MIDAS (Migraine Disability Assessment)
Migraine Disability Assessment (MIDAS) questionnaire. Quantifies headache-related disability over the past 3 months across work, household, and social activities. Guides treatment intensity.
Score interpretation
→ MIDAS Grade I (0–5): Minimal or infrequent disability. Simple analgesia (paracetamol, NSAIDs, aspirin); lifestyle advice; headache diary; neurology referral only if diagnostic uncertainty.
→ MIDAS Grade II (6–10): Mild disability. Specific migraine therapy (triptan) for acute attacks; identify and avoid triggers; consider prophylaxis if ≥4 attacks/month.
→ MIDAS Grade III (11–20): Moderate disability. Optimise acute therapy (oral triptan + NSAID); strongly consider preventive therapy (topiramate, propranolol, amitriptyline, or CGRP monoclonal antibody); neurology review.
→ MIDAS Grade IV (≥21): Severe disability. Urgent preventive therapy initiation; CGRP antagonists (erenumab, fremanezumab, galcanezumab) if 2 preventives failed; specialist headache clinic referral; CBT and multidisciplinary support.
Interpretation bands for the MIDAS Score. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Erenumab · CGRP Receptor Monoclonal Antibody — Migraine Prevention
- Atogepant · CGRP Receptor Antagonist (Gepant — Migraine Prevention)
- Propranolol (Migraine Prevention) · Beta-Blocker — Migraine Prophylaxis
- Thiamine (IV/IM — Pabrinex) · Vitamin B1 (Thiamine) — deficiency treatment / Wernicke's encephalopathy prevention
- Anthrax Vaccine · Vaccine (Bacterial — Anthrax Prevention)
- Edoxaban (AF Stroke Prevention / VTE) · Direct Factor Xa Inhibitor (DOAC)
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.