diagnosis

diagnosis

Effective treatment is only possible if the disease is precisely known. This means that a detailed diagnosis must first be made according to the criteria of the International Headache Society. Whether the criteria for the respective category are met can only be found out through a detailed discussion between doctor and patient about the symptoms.

In addition, the patient's entire medical history must of course be examined and a general and a neurological examination must be carried out. This is the basis for a relationship of trust between the patient and the treating doctor: If the patient feels taken seriously and his illness, he will also be willing to actively participate in the prevention. This is understandably not achieved in a ten -minute conversation.

Mostly more than a headache

In the typical case, the patient not only suffers from one, but two or even more shapes of headache. For this reason, the patient must know which shape of the headache he should specifically treat with which measure. The headache patient must be able to use the recommended therapy for the respective headache form outside of practice without a doctor.

For this reason, not only the doctor must know the diagnostic criteria of the different headache diseases, but also the patient. To do this, the patient must get a headache questionnaire, headache calendar, information material and a list of patient guides. Also ideal is a treatment pass that provides information about the characteristics of the most important shapes of headache, contains a headache calendar and on the last pages offers the opportunity to outline the different therapy suggestions for the different shapes of headache.

It is impossible for the patient to understand and remember all information about the different shapes of headache and the respective treatment in different situations during a consultation hour session. For this reason, the doctor must ensure that written records are made during the office hour, which the patient can then take home.

Just no diagnostic zigzag

A common mistake in migraine therapy is unfortunately that the patient is unsettled by his diagnosis. Because many doctors repeatedly initiate further diagnostic measures during the course of treatment. Then, for example, the sinuses, the eyes, the temporomandibular joint or the cervical spine are examined again. The patient then naturally realizes immediately that the doctor is not sure in his diagnosis, otherwise he would no longer need any further examinations. The motivation of a patient to engage in therapeutic measures - which are obviously on uncertain ground - is logically low. Either you have migraines or you have no migraines. The doctor and patient must therefore commit themselves before starting therapy and then take a consistent way. Changes are only justified when new headache characteristics arise.

The diagnosis of migraines

I have already explained the main forms of migraines: the migraines with and without aura. It has already been mentioned that there are cases in which the auras symptoms take longer than usual and thus reach into the headache phase. You now also know that the migraines can run without headache and only with auras symptoms. Before you learn something about other migraine forms, let me say something fundamentally.

This division into “drawers” ​​is an attempt to get a diverse clinical picture as the migraine diagnostically under control. But we should always keep in mind that the migraines do not care about the division at all. In other words, the dividing lines drawn here are not available in the reality of the disease. They blur on the edges, become blurred, overlaps each other. The migraines from the textbook or the classification of the international headache company is a helpful setting box for diagnoses, not nature itself. The “picture-book migraine” must always be measured by the experience of the patient.

Under this link you will find the current classification of the International Headache Society in the current second edition.

You can find the individual types of migraine here

If you are affected yourself, you should keep a diagnostic headache calendar. If you do this diligently, you can continually determine your headache type and discuss it with your doctor.

With retrospectively, you can enter your experiences in the diagnostic headache questionnaire. It helps them find out whether they suffer from the type of voltage from a migraine or headache.