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Table 2 Clinical features warning of a possible underlying disorder

From: Consensus of the Hellenic Headache Society on the diagnosis and treatment of migraine

• Headache that peaks in severity in less than five minutes
• New headache type versus a worsening of a previous headache
• Change in previously stable headache pattern (e.g. progressive headache, worsening over weeks or longer)
• Headache that changes with posture (e.g. standing up)
• Headache awakening the patient
• Headache precipitated by physical activity or Valsalva manoeuvre (e.g. coughing, laughing, straining)
• First onset ≥50 years of age
• Focal neurological symptoms or signs
• Trauma
• Fever
• Seizures
• History of malignancy
• History of HIV or active infections
  1. Adapted from Mitsikostas et al., 2015 [5] with changes