There are four elements to good migraine management:
correct and timely diagnosis
predisposition / trigger identification and avoidance
intervention (drug or non-drug)
Confirm that the diagnosis is correct! Migraine with aura is readily diagnosed - the headache is preceded by transient hemianopic disturbance, a spreading scintillating scotoma, or transient sensory or dysphasia symptoms usually involving the face or arm, (but rarely the leg).
Migraine without aura may be more difficult to diagnose: the International Headache Society criteria include the following:
Headaches having at least two of the following characteristics
and during headache at least one of the following:
Every day headache is not a simple migraine. Some patients may develop chronic daily headaches in association with pre-existing migraine as a result of excessive analgesic usage (medication overuse headache), and it is important to identify this group.