Chronic migraine is diagnosed by frequency: headache on fifteen or more days per month for more than three months, with at least eight of those days having migraine features. It is established by counting days rather than by any scan or blood test.
Chronic migraine is diagnosed by frequency: headache on fifteen or more days per month for more than three months, with at least eight of those days having migraine features. It is established by counting days rather than by any scan or blood test.
The threshold is specific and it is about frequency rather than severity. Fifteen or more headache days a month, sustained over more than three months, with at least eight showing migraine features such as throbbing pain, one-sided location, nausea, or sensitivity to light and sound. Severe migraines occurring four days a month are episodic migraine, not chronic, however disabling each attack is. That distinction determines which treatments you are eligible for, which is why the count genuinely matters.
Almost nobody accurately recalls how many headache days they had last month, and people generally underestimate. A simple calendar tally kept for four to eight weeks, marking any day with any headache and noting which medication was taken, transforms the consultation. It establishes whether the threshold is met, reveals patterns around sleep, menstrual cycle or work, and provides the baseline against which any preventive treatment will later be judged.
A large proportion of chronic migraine involves medication overuse headache, where frequent use of acute painkillers converts an episodic problem into a daily one. Recording exactly what you take and on how many days is therefore part of the diagnosis rather than an afterthought. The assessment also excludes secondary causes: red flags such as new headache after fifty, headache worse lying flat, or an abnormal examination prompt imaging, which is arranged externally since these offices have no imaging suite.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: MedlinePlus: migraine; American Academy of Neurology; National Institute of Neurological Disorders and Stroke.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.