Diagnostic criteria for migraine*

Migraine without aura

At least five attacks fulfilling criteria B through D

Headache attacks lasting 4 to 72 hours (untreated or unsuccessfully treated)

Headache has at least two of the following characteristics:

Unilateral location

Pulsating quality

Moderate or severe pain intensity

Aggravation by or causing avoidance of routine physical activity (eg, walking or climbing stairs)

During headache at least one of the following:

Nausea, vomiting, or both

Photophobia and phonophobia

Not better accounted for by another ICHD-3 diagnosis

Migraine with aura

At least two attacks fulfilling criteria B and C

One or more of the following fully reversible aura symptoms:

Visual

Sensory

Speech and/or language

Motor

Brainstem

Retinal

At least three of the following six characteristics:

At least one aura symptom spreads gradually over ≥5 minutes

Two or more symptoms occur in succession

Each individual aura symptom lasts 5 to 60 minutes

At least one aura symptom is unilateral

At least one aura symptom is positive^¶

The aura is accompanied or followed within 60 minutes by headache

Not better accounted for by another ICHD-3 diagnosis

Features of migraine in children and adolescents

Attacks may last 2 to 72 hours^Δ

Headache is more often bilateral than in adults; an adult pattern of unilateral pain usually emerges in late adolescence or early adulthood

Photophobia and phonophobia may be inferred by behavior in young children

ICHD-3: International Classification of Headache Disorders, 3^rd edition.

* These criteria were developed for adults. Features that are different in children are listed in the third panel of the table.

¶ Scintillations and pins and needles are examples of positive symptoms.

Δ The evidence for untreated durations of less than 2 hours in children has not been substantiated.

Adapted with permission of the International Headache Society. From: Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018; 38:1. Copyright © 2018 International Headache Society. https://ihs-headache.org/en/. https://journals.sagepub.com/home/cep.

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Diagnostic criteria for migraine*