Headache is ubiquitous in the United States with over 90% of adults having had at least some degree of headache within the last year. Migraine occurs in approximately 17.6% of females and 5.7% of males for a total of 13% of the population. This translates to 8.7 million females and 2.6 million males who are occasionally moderately to severely disabled by their migraine headaches.

Migraine frequently goes undiagnosed by a physician. Only 29% of males and 41% of females are properly diagnosed. Migraineurs most likely to go undiagnosed are:

1. Males
2. People living in low income households.
3. People who do not experience aura, vomiting, or disability.

Headache has a big impact on society being the primary complaint in over 10 million consulting patients. The annual cost of lost labor is approximately 17 billion dollars. Forty percent of Americans experience significant headaches.

A new headache classification was introduced by the International Headache Society in 1988 and published in the international journal Cephalalgia that year. It breaks headache disorders into 13 categories headed up by migraine, tension-type headache, and cluster headache. It differentiates these headaches from secondary or organic headaches. To diagnose migraine without aura one must have had at least five attacks lasting between 4 and 72 hours. At least two of the following four characteristics must be present:

1. Unilateral location (one side of the head)
2. Pulsating quality of the pain (to the beat of your heart)
3. Moderate or severe intensity
4. Aggravated by mild activity (such as bending over or walking up stairs)

At least one of the following must be present:

1. Nausea or vomiting or both
2. Photophobia and phonophobia (both sensitivity to light and sound)

Migraine with aura (classical) begins with visual changes such as colored, zig-zag lines, blinking and moving across the visual field for 20-30 minutes, followed by a unilateral headache.