Classification and clinical symptomatology of migraine
1. Big picture
Migraine is a common primary headache disorder characterized by recurrent attacks of moderate-to-severe headache, usually with nausea, vomiting, photophobia, phonophobia, and worsening with physical activity.
The key exam idea:
Migraine = recurrent headache lasting 4–72 hours, usually unilateral, pulsating, moderate/severe, aggravated by activity, with nausea/vomiting or photo-/phonophobia.
Migraine is not just “a bad headache.” It is a neurovascular brain disorder involving the trigeminovascular system, brainstem activation, neuropeptide release, and, in aura, cortical spreading depression.
The most important classification:
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Migraine without aura = common migraine
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Migraine with aura = classic migraine
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