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Individuals suffering from migraine headache, or migraineurs as they are often referred to, and the clinicians treating them are well-informed of the excruciating and debilitating nature of such episodes. However, the theoretical definition of migraine, i.e. a primary, recurrent and mostly unilateral headache characterised by throbbing pain,1 also seems to describe the presentation of often non-migraine headaches, thus somewhat failing to encompass the actual incapacitating nature of the condition. Importantly, migraine is diagnosed according to criteria stipulated by the International Headache Society (IHS)1 1) if patients experience 5 or more attacks of unilateral, pulsating, moderate to severe pain that last 4–72 hours, 2) if such attacks are associated with nausea and/or photoand phonophobia, and 3) if they are aggravated by, or prevent patients from engaging in normal routine physical activity.1 Interestingly, migraine is regarded as episodic or acute if it occurs less than 15 times per month, while chronic migraine is defined as more than 15 episodes per month continuing for more than 3 consecutive months.2 Considering that a single attack can last up to 72 hours,1 and that clinicians often design therapeutic intervention based on accurate diagnoses, this classification seems somewhat counterintuitive. Indeed, patients will often regard a single migraine attack as one too many, with 15 migraine episodes per month essentially equating to permanent incapacity.3,4

All headaches are not equal: A review of migraine as a state of brain dysfunction