span>\n\n[embed]https:\/\/www.youtube.com\/watch?v=6ZeOGr_8AFI[\/embed]\n\nDiagnostic criteria for migraine without aura (A-D need to be fulfilled):\n\n<strong>A<\/strong>. At least 5 attacks fulfilling criteria\n\n<strong> B.<\/strong> Headache attacks lasting 4-72 hours (untreated or unsuccessfully treated)\n\n<strong>C.<\/strong> Headache has at least 2 out of the following 4 characteristics:\n<ul>\n \t<li>Unilateral location<\/li>\n \t<li>Pulsating quality<\/li>\n \t<li>Moderate or severe pain intensity<\/li>\n \t<li>Aggravation by or causing avoidance of routine physical activity (e.g.walking or climbing stairs)<\/li>\n<\/ul>\n<strong>D.<\/strong> During headache at least one of the following:\n<ul>\n \t<li>Nausea and\/or vomiting<\/li>\n \t<li>Photophobia and phonophobia<\/li>\n<\/ul>\n<strong>E.<\/strong> Not better accounted for by another ICHD-3 diagnosis\n\n<span style=\"font-weight: 400;\">In order for a headache to be classified as migraine with aura, a patient has to present with the previously mentioned criteria AND one or more reversible Aura symptoms. These are disturbances in the following subsystems:<\/span>\n<ul>\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Visual<\/span><\/li>\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sensory<\/span><\/li>\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Speech<\/span><\/li>\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Motor<\/span><\/li>\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Brainstem<\/span><\/li>\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Retina<\/span><\/li>\n<\/ul>\n<span style=\"font-weight: 400;\">Imagine vision changes, numbness, dizziness, confusion, etc.\u00a0<\/span>\n\n<span style=\"font-weight: 400;\">Furthermore, at least 2 of the 4 characteristics have to apply:\u00a0<\/span>\n<ol>\n \t<li><span style=\"font-weight: 400;\"> At least one aura symptom spreads gradually over \u2265 5 minutes, and\/or two or <\/span>more symptoms occur in succession<\/li>\n \t<li><span style=\"font-weight: 400;\"> each individual aura symptom lasts 5-60 minutes<\/span><\/li>\n \t<li><span style=\"font-weight: 400;\"> at least one aura symptom is unilateral<\/span><\/li>\n \t<li><span style=\"font-weight: 400;\"> the aura is accompanied, or followed within 60 minutes, by headache<\/span><\/li>\n<\/ol>\n<span style=\"font-weight: 400;\">While the Aura symptoms resemble those of a CVA, they build up much slower. Over 5 minutes compared to within seconds in a CVA.\u00a0<\/span>\n\n[cta]\n\n<span style=\"font-weight: 400;\">Tools you can use to assess the impact of a headache on your patient are the <a href=\"https:\/\/bash.org.uk\/wp-content\/uploads\/2012\/07\/English.pdf\" target=\"_blank\" rel=\"noopener\">HIT-6<\/a> questionnaire which you can find in the video description. Also note that it can be difficult for a patient to answer all of the questions on duration, intensity, and characteristics of their headache during your assessment. Therefore asking them to complete a headache diary can help in the assessment and management of the headache and you should be aware that there can be overlap between multiple headache disorders.<\/span>\n\nIf you would like to learn how to diagnose other common forms of headaches, check out the posts below:\n<ul>\n \t<li><a href=\"https:\/\/www.physiotutors.com\/wiki\/tension-type-headache\/\">Tension-type headache<\/a><\/li>\n \t<li><a href=\"https:\/\/www.physiotutors.com\/wiki\/cluster-headache\/\">Cluster Headaches<\/a><\/li>\n \t<li><a href=\"https:\/\/www.physiotutors.com\/wiki\/cervicogenic-headache\/\">Cervicogenic Headache<\/a><\/li>\n \t<li><a href=\"https:\/\/www.physiotutors.com\/wiki\/medication-overuse-headache\/\">Medication Overuse Headache<\/a><\/li>\n<\/ul>\nThe <a href=\"https:\/\/www.physiotutors.com\/wiki\/watson-headache-test\/\">Watson Test<\/a> is a common provocation test used in the assessment of tension-type headaches and migraines.\n\n&nbsp;\n<h6><strong>References:<\/strong><\/h3>\n<a href=\"https:\/\/www.thelancet.com\/journals\/laneur\/article\/PIIS1474-4422(18)30085-1\/fulltext\" target=\"_blank\" rel=\"noopener\">Olesen, J. (2018). International classification of headache disorders.\u00a0<i>The Lancet Neurology<\/i>,\u00a0<i>17<\/i>(5), 396-397.<\/a>"}},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h4>References<\/h4>"},"column_right":{"content_editor":"<a href=\"https:\/\/www.thelancet.com\/journals\/laneur\/article\/PIIS1474-4422(18)30085-1\/fulltext\" target=\"_blank\" rel=\"noopener\">Olesen, J. (2018). International classification of headache disorders.\u00a0<i>The Lancet Neurology<\/i>,\u00a0<i>17<\/i>(5), 396-397.<\/a>"}},{"acf_fc_layout":"cta-image-v2","layout":"","background":"transparent","heading":"","content_editor":"<p class=\"subheading\">Like what you\u2019re learning?<\/p>\n<p class=\"heading-two\">BUY THE FULL PHYSIOTUTORS <strong>ASSESSMENT BOOK<\/strong><\/p>\n\n<ul>\n \t<li>600+ Pages e-Book<\/li>\n \t<li>Interactive Content (Direct Video Demonstration, PubMed articles)<\/li>\n \t<li>Statistical Values for all Special Tests from the latest research<\/li>\n \t<li>Available in \ud83c\uddec\ud83c\udde7 \ud83c\udde9\ud83c\uddea \ud83c\uddeb\ud83c\uddf7 \ud83c\uddea\ud83c\uddf8 \ud83c\uddee\ud83c\uddf9 \ud83c\uddf5\ud83c\uddf9 \ud83c\uddf9\ud83c\uddf7<\/li>\n \t<li>And much more!<\/li>\n<\/ul>","button_type":"internal_link","button_label":"Check out our shop","button_style":"button-two","button_internal_link":4464,"button_anchor":"","button_url":"","button_file":null,"side_button":{"side_button_content_editor":""},"bottom_button":{"bottom_button_content_editor":""},"image":22705,"image_alt_text":""},{"acf_fc_layout":"review-slider","heading":"WHAT CUSTOMERS HAVE TO SAY ABOUT THE ASSESSMENT E-BOOK","image_shortcode":"","image":"","image_alt_text":"","shortcode":"[wprevpro_usetemplate tid=\"2\"]","button_type":"internal_link","button_label":"","button_style":"button-one","button_internal_link":"","button_anchor":"","button_url":"","button_file":null},{"acf_fc_layout":"cta-full-width-v2","logo":{"logo_image":22443,"logo_image_alt_text":""},"heading":"<strong>Download<\/strong> the free Physiotutors app now!","content_editor":"","download_image":{"download_image_image":22444,"download_image_image_alt_text":""},"mobile_download_image":{"mobile_download_image_image":22445,"mobile_download_image_image_alt_text":""},"download_image_link":"https:\/\/onelink.to\/6dtzk5","mockup_image":{"mockup_image_image":22447,"mockup_image_image_alt_text":""},"mobile_mockup_image":{"mobile_mockup_image_image":22446,"mobile_mockup_image_image_alt_text":""}}]},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Migraine Headache | Headache &amp; Dizziness Assessment<\/title>\n<meta name=\"description\" content=\"Migraine is the second most prevalent form of headache worldwide. 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