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History is Key
- Prioritize the history in headache assessments, as physical exams are often unrevealing.
- Always ensure good follow-up to address any changes in the patient's history.
Comprehensive Pain History
- Start with a basic pain history, including location, characteristics, onset, and duration.
- Inquire about associated factors like nausea, vomiting, sleep disturbances, photophobia, and phonophobia.
Migraine as a Sensory Phenomenon
- Use the headache's location to localize the source of pain and generate a differential diagnosis.
- Migraine is a sensory sensitivity syndrome, not just a headache, marked by photophobia, phonophobia, and sometimes even smell/taste sensitivities.