This post is part of our "Key Questions" series, which we developed to help you understand more about what questions a Headache Specialist should ask during the process of diagnosis and treatment. Click here to visit the Key Questions Series page to see all the posts in the series and learn more!
Your medical professional should address the following questions and concerns regarding your personal and family history of headache and migraine symptoms:
Does anyone in your family have headaches?
I did not ask if they had migraine headaches or headaches as severe or frequent. Your parents may not have called it migraine. Likely, they were never diagnosed and properly treated. They may have called them "regular" headaches or "sinus" headaches or "stress" headaches or "sick" headaches or "menstrual" headaches or "hormonal" headaches or "cervicogenic" headaches or "MSG allergy" headaches or "skipped a meal" headaches. Some people hate to complain and just take a BC every morning or an Excedrin.
You inherit the genes for migraine and other primary headache conditions from your parents. If you have one parent with migraine, you have a 40-50% chance of inheriting the migraine disorder. If you have two parents with migraine, you have a 70-90% chance of getting the condition.
You may never remember if your parents had headaches, but if your children have headaches too, they got that gene somewhere. Aunts, uncles, grandparents, siblings and cousins should all be considered when asking about the family history of headaches. You inherit the gene for the disorder but not necessarily the same phenotype. This means that although your mother had headaches with her cycle that responded to Advil with no disability, yours could be much more severe and chronic and disabling with completely different accompanying symptoms.
PERSONAL HISTORY OF HEADACHE:
Can you recall when you first started complaining of headaches? Grade school? Earlier? Puberty? After starting your cycle? Did you have headaches as a teenager? Did you have headaches with your cycle as a teen? Did they start after the birth of your first, second or third child? At or around age 30? After age 50? After a trauma: physical or emotional? Did they start after an infection? After a hysterectomy?
Not when was your first "migraine" headache. Not when were you officially diagnosed with migraine. These are predicable times that migraines start to surface. Cluster headaches tend to start around age 30. New onset headache after age 50 is a red flag that warrants a more in depth investigation. If the pattern has been the same for a decade or two, episodic and recurrent, that is a very reassuring sign. Usually a brain scan is not necessary in those cases.
MISSED WORK DUE TO HEADACHE:
Have you ever missed work/school for a headache? Have you had to leave work/school for a headache? How often do you miss? Do you ever have to put your head down at work? Do headaches cause your productivity to slow down at work, school or home?