The Difficulty of Diagnosing Migraines.

The Difficulty of Diagnosing Migraines | Dr. Ali Ghahary

Aside from the common cold or flu, headaches are one of the most common ailments that healthcare professionals like Dr. Ali Ghahary treat. There are two different types of headaches that an individual can experience: Tension headaches, which is the most common form of headache and is often attributed to things like stress, lack of sleep, or skipping meals; and Cluster headaches, which are relatively short but painful one-sided headaches that recur over a period of several weeks followed by periods of remission. Aside from the aforementioned causes, headaches can also be the result of things such as caffeine withdrawal, noise, infections (i.e. sinus infections), and other underlying medical conditions. It’s important to note that if you develop a sudden, severe headache that is unlike any headache you’ve ever experienced before, you should seek immediate medical treatment as it could be a matter of life or death.

You’re also likely aware of the term “migraine” – a term that is often used to describe a headache, but is considered to be a much more severe form of a headache and can be quite debilitating – even chronic in nature. A migraine is often described as a strong pulsating, pounding, throbbing and/or aching pain. During a migraine attack, this pain can last anywhere from a few hours to several days, and can interfere with one’s ability to carry out their daily activities (i.e. going to work, school, as well as social interactions.) A migraine can come on without any warning, or there may be indicators leading up to a migraine – also known as aura. Auras, which typically occur about an hour before a migraine sets in, can be visual (i.e. changes in vision/blurred vision, seeing flashing/blinking lights), and they can also cause sensory, motor and/or verbal disturbances. For example, you might smell or see things that aren’t there (also known as hallucinations), you could develop temporary paresthesia (tingling or numb sensation), as well as temporary aphasia (trouble speaking.) Approximately one third of all migraine sufferers will also develop additional warning signs hours or days leading up to an attack, including food cravings, changes in mood, stiff/sore neck, feeling fatigued, frequent urination, constipation, or diarrhea. This is known as a prodrome phase. During a headache it is not uncommon to also develop nausea and/or vomiting, as well as sensitivity to light and sound.

While they’re increasingly common, diagnosing migraines (and even headaches in general) can sometimes be tough, especially since there are so many possibilities as to why one might develop a headache or a migraine to begin with. For example, if you have high blood pressure, headaches are a common symptom associated with that, therefore to be able to diagnose a headache or a migraine, physicians like Dr. Ali Ghahary first need to eliminate or treat any other contributing factors. To accurately diagnose migraines, it’s also a good idea to have a detailed headache history – especially if the cause is initially unknown. Dr. Ghahary recommends writing down the frequency and duration of your headaches, the pain level, any accompanying symptoms, events or potential triggers surrounding the development of the headache, and which, if any, treatment methods you’ve tried. This will give both the patient and the physician a better understanding of the pattern of their headaches and migraines, what to avoid, and what you’ve yet to try.

An average headache is usually easily treated with medication like Acetaminophen or Ibuprofen. However, if you suffer from chronic headaches or migraines, medications known as triptans are also commonly used. Triptans, also known as selective serotonin receptor agonists, work by stimulating the brain’s serotonin and help to reduce inflammation and constrict blood vessels which then stops the headache or migraine in its tracks. It’s also important to pay attention to triggers. Certain foods (especially chocolate, peanut butter, dairy products and citrus fruits), sounds and smells have been known to lead to a headache or migraine attack, so you should avoid any known triggers as much as possible. (For a list of migraine/pain-safe foods, click here.) You’re also at an increased risk of developing chronic headaches or migraines yourself if they run in your family. Basically, the more information you have about your headaches and migraines, the easier it will be for your physician to help you come up with a treatment plan that is best suited for you, as not all headaches and migraines are alike.

If you suffer from headaches or migraines and have found certain things helpful, follow Dr. Ali Ghahary on Twitter at @DrAliGhahary and share your tips! For more information about migraines, visit