Keywords: Migraine headache without aura, Headache, International Headache Society, International Headache Society Criteria for Migraine (PubMed Search)
Several medications such as dopamine-blocking anti-emetics, triptans, and ergotamine derivatives have been shown to more effectively treat migraine headaches over other types of headaches, making the ability to accurately recognize this common (2.2% of all ED visits) condition essential.
According to the International Headache Society, one meets diagnostic criteria for migraine headache without aurawhen they have experienced at least 5 attacks, each lasting 4 to 72 hours (untreated or unsuccessfully treated) and accompanied by at least 2 of the 4 following characteristics ("PUMA"):
A.
1. Pulsatile or throbbing in quality
2. Unilateral in location
3. Moderate to severe in intensity
4. Aggravated by activity (i.e.climbing stairs, exertion), plus
B. at least 1 of the following 2 during the headache ("VP"):
1. Vomiting and/or nausea
2. Photophobia and/or phonophobia
References
Goadsby EJ, et al. "Migraine: Current Understanding and Treatment." New Engl Journal of Medicine 2002;346:257-270.
Kostic MA et al. "A Prospective, Randomized Trial of Intravenous Prochlorperazine Versus Subcutaneous Sumatriptan in Acute Migraine Therapy in the Emergency Department." Annals of Emergency Medicine 2010; 56;1:1-6.
