POUND Mnemonic for Diagnosis of Migraine Headache



P - Pulsating quality - Throbbing or pulsatile rhythmic pain, reflecting the vascular nature of migraines, typically worse with activity.

O - One-day duration (4-72h if untreated)

U - Unilateral - Often unilateral, however can often switch sides and sometimes become bilateral.  Typically affecting the temple, eye or forehead.

N - Nausea or vomiting - Nausea is a hallmark symptom, with vomiting in severe cases

D - Disabling - Significantly impairs daily activities- work, school or social activities.



Diagnostic Likelihood Ratios:

≤2 features - LR 0.4;   

3 features - LR 3.5;   

≥4 features - LR 24 



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