Headache and migraine symptoms

Overview

Most headaches are tension-type or migraine. Migraine is a full neurologic syndrome — throbbing one-sided pain with light/sound sensitivity, nausea, sometimes aura.

Symptoms to watch for

• Tension: bilateral band-like pressure, mild-moderate, no other symptoms
• Migraine: unilateral throbbing, moderate-severe, 4–72 hours, nausea, photophobia, phonophobia, worse with activity
• Aura: visual (zigzags, blind spots) 5–60 min before pain

What else could this be?

• Cluster headache (excruciating, orbital, with tearing/nasal symptoms)
• Sinus headache
• Cervicogenic (neck-origin)
• Medication overuse headache

How it's diagnosed

Clinical. Imaging only if red flags.

Treatment

Acute: triptans (sumatriptan, rizatriptan), gepants (ubrogepant, rimegepant), NSAIDs. Preventive (if >4 attacks/month): topiramate, propranolol, amitriptyline, CGRP inhibitors (Aimovig, Emgality, Ajovy). Lifestyle: sleep, hydration, trigger avoidance.

Frequently asked