6 Conditions That Can Look Like Migraine and Vice Versa

Migraine can sometimes be misdiagnosed. Conditions like cluster or hypnic headaches can be mistaken for migraine. Share your symptoms with your doctor to rule out other conditions.

Migraine can go undiagnosed or misdiagnosed, leaving many without the proper care they need. There are several conditions that can be mistaken for migraine, even by health professionals.

Here are six conditions that can look like migraine, plus what to ask medical staff to get your diagnosis right.

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1. Cluster headache

Cluster headache is a rare primary headache disorder that can be confused with migraine due to the severe head pain it causes.

Cluster headache attacks last anywhere from minutes to a few hours. They may happen once every other day up to 8 times a day.

The primary symptom of a cluster headache is excruciating, one-sided head pain.

Other symptoms can include:

• red or watery eyes
• drooping or swelling eyelids
• congestion or runny nose
• facial sweating
• restlessness
• agitation

2. Hemicrania continua

Hemicrania continua (HC) is a primary headache disorder that can be easily confused with migraine.

Hemicrania means “one side of the head” and continua means continuous. As the name suggests, HC involves continuous one-sided head pain.

Although migraine often features one-sided head pain, it’s not uncommon for the head pain to switch sides or move around to different parts of the head. With HC, head pain is consistently on the same side of the head.

Other symptoms of HC include:

• non-stop pain
• eye redness
• watery eyes
• a drooping eyelid on the same side as the pain
• nasal congestion
• sweating
• restlessness or agitation

An HC diagnosis is confirmed by a positive response to a medication called indomethacin.

3. Low cerebrospinal fluid (CSF) pressure headaches

Low cerebrospinal fluid (CSF) headaches are a rare type of secondary headache. They may be due to low CSF pressure or a CSF leak. Leaks can be caused by a puncture in the protective tissue layers covering the brain and spinal cord.

Low CSF headaches typically start after you’ve had surgery or an injury. The main symptom is an ongoing headache that won’t go away. These headaches tend to worsen when you’re up and about and are often relieved when lying down.

Other symptoms include:

• dizziness
• brain fog
• ringing in the ears
• nausea
• loss of taste and smell

4. Hypnic headache

Hypnic headaches, also known as “alarm clock” headaches, are a rare primary headache disorder that causes people to wake up with head pain in the middle of the night.

Although people with migraine can wake up to a migraine attack, hypnic headaches are unique because they only come on at night.

Hypnic headaches typically occur in people over 50 years old but can affect younger people as well. They tend to last between 15 minutes and 4 hours and aren’t usually accompanied by general restlessness or insomnia.

The primary symptom of hypnic headaches is head pain. However, some people experience migraine-like symptoms, including nausea and sensitivity to light and sound.

5. New daily persistent headache (NDPH)

New daily persistent headache (NDPH) is another primary headache disorder that can look very similar to chronic migraine.

With NDPH, you get a headache one day out of the blue that won’t go away. People with this type of headache disorder can usually remember the exact day and time as well as what they were doing when the headache first started.

NDPH can look very similar to migraine, including throbbing pain, sensitivity to light and sound, and nausea. It can also present as a constant tension-type headache.

Some people with chronic migraine have daily background head pain in addition to migraine attacks. This can make it difficult to distinguish the two diagnoses.

6. Thunderclap headache

Thunderclap headache is a very serious secondary headache that’s important to be aware of.

This type of headache comes on suddenly and typically reaches maximum intensity within 1 minute. It’s often described as the “worst headache ever” by those who experience it.

This type of headache requires emergency medical attention because it can be caused by a serious secondary issue, like a brain aneurysm.

What to ask your doctor

If you feel that you might have been misdiagnosed with the wrong type of headache disorder, it’s important to discuss it with your doctor or a headache specialist.

You can consider each headache type’s symptoms and diagnostic criteria before your appointment, then bring that information with you to discuss what applies to your own experience.

Keeping a headache diary and tracking your pain and symptoms will help your doctor make an accurate diagnosis and develop a treatment plan that’s best for you.

Takeaway

While migraine can look like other headache disorders, it has unique characteristics. Getting the right diagnosis is essential so you can access the treatments that work best for you.

Open communication with your doctor can help you determine whether your symptoms are due to migraine or another headache disorder.