ICHD-3 diagnostic criteria – episodic migraine with/without aura

1.1 Migraine without aura^{[IHS, 2018]}
A. At least five attacksa fulfilling criteria B–D.
B. Headache attacks lasting 4–72 hours (when untreated or unsuccessfully treated).b,c
C. Headache has at least two of the following four characteristics:

1. unilateral location
2. pulsating quality
3. moderate or severe pain intensity
4. aggravation by or causing avoidance of routine physical activity (e.g., walking or climbing stairs).

D. During headache at least one of the following:

1. nausea and/or vomiting
2. photophobia and phonophobia.

E. Not better accounted for by another ICHD-3 diagnosis.
^aOne or a few migraine attacks may be difficult to distinguish from symptomatic migraine-like attacks. Furthermore, the nature of a single or a few attacks may be difficult to understand. Therefore, at least five attacks are required. Individuals who otherwise meet criteria for ‘1.1 Migraine without aura’ but have had fewer than five attacks should be coded ‘1.5.1 Probable migraine without aura’.
^bWhen the patient falls asleep during a migraine attack and wakes up without it, duration of the attack is reckoned until the time of awakening.
^cIn children and adolescents (aged under 18 years), attacks may last 2–72 hours (the evidence for untreated durations of less than two hours in children has not been substantiated).

1.2 Migraine with aura^{[IHS, 2018]}
A. At least two attacks fulfilling criteria B and C.
B. One or more of the following fully reversible aura symptoms:

1. visual
2. sensory
3. speech and/or language
4. motor
5. brainstem
6. retinal.

C. At least three of the following six characteristics:

1. at least one aura symptom spreads gradually over 5 minutes
2. two or more aura symptoms occur in succession
3. each individual aura symptom lasts 5–60 minutesa
4. at least one aura symptom is unilateralb
5. at least one aura symptom is positivec
6. the aura is accompanied, or followed within 60 minutes, by headache.

D. Not better accounted for by another ICHD-3 diagnosis.
^aWhen, for example, three symptoms occur during an aura, the acceptable maximal duration is 3×60 minutes. Motor symptoms may last up to 72 hours.
^bAphasia is always regarded as a unilateral symptom; dysarthria may or may not be.
^cScintillations, and pins and needles, are positive symptoms of aura.

Reference:
Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018; 38 (1): 1–211.