Common migraine ("migraine without aura"): localization of the initial pain of attack

In classical migraine ("migraine with aura"), the attack pain is usually initially felt in the oculo-fronto-temporal area (around 90% of the cases). A fronto-temporal onset of pain is in other words a typical trait of classic migraine. The initial location of pain in common migraine ("migraine without aura") is not so well known. In the present study, 32 migraine patients and 29 cervicogenic headache patients were compared as for localization of pain onset. Twenty-four of 32 migraine patients (75%) felt the initial pain in the oculo-fronto-temporal area; in 28 of 32 cases the onset was in the "anterior" parts (88%). The corresponding figures in the cervicogenic group were: 5 of 29 (17%) and 6 of 29 (21%) respectively. There is thus a clear-cut difference between the two groups in this respect. The initial localization of pain can probably also be used for diagnostic purposes. The similarity between classic and common migraine in this respect is striking.