American Board of Internal Medicine (ABIM) Certification Practice Exam

Which feature is NOT part of the criteria for diagnosing a migraine?

1. Throbbing nature

2. Aggravation with physical activity

3. Unilateral location

4. Progressive increase in duration

The correct answer is: Progressive increase in duration

The criterion for diagnosing migraines typically includes specific characteristics about the nature, location, and triggers of the headache. One key aspect is that migraines often present with a throbbing or pulsating quality, which is significant in differentiating them from other types of headaches. Additionally, migraines are commonly exacerbated by physical activity, leading to increased pain when engaging in everyday activities. Unilateral location is also a crucial feature, as migraines frequently occur on one side of the head, although they can also be bilateral in some cases. However, the progressive increase in duration is not a standard feature of migraine diagnosis. While migraines can vary in duration, they typically last from 4 to 72 hours if untreated and do not consistently exhibit a progressive increase in how long each attack lasts. Thus, the fact that progressive increase in duration is not part of the criteria reinforces that the essential features used to diagnose migraines focus more on the characteristics of the headache itself rather than changes in duration over time.