As mentioned before the diagnosis begins with history taking in a semi structured manner eliciting answers to questions regarding the physical symptoms of migraines. This is followed by a physical examination with particular attention given to cardiac and neurological signs and abnormalities which may be attributed to systemic diseases. Additionally investigations are also undertaken such as an electroencephalogram to exclude seizure as a cause. MRI’s or CT scans can also be done to rule out other causes of seizures or focal neurological symptoms. Finally, a lumbar puncture is also done in order to rule out similar symptoms which may be due to meningitis, encephalitis or subarachnoid hemorrhage (Pryse-Phillips, et al., 1997). Optometric testing for suspected migraine patients can also approach the disorder by examining it from refractive, binocular, neurologic and pathological angles each of which may have a role within the incidence of the headache (Abel, 2009).
In the article simplifying the diagnosis of migraine headache V. Martin created a mnemonic “SNOOP” to characterize the signs which are not only the most associated with headaches but also suggest causes for a more serious pathology. In this S is for systemic signs and symptoms, while N is for neurologic signs or symptoms followed by O which is for onset and the second O for old age with onset greater at an age greater than 40 and P for increasingly worsening symptoms (Martin, 2004 Issue 4).
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