Diagnosing Migraine without aura

ICHD3 diagnostic criteria for migraine without aura are- 

1. At least five attacks fulfilling criteria 2-4
2. Headache attacks lasting 4-72 hr (untreated or unsuccessfully treated ^a,b)
3. Headache has at least two of the following four characteristics:
   • unilateral location
   • pulsating quality
   • moderate or severe pain intensity
   • aggravation by or causing avoidance of routine physical activity (eg, walking or climbing stairs)
4. During headache at least one of the following:
   • nausea and/or vomiting
   • photophobia and phonophobia
5. Not better accounted for by another ICHD-3 diagnosis.

Notes:

a.When the patient falls asleep during migraine and wakes up without it, duration of the attack is reckoned until the time of awakening.

b. In children and adolescents (aged under 18 years), attacks may last 2-72 hours (the evidence for untreated durations of less than two hours in children has not been substantiated).

Also, in children the primary headaches are mostly bilateral and avoidance of daily activity needs to be inferenced by the behaviour of the child.

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