Migraine-like symptoms can also be caused by meningitis, stroke, brain tumor, aneurysm, or hemorrhage—all very serious conditions that require immediate treatment. A migraine diagnosis should rule out these and other conditions during a thorough discussion between physician and patient and, in some instances, a variety of physical and neurological exams and tests.

Your doctor may order a computerized tomography scan (CT) or  magnetic resonance imaging (MRI). If there are concerns about an underlying problem, doctors could order a lumbar puncture (also called spinal tap), although this procedure is not considered a common test migraine.

Once your doctor rules out more serious brain problems, there is no test that can positively confirm migraine. A diagnosis is based on the symptoms a patient experiences. According to criteria established by the International Headache Society, for example, a person suffers from migraine without aura if they have had at least five episodes of headache lasting four to 72 hours that were accompanied by either nausea and vomiting or sensitivity to light and sound and had at least two of the following characteristics:

  • pain on one or both sides of head
  • throbbing or pulsating pain
  • pain severe enough to limit normal activities
  • pain that gets worse with physical activity, such as walking or climbing stairs