Migraine is diagnosed clinically, from the pattern of attacks rather than from any scan or blood test. The core features are recurrent headache lasting hours to days, often one-sided and throbbing, worsened by activity, with nausea or sensitivity to light and sound.
Migraine is diagnosed clinically, from the pattern of attacks rather than from any scan or blood test. The core features are recurrent headache lasting hours to days, often one-sided and throbbing, worsened by activity, with nausea or sensitivity to light and sound.
A migraine attack typically lasts between four and seventy-two hours untreated. The pain is frequently one-sided and pulsating, is moderate to severe, and is made worse by ordinary physical activity such as walking upstairs. It is accompanied by nausea or vomiting, or by sensitivity to light and sound, and often both. People generally want to lie still in a dark, quiet room, which is the opposite of the restlessness seen in cluster headache. Recognising that combination is what makes the diagnosis, and it is made from the history rather than from testing.
About a third of people with migraine experience aura, which is a reversible neurological disturbance developing over five to twenty minutes and lasting less than an hour, usually just before or as the headache begins. Visual aura is commonest: zigzag lines, shimmering, or a blind spot that expands. Sensory aura produces tingling spreading up an arm or across the face. Speech disturbance can occur. Aura that comes on suddenly rather than spreading gradually, or that lasts beyond an hour, needs assessment rather than assumption, because that pattern points elsewhere.
Migraine is a diagnosis of pattern, but secondary causes are considered before settling on it. Red flags that prompt imaging include a first or worst headache after age fifty, a headache that arrives explosively and peaks within seconds, headache worse when lying flat or with coughing and straining, headache with fever and neck stiffness, a change in an established pattern, or an abnormal neurological examination. Imaging is arranged at an imaging centre since these offices have no imaging suite, and the report is reviewed here.
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.