According to the International Classification of Headache Disorders, there are over 250 types, sub-types, and sub-forms of headaches.1
There are three common types of headaches: migraine, tension-type and cervicogenic headaches.2
The signs and symptoms of these common headaches overlap, which complicates adequate diagnosis AND treatment. If you are diagnosed incorrectly, the treatment will most likely be incorrect.
A migraine is a common headache disorder, with a 1-year mean prevalence of 5.25% in men and 16.25% in women. 3
A review published in the Journal of Acta Anaesthesiologica Taiwanica examined several validated diagnostic tools and questionnaires for the diagnosis of Migraine:3
Three-question test to screen for a migraine.
If you respond “yes” to two or more of these three questions, you may have a migraine:
- Has a headache limited your activities for a day or more in the last three months?
- Are you nauseated or sick to your stomach when you have a headache?
- Does light bother you when you have a headache? 4
An additional tool for diagnosis of a migraine with Aura.
The maximum VARS score is 10 points, which is the sum of the presence of five visual symptom characteristics:
- Duration 5-60 min (3 points)
- Develops gradually over 5 min or more (2 points)
- Scotoma = partial loss of vision or an unusual blind spot in your visual field (2 points)
- Wavy or Zig-zag lines surround the blind spot (2 points)
- Unilateral = head pain either left or right sided (1 point)
A VARS score of 5 or more indicates a migraine with aura with high sensitivity and specificity. 5
Questionnaires to assess ‘psychiatric co-morbidities’ with may occur with migraine sufferers:
- Beck Depression Inventory
- 9-item Patient Health Questionnaire
- Hospital Anxiety and Depression Scale
Questionnaire to evaluate the disability impact on the migraine sufferer:
Migraine Disability Assessment Questionnaire
The review study reported that the ID-Migraine tool and Visual Aura Rating Scale are both valid methods that also improve the rapid diagnosis of a migraine.3 Furthermore, the questionnaire assists in evaluating the psychiatric comorbidities and disability of the migraines sufferers. Each tool has its own purpose. Thus propper selection of the various diagnostic tools out there for a migraine is essential for interpretation of the diagnostic results.
Make sure you are not being miss-treated for your type of a headache.
1. The International Classification of Headache Disorders (2013). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia; 33(9) 629-808.
2. Fernandez-De-Las-Penas, C. Madeleine, P. Caminero, A. B. Cuadrado, M. L. Arendt-Nielsen, L. Pareja, J. A. (2010). Generalized neck-shoulder hyperalgesia in chronic tension-type headache and unilateral migraine assessed by pressure pain sensitivity topographical maps of the trapezius muscle. Cephalalgia;(30)1,77-86.
3. Peng, K and Wang, S (2012). Migraine diagnosis: Screening items, instruments, and scales. Acta Anaesthesiologica Taiwanica;50,69-73.
4. National Headache Foundation. 2007. Headache Management Tools: ID Migraine. [ONLINE] Available at: http://www.headaches.org/category/headache-tools/headache-tests-questionnaires/. [Accessed 9 December 2016].
5. Eriksen MK, Thomsen LL, Olesen J (2005). The visual aura rating scale (VARS) for migraine with aura diagnosis. Cephalalgia;25(10):801-10.