The list below is a comprehensive guide to commonly used migraine terms.
American Headache Society (AHS)
The American Headache Society (AHS) is a professional society of healthcare providers dedicated to the study and treatment of headache and face pain. The AHS was founded in 1959.
Analgesics
Analgesics are a diverse group of drugs used to relieve pain. They include aspirin, paracetamol (acetaminophen) and non-steroidal anti-inflammatory drugs such as naproxen and ibuprofen. Analgesics may be effective for the treatment of migraine, particularly in those patients with attacks of mild intensity.
Migraine Aura
Aura is a symptom of the classic migraine headache, and comprises warning signs that generally occur before a migraine headache begins.
Migraine aura can be visual (bright flashing lights, flickering, coloured zigzag lines, etc.), sensory (tingling sensation, numbness, etc.) or motor
(temporary weakness or paralysis) in nature, with visual aura being the most common. The word aura comes from the Greek word for wind and, just as a strong wind may precede a storm, an aura may precede a migraine. Aura may occur without head pain.
Basilar-type migraine
Basilar-type migraine is characterised by migraine with aura symptoms originating from the brainstem and/or affecting both hemispheres of the brain at the same time, but generally without any motor weakness.
Basilar-type attacks are most often observed in young adults.
Biofeedback
Biofeedback is a non-pharmacological form of migraine treatment that educates patients about their physiological state and how to control it using visual or auditory instruments. Patients are taught to self-regulate their heart rate, blood pressure and muscle tension, and acquiring and regularly practising these skills may reduce the frequency and severity of migraine and tension-type headaches.
Chronic migraine
Patients with chronic migraine experience migraine headache on at least 15 days per month for more than 3 months in the absence of medication overuse.
Chronic paroxysmal hemicrania
Paroxysmal hemicrania is associated with similar pain characteristics and symptoms as cluster headache, but headaches are shorter-lasting, more frequent, occur more often in females, and respond to treatment with indomethacin (a non-steroidal anti-inflammatory drug).
Chronic paroxysmal hemicrania comprises attacks of paroxysmal hemicrania that occur for a year or more without remission, or with remissions lasting less than a month.
Classic migraine (migraine with typical aura)
Classic migraine is a migraine associated with the appearance of aura just before, or at the onset of, an attack. Aura may comprise fully reversible visual symptoms (flickering lights, spots or lines, or loss of vision), sensory symptoms (pins and needles and/or numbness) and/or speech disturbances. Classic migraines differ from common migraines, which have no aura.
Cluster headache
A cluster headache is a particular type of headache characterised by severe pain on one side of the head. Headaches generally last up to 180 minutes and occur in ‘clusters’ at a frequency of once every other day to eight times a day. Attacks are associated with nasal congestion,
rhinorrhoea and forehead (and/or facial) sweating, usually on the same side of the head as the headache. The age of first onset of cluster headache is generally 20-40 years. The prevalence of cluster headache is 3-4 times higher in men than in women.
Cognitive behavioural therapy
Cognitive behavioural therapy is a non-pharmacological treatment for migraine that encourages patients to take control of their illness through insight, self-knowledge and planning. It involves identifying and modifying a patient’s response, such as anxiety and distress, to migraine,
and, where possible, removing such stressors.
Common migraine (migraine without aura)
Common migraine is a migraine that is not preceded by aura.
Migraine without aura generally lasts 4-72 hours. Pain is typically located on one side of the head, is pulsating in nature, is moderate or severe in intensity and is aggravated by normal physical activity. It may also be associated with nausea and/or sensitivity to light (photophobia) and/or sensitivity to sound (phonophobia).
Disability In Strategies of Care (DISC) study
The Disability in Strategies of Care (DISC) study involved more than 1000 migraine sufferers from 13 countries who were randomised to one of three treatment strategies for a series of six migraine attacks. In one treatment strategy (stratified care), patients received treatment according to their level of disability (as per their MIDAS score), while in the other two strategies (step care), all patients started with simple analgesics,
regardless of the severity of their migraine, and worked their way up to more potent, migraine-specific medications over time. The results of the study showed that a stratified-care approach in which patients were treated according to their MIDAS scores produced better outcomes (i.e. less disability time and greater pain relief) than traditional step-care approaches. In addition, a subsequent cost-effectiveness analysis showed that a stratified care approach was more cost-effective overall.
Ergotamine
Ergotamine is a drug originally derived from the ergot fungus that causes constriction of the blood vessels and has been used since the 1920s to treat migraine headaches.
Familial hemiplegic migraine
Familial hemiplegic migraine is migraine with aura including weakness on one side of the body, with the patient having at least one first- or second-degree relative with migraine with aura including muscle weakness.
Headache Care for Practising Physicians (HCPC)
Headache Care for Practising Physicians (HCPC) is an independent organisation that aims to improve the management of headache worldwide. The HCPC group has developed international guidelines designed to set new standards for the screening, diagnosis, management, treatment and follow-up of migraine patients in primary care.
Headache diary
A headache diary is a tool used by patients to record important information about their migraine both before and after they see a physician. It is useful in establishing the characteristics of patients’
headaches and the effectiveness of currently used treatments. It can also be used to monitor changes in the frequency, severity and disability of migraine and to identify migraine triggers.
International Headache Society (IHS)
The International Headache Society (IHS) is an international membership organisation for healthcare professionals committed to helping people whose lives are affected by headache disorders. In 2004, the IHS published the second edition of the International Classification of Headache Disorders, which comprises comprehensive classification and diagnostic criteria for headache disorders.
