Pattern Recognition
History
A systematic history is the single most important factor in establishing a headache diagnosis and determining the future work-up and treatment plan. A thorough history also helps focus the physical examination and prevent unnecessary investigation and imaging studies.
A systematic case history should include the following:
• Age at onset
• Presence or absence of aura and prodrome
• Frequency, intensity and duration of attack
• Time and mode of onset
• Quality, site, and radiation of pain
• Associated symptoms and abnormalities
• Family history of migraine
• Precipitating and relieving factors
• Effect of activity on pain
• Relationship with food/alcohol
• Response to any previous treatment
• Any recent change in weight or vision
• Association with recent trauma
• Any recent changes in sleep, exercise, or diet
• State of general health
• Change in work or lifestyle
• Change in method of birth control (women)
• Frequency, intensity and duration of attack
• Time and mode of onset
• Quality, site, and radiation of pain
• Associated symptoms and abnormalities
• Family history of migraine
• Precipitating and relieving factors
• Effect of activity on pain
• Relationship with food/alcohol
• Response to any previous treatment
• Any recent change in weight or vision
• Association with recent trauma
• Any recent changes in sleep, exercise, or diet
• State of general health
• Change in work or lifestyle
• Change in method of birth control (women)
