How to Asses Severity of Migraine?

After diagnosis of migraine headache is confirmed the assessment of severity of migraine headache is very important. The assessment of severity of migraine headache is generally done by asking the patient to answer a set of questionnaire known as “The Migraine Disability Assessment Score (MIDAS)”. This (The Migraine Disability Assessment Score) is a well-validated, easy-to-use tool which is most commonly used and very practicable.

The following are the MIDAS questionnaire:

  1. How many days did you miss school or work because of your headaches in the last 3 months?
  2. How many days was your productivity reduced by half or more because of you headaches in the last 3 months (excluding the days of question 1 or number of days you missed school or work due to headache)?
  3. How many days you did not do household works because of headache in the last 3 months?
  4. How many days in the last 3 months was your productivity in household work reduced by half or more due to your headaches (do not include the days you counted in the question 3 where you did not do any household works)?
  5. On how many days did you miss family, social or leisure activities because of your headaches in the last 3 months?
    • On how many days did you have a headache in the last 3 months (if headache lasted for more than a day you should count each day)?
    • On a scale of 0-10, on an average how painful were these headaches? (Where 0 = no pain at all and 10 = severe most pain or pain as bad as it can be).

The Migraine Disability Assessment Score or MIDAS (questions 1-5 are used for calculating MIDAS score):

Grade-I – 0-5: minimal and infrequent disability

Grade II – 6-10: mild and infrequent disability

Grade III – 11-20: moderate disability

Grade II – more than 20: sever disability.

Instructions: Answer the above questions about all types of headaches (including migraine and non migraine type of headaches) you have had in the last 3 months.

N.B. The management of migraine headache to large extent depends on the severity of the headache.