Landmark study
The Landmark study was a large-scale study assessing the diagnosis of headache in everyday clinical practice. The study included more than 1000 patients who consulted their primary care physician due to episodic headache. In the first instance, patients received a diagnosis from their primary care provider. Thereafter, those patients with newly diagnosed migraine or non-migraine primary headache received diaries in which to record their headache symptoms for up to three months or six attacks. Members of an expert panel (who were not aware of the original diagnosis made by the physician) used the information from the diaries to assign a headache diagnosis to each attack and to each patient.
The study found that the majority of patients (87%) who received a diagnosis of migraine by their primary care physician met the official criteria for either migraine (with or without aura) or migrainous headache.
Interestingly, 48% of patients who received a diagnosis of non-migraine by their primary care physician did in fact have migraine (with or without aura), showing that the use of a diary is very useful in diagnosing headache disorders.
Medication-overuse headache
Medication-overuse headache is caused by regular overuse (for more than three months) of one or more drugs used in the treatment of headache.
Headaches occur on at least 15 days per months, are variable in nature and often have characteristics that shift, even within the same day, from migraine-like headache to tension-type headache.
Menstrual migraine
Menstrual migraine relates to migraine attacks that occur in women around the time of menstruation. Menstrual attacks are mostly migraine without aura. Attacks that occur only with menstruation are known as pure menstrual migraine and occur exclusively on the first day of menstruation
(±2 days) in at least two out of three menstrual cycles. Menstrually related migraines have similar criteria, but can also occur at other times of the menstrual cycle.
Migraine Disability Assessment (MIDAS) questionnaire
The Migraine Disability Assessment (MIDAS) questionnaire is a patient-completed form that measures headache-related disability. It was developed for use in primary care and has been rigorously tested for reliability and validity in clinical and research settings. The questionnaire is designed to help both patients and physicians improve the management of migraine.
Migraineur
Migraineur is a designation sometimes used for a person with migraine.
New daily persistent headache (NDPH)
New daily persistent headache (NDPH) is a disorder that evolves from episodic tension-type headache. It is associated with daily or very frequent episodes of headache that lasts minutes to days. Pain is mild to moderate in intensity, usually occurs on both sides of the head, and is pressing or tightening in quality. With NDPH, pain does not worsen with normal physical activity. Mild nausea, photophobia or phonophobia may occur.
ODT
ODT is the abbreviated version of orally disintegrating tablet, a tablet that dissolves on the tongue without the need for the intake of fluids.
Osmophobia
Osmophobia is defined as an abnormal sensitivity to smell.
Phonophobia
Phonophobia is defined as an abnormal sensitivity to sound.
Photophobia
Photophobia is defined as an abnormal sensitivity to light.
Primary headache
A primary headache is one with no underlying cause. Primary headaches include migraine, tension-type headache and cluster headache.
Prophylactic medication
Prophylactic (preventative) medications are those taken on a regular basis to prevent the onset of an ailment such as migraine.
Secondary headache
A secondary headache is one that results from an underlying medical cause. Secondary headaches may be the result of a tumour,
meningitis, vascular disorders, systemic infection or a head injury.
Serotonin
Serotonin (5-hydroxytryptamine) is a neurotransmitter that is thought to be important in the mechanism of migraine headaches.
Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)
Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a syndrome that is characterised by short-lasting attacks that occur 3 to 200 times a day.
Pain lasts for five seconds to four minutes, is stabbing or pulsating in nature, and occurs on one side of the head.
Sinister headache
Sinister headaches are serious but rare secondary headaches.
Sinister headaches are new in onset and acute in nature, and may be associated with a range of other symptoms, including neurological deficit,
pain or tenderness, rash and/or vomiting. Such headaches may be associated with an accident or head injury, infection or hypertension. If sinister headache is suspected a full neurological examination should be undertaken.
Tension-type headache
Tension-type headache is the most common type of primary headache.
It may be episodic (infrequent or frequent) or chronic in nature and is characterised by pain that is bilateral, pressing or tightening in quality and of mild-to-moderate intensity. Pain does not worsen with routine physical activity and, although no nausea is present, photophobia or phonophobia may occur. Frequent episodic tension-type headache is characterised by at least ten episodes occurring on less than one day per month, while frequent episodic tension-type headache is characterised by at least ten episodes occurring on more than one but fewer than 15 days per month for at least three months. Chronic tension-type headache is similar in nature but occurs on at least 15 days per month for more than three months (i.e. occurring on at least 180 days per year).
Transcutaneous electrical nerve stimulation (TENS)
Transcutaneous electrical nerve stimulation (TENS) is a non-pharmacological method of treating chronic pain problems, including migraine. A TENS unit is a small battery-powered device with wires that attach to electrodes pasted to the skin. Small electrical stimuli are applied to the skin and interfere with the transmission of pain signals to the brain.
Trigger
A trigger is anything that can induce a migraine headache in a genetically predisposed individual. Common triggers include (but are not limited to) stress, changes in hormone levels in females, skipping meals,
certain odours such as perfume, sleeping late at weekends, sleep loss,
alcohol, and some foods, including cheese, chocolate and monosodium glutamate.
Triptans
Triptans are the first class of drugs designed to relieve migraine symptoms by directly targeting the disease pathology. Currently, seven triptans are available for the treatment of migraine, including zolmitriptan.
US Headache Consortium
The US Headache Consortium is a group composed of seven member organisations that have developed guidelines to prevent, treat, and improve the diagnosis of migraine.
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