Migraine Headache Disease Summary

Last updated: 08 June 2026

Overview

Migraine headache is a common episodic primary headache that is disabling with associated nausea and/or light and sound sensitivity, as stated in the Introduction section.

Based on the 2015 data from the World Health Organization (WHO), 50-75% of adults aged 18-65 years old in the world have had headaches, and ≥30% of them have reported having migraine headaches. A detailed discussion about the prevalence of migraine headaches is in the Epidemiology section.

The Pathophysiology section discusses the developmental process of migraine headache, which includes the activation of the trigeminovascular system and the pain of migraine being linked to the onset of neurogenic inflammation.

The risk factors and possible triggers of migraine headache are discussed in the Risk Factors section.



Migraine Headache_Disease SummaryMigraine Headache_Disease Summary

History and Physical Examination

The Clinical Presentation section describes the clinical features of migraine headache. The History and Physical Examination sections emphasize the importance of a thorough history and physical examination in the proper diagnosis of migraine headache.

Diagnosis

The Diagnosis or Diagnostic Criteria section features the different bases in classifying migraine headache as migraine with or without aura, chronic migraine, and episodic migraine.

The diseases that should be ruled out in the diagnosis of migraine headache are listed in the Differential Diagnosis section.

Management

Therapy decisions should be made based on the severity of headache. Severity categories and indications for prophylactic therapy are enumerated in the Evaluation section.

General therapy principles and management strategies for migraine headache dependent on whether such treatment is for an acute episode or for prophylaxis are discussed in the Principles of Therapy section.

The Pharmacological Therapy section discusses in detail the medication options for acute episodes and prophylactic treatment of migraine headache.

The Nonpharmacological section discusses the importance of patient education and lifestyle modification in the successful management of migraine headache. 

Frequently Asked Questions

How is migraine without aura diagnosed clinically?
Migraine without aura requires at least five attacks lasting 4–72 hours when untreated or unsuccessfully treated. Headache should have at least two features: unilateral location, pulsating quality, moderate to severe intensity or aggravation by routine physical activity. During headache, nausea and/or vomiting or both photophobia and phonophobia should occur, and symptoms should not be better accounted for by another headache disorder. Read more  
When should migraine prophylactic therapy be considered?
Prophylactic treatment should be considered when migraine occurs on at least four days per month, significantly interferes with daily activities despite acute treatment, or when acute therapy fails, is contraindicated or causes adverse effects. Other indications include medication overuse, attacks lasting more than 24 hours, menstrual migraine, patient preference and neurologic damage associated with uncommon migraine types. Read more  
How should acute migraine treatment be selected?
Acute treatment should be guided by attack frequency, duration and severity, associated symptoms, degree of disability, previous treatment response, evidence-based efficacy and patient preference. Coexisting medical conditions should also be considered. A non-oral route may be appropriate when severe nausea or vomiting occurs, and antiemetics should be added when nausea or vomiting is likely. Read more
Which medicines are used for acute migraine attacks?
Analgesics and NSAIDs such as Paracetamol, Aspirin, Ibuprofen, Ketoprofen and Naproxen are used for acute migraine treatment. Triptans are recommended when previous attacks are not adequately controlled by simple analgesics and are more effective when taken at headache onset or while pain is still mild. Antiemetics may be added when nausea or vomiting occurs. CGRP antagonists may be considered in patients unresponsive or intolerant to at least two triptans. Read more
What defines successful acute migraine treatment?
Successful acute treatment includes being pain-free after 2 hours or improving a moderate or severe migraine to mild or no headache within 2 hours. Treatment should provide consistent efficacy in two of three migraine attacks. Sustained pain relief also requires absence of headache recurrence and no additional medication intake within 24 hours. Read more