Diagnosing someone with a migraine disorder is not as easy as determining the presence of other conditions.

A doctor can take an x-ray and find out if one suffers from a broken leg. It's an objective reality that can be viewed. There usually isn't a lot of guesswork in diagnosing snapped bones!

A physician can take a blood sample, have it tested, and determine that you are anemic. Again, it's an objective measure. There are established norms for iron in the blood, and the test can make precise measurements. Some may be "borderline" cases, but more often than not, a professional can make a "cut and dried" determination.

Migraine syndromes are different. There is no real objective evidence that can be viewed of tested. You may suffer from the most unimaginably severe migraine headaches on record, but if a doctor should run you through an MRI, CAT scan, or x-ray, nothing will look unusual. There will be no concrete evidence demonstrating the presence of migraine problems.

We know a lot about the human body, but we still have questions. Migraine syndromes are one of those questions. We know what they are and we know that they happen, but we don't really know exactly what causes them. Sure, we can pinpoint a few triggers that seem to be related, but we cannot actually discern the physical reality underlying the symptoms.

Some have developed theories about blood flow, sensitive blood vessels and involuntary vessel restrictions to explain migraines. Others use the metaphor of an "electrical storm," conjuring up images of microscopic lightning bolts to explain the illness. Regardless of the theory, however, the proof is never in a scan or a test. Theory is theory, and that is a long step from objective reality or solid proof.

Thus, doctors must treat the problem differently. Instead of searching for signs of a migraine, they must first rule out other possible causes for the symptoms. The nature and symptoms of migraine attacks varies, so this can require quite a bit of thought, patient questioning and testing. Then, the doctor learn enough from the patient to make sure what is happening "sounds like" or "appears to be" a migraine disorder.

The process of migraine diagnosis is interesting. Though the physician may be the most recognized living symbol of science in our culture, he or she must bring a bit of artistry and sense of feel to the process in order to determine whether one is suffering from migraine headaches or headaches of some other origin.

In time, we may unlock the secrets of the migraine and be able to devise a foolproof test to tell us whether or not one has a migraine or something else. As of today, however, we are left with a list of symptoms, a process of elimination, patient self-reporting and the physician's skills to reach a determination.