In approaching a patient with the headache disorder because headaches can have many causes. What doctors tried to do is first rule out potentially serious causes of headache on the rarest of occasions a headache maybe a presenting feature uva very serious disorder like a brain tumor a stroke. The reality is that although many the patients we see arrived worried that they’re suffering from something serious like a brain tumor. Very often most of an almost all the time we can reassure people that their headaches have about nine cause they’re not gonna shortened someone’s life they just reduce the quality of life of people who have the where to buy steroids headache disorder. So our approach is to make a specific headache diagnosis. We rule out serious causes by taking a history and doing a careful neurological examination and occasionally we need to do some diagnostic tests to rule out serious disorders as well. And then the diagnosis of migraine itself is based on the future is above the headache. The one-sided throbbing pain the associated symptoms the disability the time course the headaches. By definition we said we don’t diagnose migraine in till somebody’s had at least 5 characteristic attacks in their lives. Frequency varies vary widely from person to person. So in the general population the average frequency is one or two attacks per month. But in people who seek medical care frequency can be much higher. So I will often see patients who have had eggs almost every day. The issuer frequency is not so important diagnostically but it’s very important in deciding how to treat the disorder. So if someone has one had a good month treatment is usually about learning to identify and avoid triggers to prevent headache and then having effective medications to take when a headache begins to relieve pain and restore people’s ability to function.