Prostrating attack

A prostrating attack is the VA rating schedule's phrase for a headache episode severe enough that a person has to stop what they are doing until it passes, typically by lying down away from light and noise. It appears in the criteria the schedule sets for migraine at 38 CFR Part 4, where the levels turn on how often such attacks occur and, at the more severe levels, on how prolonged they are.

The phrase comes from the regulation rather than from clinical vocabulary, so a treatment note is unlikely to contain the word itself. That gap is where records and criteria fail to meet. A note recording chronic headaches says nothing about frequency or about what an episode interrupts, and both are what the criteria ask about.

What closes the gap is ordinary description written down at the time: how often episodes happen, how long they last, what the person had to stop doing, and what treatment was tried and with what effect. A headache diary brought to an appointment gives the clinician something to record. Whether the criteria are met in a given case is the VA's determination on the evidence in the file.