Migraine is most often diagnosed by a primary care provider. If your headaches are persistent or don’t respond to treatment, your doctor may refer you to a neurologist.

What Tests Can Diagnose Migraine?

No single test is conclusive for a diagnosis of migraine. Migraine is generally diagnosed through a combination of medical history and physical and neurological examinations. In some cases, blood tests, imaging scans, or a lumbar puncture may help rule out conditions with similar symptoms. A doctor carefully considers the evidence of all these tests before concluding that migraine is the correct diagnosis or ruling it out.

Medical and Family History

Your doctor will ask about the history of your symptoms. Provide as much detail as possible about the type of head pain you feel during a migraine, any other symptoms you experience, and the frequency and timing of attacks. Be sure to mention anything that seems to trigger or relieve your headaches.

It’s helpful to keep a migraine diary to record migraine symptoms. Note the dates when you have a headache, any medicine you take to treat it, and any symptoms you have other than headache, such as light sensitivity or nausea. The diary may show a clear pattern that can help you identify migraine triggers. Bring this information when you meet with your doctor.

Your doctor will likely ask about family history of headaches because heredity is a major risk factor for developing migraine.

Depending on your symptoms and migraine attack frequency, these criteria may point to a specific type of migraine.

Physical and Neurological Exams

Your doctor may perform a physical and neurological exam. They’ll carefully examine your eyes and reflexes for signs of nerve damage. You will be asked to move your arms and legs in specific ways to test for weakness or lack of coordination. Your doctor will test for loss of sensation by touching various parts of your body with a vibrating tuning fork or sharp or dull items. The neurological exam provides an objective assessment of signs and symptoms that may suggest migraine or another condition.

Imaging

In most cases, imaging scans aren’t necessary to diagnose migraine. However, if your doctor suspects your symptoms are caused by another condition, they may order imaging procedures such as computed tomography (CT) or magnetic resonance imaging (MRI). Scans allow them to check for evidence that your symptoms might be caused by a brain tumor, multiple sclerosis lesions, hemorrhages (bleeds), or stroke. Imaging scans are painless.

Blood Tests

Although blood tests can’t show whether you have migraine, they can identify whether symptoms might be caused by toxins or a brain infection.

Lumbar Puncture

A lumbar puncture, or spinal tap, can be used to check for infection or inflammation in the brain. A lumbar puncture involves a doctor inserting a thin, hollow needle between two vertebrae in a person’s back to collect a sample of cerebrospinal fluid, which bathes the brain and spinal cord. A lumbar puncture can cause discomfort, and many people develop a headache after the procedure.

At What Age Does Migraine Usually Start?

Migraine attacks begin before age 40 in more than 90 percent of people who get them. Some types of migraine are more common in children, while others are more common in older people.

What Other Conditions Can Resemble Migraine?

The process of ruling out similar conditions is referred to as differential diagnosis. Conditions that may resemble migraine include headaches associated with head trauma, temporal arteritis (inflammation of the arteries that supply blood to the head and brain), brain infections, hypoglycemia (low blood sugar), hemorrhage in the brain, and hydrocephalus (a buildup of cerebrospinal fluid in the brain).

If you think you are experiencing migraine attacks, talk to your primary care doctor to begin the process of diagnosis. They can help you learn more about the cause of your symptoms and create a treatment plan to help you manage them.

Talk With Others Who Understand

MyMigraineTeam is the social network for people with migraine and their loved ones. On MyMigraineTeam, more than 84,000 members come together to ask questions, give advice, and share their stories with others who understand life with migraine.

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