There is variation in the duration of attacks and it is important to emphasize that the duration of migraine may be different from the 4-72 hours specified in the IHS classification system. 1 Children have shorter headaches and some adults with chronic headaches may have prolonged migraine lasting much longer than 72 hours. Autonomic features such as watering from the eyes, redness of the eyes, Horner's syndrome, and runny nose are strongly indicative of cluster headache, but occasionally patients with migraine also have some autonomic features in and around the eyes. Nausea, vomiting, and photophobia are predominantly seen in migraine, rarely in other conditions. In migraine, movement often aggravates the headaches, whereas cluster headache patients like to move around.
Family history is important in diagnosis.
Status migrainosus refers to a severe attack of migraine lasting more than 72 hours. Patients are usually extremely sick with nausea, vomiting, and dehydration. This should be considered a medical emergency.