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According to IHS, a common migraine headache, also known as a migraine without aura, is defined by the specific criteria found below.

Frequency

The patient must have at least five of these headaches.

Duration

The headache, excluding attendant symptoms or prodromes, must last a minimum of four hours, up to seventy-two hours.  Headaches that last over seventy-two hours generally require immediate medical attention in order to rule out other, more dangerous conditions.

Pain Descriptors

In order to be classed as a migraine a headache must include at least two of four different qualities of pain:

1) The pain is one-sided; the headache is primarily on one side of the head.
2) The pain is not constant; it throbs, pounds, or pulsates.
3) The pain must be of moderate or severe intensity, to the point where the sufferer is inhibited in daily activity, potentially to the point of being temporarily disabled.
4) The pain is increased, sometimes only slightly, by routine physical activity like bending over, climbing stairs, or moving quickly.

Side Effects

Headache pain must be accompanied at least one of four common side effects:

1) Nausea
2) Vomiting
3) Photophobia – sensitivity to light
4) Phonophobia – sensitivity to sound

Secondary Exclusions

Appropriate medical testing, such as a MRI or CAT scan, and/or a physician’s exam must be conducted to rule out other conditions that may have caused the headache.

These criteria have helped simplify the diagnosis of migraine for many.  However, because migraines are historically associated with extremely high levels of pain, people suffering from moderate migraine may not realize that is what they are experiencing.

Aura effects develop over about five minutes and generally occur from twenty minutes to an hour prior to the start of a headache.  They are a symptom of what used to be called “classic migraine”.  Recently, medical practitioners have moved to a more scientifically accurate term, migraine-with-aura.  Only about 15-20% of migraineurs consistently experience any kind of aura before a headache begins.

Aura Effects

Most migraine auras are visual.  These auras are called positive visual phenomena because, rather than their vision fading or going dark, people who experience them see things. Examples include:

-Auras or Haloes: a nimbus of light or haze surrounding objects, particularly light sources

-Flashing or Floating Lights:  colored or white (rarely dark) spots that appear to move

-Lightning Bolts: a jagged or zigzag line that sparkles and/or arcs over the field of vision; with the frequency or severity increasing over time until the person can no longer see (a whiteout); This effect usually stops with the onset of headache pain.

-Photophobia: an extreme sensitivity to light; this effect frequently lasts the duration of the headache

Most auras last less than an hour.  Migraineurs who experience auras that last more than an hour are said to suffer from migraines with prolonged aura.  In some cases a migraineur may experience aura effects without a headache developing, but it is still considered to be a symptom of chronic migraines.  At various times the same person may experience all three variations, migraine with aura, migraine with prolonged aura, or typical aura without headache.

How can migraineurs make sure their homes aren’t giving them headaches?  Clear out known offenders, one at a time.  Things to look out for:

* Common household allergens, things like mold, mildew, and dust and dust mites.  Changing the air filter and switching to cotton sheets both help with these household horrors.
* Tobacco smoke.  Whether it’s a cigarette or a pipe, ask smokers to take it outside.
* Carbon monoxide.  This odorless, colorless, and poisonous gas can come from poorly ventilated fireplaces, furnaces, gas appliances, or cars running in the garage.  Installing carbon monoxide detectors near possible carbon monoxide sources and checking the batteries regularly may not only prevent migraines, it may save a life.
* Water-borne impurities.  Eliminating potential chemical trouble from the faucet can be as simple as purchasing a small water filtering pitcher for drinking water.  For extremely sensitive people a household filtration or softener system may be the answer.
* Pesticides.  No one wants to share their home with insects and rodents, but the chemicals used to repel them may be inviting in migraines.  Temporarily eliminating pesticide use or switching to organic pest control may help.
* Pet dander.  Migraineurs who are allergic to their pet may want to consider allergy treatment to help them live with the problem.
* Cleaning solutions.  The number and variety of harsh chemicals found in cleansers is boggling.  Switching to all-natural cleansers may clean up migraines.

Deciding if you are able to go out when you have a migraine is a tough decision.  You are in pain, you do not feel well, and more likely than not you are not thinking clearly.  The ability to determine when you are okay to leave home when you have a migraine is a big part of learning to manage your condition.  Here are a few things to take into consideration when deciding if you are in or out for the day.

How do you feel?

Yes, you have a migraine, but can you function?  Only you know your personal headache pattern, is it likely to get better or worse from where it is now?  What’s your mood?  Are you sufficiently enthused about the day to be willing to function while in pain?

What did you take?

Stop and think about your pain relief for a minute.  Did you take an over-the-counter remedy, or something a little stronger?  If it was a prescription medication, go read the label and see what it says about driving and operating heavy machinery.  If you aren’t supposed to do those things, it’s probably a good idea to hang out at home.  This is not a hard and fast rule since only you know how you react to a medicine, particularly one you are familiar with.  If you don’t think you’ll be impaired by your medications, great, but really think about it first.

Why?

Why are you going out?  Basically, you have to decide how important it is that you go out.  Work is important, but not if you have a job where potentially impaired function can be dangerous.  Errands can always be run later.  The class play?  That might be worth it, if you can handle it.