How is Migraine Diagnosed?


Migraine diagnosis is typically based on medical signs and the symptoms the patient describes, rather than tests. To diagnose a migraine, the neurologist will ask about the patient’s history and family history, review the specific symptoms, and perform a physical examination. The doctor may order tests to rule out other possible causes of severe headaches.

Patients will be asked about their:

  • Medical history
  • Family medical history
  • Specific headache symptoms
  • Specific pain area
  • Headache triggers
  • Medications taken including over-the-counter (OTC) pain-relieving medications

Additional tests to rule out other medical conditions may include:

  • Blood tests
  • Imaging tests, including computed tomography (CT) or magnetic resonance imaging (MRI) brain scans, to rule out other causes for the headache such as a brain tumor
  • Electroencephalogram (EEG) may be ordered to rule out seizures

How is Migraine Treated?



  • Abortive medications: Abortive, or acute migraine treatments, are taken at the onset of an episode to stop or reduce the severity of symptoms. Some medications are not safe to take during pregnancy.

    Prescription and over-the-counter medications that can be used to relieve pain and treat other migraine symptoms include:
    • Pain relievers: These include over-the-counter pain relievers including aspirin, ibuprofen, acetaminophen, and others.
    • Triptans: Prescription drugs such as sumatriptan and rizatriptan block pain pathways in the brain and can relieve many symptoms of migraine.
    • Dihydroergotamine (DHE): This is an ergot alkaloid that is often taken as a nasal spray.
    • Lasmiditan: A serotonin receptor agonist, Lasmiditan is approved to treat migraine with or without aura.
    • CGRP antagonists: Typically taken as a monthly injection, CGRP antagonists are approved for the treatment of acute migraine with or without aura in adults.
    • Antiemetic (anti-nausea) drugs: Both OTC and prescription medications can help alleviate nausea and vomiting associated with migraine and may reduce the pain itself. Anti-nausea drugs include chlorpromazine, metoclopramide, and prochlorperazine.
  • Preventive medications are taken regularly to reduce the number of migraine episodes.

    Medications include:
    • Antidepressants including tricyclic antidepressants, SSRIs, SNRIs, serotonin antagonists, and monoamine oxidase inhibitors (MAOIs) have been shown to improve symptoms in more than a third of patients. These drugs typically have an array of side effects, such as weight changes and nausea.
    • Antiepileptic (anti-seizure) drugs may help but can cause side effects such as dizziness, weight changes, and nausea and are not recommended for pregnant people or those trying to get pregnant.
    • Blood pressure medications, such as beta-blockers like propranolol or calcium channel blockers like verapamil, have been shown to help nearly half of migraine sufferers in some studies.
    • CGRP monoclonal antibodies are newer drugs that are given monthly or quarterly by injection.
    • Botox injections (onabotulinumtoxinA) can be administered every 12 weeks to help prevent chronic migraine

Other therapies and practices

Some other therapies may help reduce migraine pain. These include:

  • Acupuncture involves placing thin needles into specific areas of the skin.
  • Cognitive behavioral therapy is a type of psychotherapy that teaches individuals how behaviors and thoughts affect pain and may help people with migraine.
  • Certain herbs, vitamins, and minerals may help prevent migraine or reduce pain.

Lifestyle changes

  • Pain relieving: When having an episode, cold or heat application and rest in in a quiet, dark room may help ease migraine pain.
  • Healthy lifestyle: Some practices and routines can prevent triggers for migraine such as stress, sleep deprivation, and dehydration.

    These practices and routines include:
    • Exercising regularly: This can help reduce the frequency of migraine episodes
    • Staying hydrated: Drinking plenty of water will help avoid dehydration
    • Healthy sleeping routine: This includes avoiding both sleeping too much or too little and following a regular sleep and wake schedule
    • Healthy diet and eating routine: Developing a regular eating routine and avoiding foods and beverages that trigger migraine, such as alcoholic beverages and coffee, can help some people with migraine
    • Relaxation techniques: Meditation, yoga, and other relaxation practices can be helpful in managing migraine



People can try different ways to stop migraine pain, including:

  • Taking over-the-counter pain relievers or prescription drugs
  • Placing an ice pack on the head and neck
  • Resting in a dark room
  • Gently massaging the temples, scalp, neck, and shoulders, or a gentle stretch of the neck

A migraine episode typically lasts a few four hours and up to three days.

Caffeine has a variable effect. It can help during a migraine by narrowing blood vessels in the body and head, which can reduce pain. It can also increase the effect of pain medicines and speed up the time it takes to feel the medicine’s effect. However, too much caffeine is a common trigger for migraine, so intake should be moderate.

Yes, migraine is hereditary. This means that sometimes parents who have migraine can pass on the tendency to have migraines to their children or grandchildren.

Migraine is more common among biologically female people, affecting one out of five, compared to one out of 15 biologically male people.

Get Care

Trust NewYork-Presbyterian for Migraine Treatment

NewYork-Presbyterian’s headache specialists have expertise in treating people who experience migraine and other types of headache disorders. Learn more about migraine symptoms. Contact us to make an appointment.