Migraine without Aura (IHS Criteria)

Migraine without aura has at least 2 of the following characteristics:
  • Unilateral location
  • Pulsating quality
  • Moderate or severe intensity that inhibits or prohibits daily activities
  • Aggravation by walking up stairs or similar routine physical activity
Left untreated, the headache attacks last 4-72 hours; in children younger than 15 years, the headache may last 2-48 hours. During the headache, at least 1 of the following occurs: (1) nausea and/or vomiting or (2) photophobia and phonophobia.
During the clinical evaluation, at least 1 of the following occurs:
  • History and physical examination findings do not suggest another disorder
  • History and physical examination findings do suggest another disorder, but the other disorder is ruled out by appropriate investigations (eg, magnetic resonance imaging [MRI] or computed tomography [CT] scanning of the head).

Migraine with Aura (IHS Criteria)

Migraine with aura is categorized by headache and aura features. The headache characteristics are the same as those for migraine without aura, above. The aura is characterized by at least 2 attacks of the following:
  • One reversible aura symptom indicating focal central nervous system (CNS) dysfunction - Ie, vertigo, tinnitus, decreased hearing, ataxia, visual symptoms in 1 hemifield of both eyes, dysarthria, double vision, paresthesias, paresis, decreased level of consciousness
  • Aura symptom that develops gradually over more than 4 minutes or 2 or more symptoms that occur in succession
  • No aura symptom that lasts more than 60 minutes unless more than 1 aura symptom is present
  • Headache occurring before, during, or up to 60 minutes after the aura is completed

Migraine with Prolonged Aura

​Migraine with prolonged aura fulfills criteria for migraine with aura; however, the aura lasts more than 60 minutes (but less than 7 days).

Basilar Migraine

Basilar migraines fulfill the criteria for migraine with aura, but 2 or more of the following aura symptoms occur:
  • Vertigo
  • Tinnitus
  • Decreased hearing
  • Ataxia
  • Visual symptoms in both hemifields of both eyes
  • Dysarthria
  • Double vision
  • Bilateral paresthesias
  • Bilateral paresis
  • Decreased level of consciousness

Migraine Aura Without Headache

​Migraine aura without headache (replaces migraine equivalent or acephalgic migraine) fulfills criteria for migraine with aura, but no headache occurs.