Presentation

Headache-Migraine Consultation

Headaches are very common.
Headaches are one of the most frequent reasons for consulting a general practitioner, whether the pain is sudden and severe, or recurs impacting one’s quality of life.

Headaches can have many causes, from the most routine to the most serious.

More than 200 different types of headaches are defined in the classification of the International Headache Society (IHS) on the basis of very specific criteria.

Migraines, the most common form, are thought to affect up to 15% of the population. The World Health Organisation considers migraines to be one of the 10 most disabling conditions.

However, it is estimated that one migraine sufferer in four is not diagnosed.

The intensity of the headache is not necessarily related to the seriousness of the condition.

When to consult an emergency department ?
If your headaches started recently, and especially if the onset was sudden or extreme, or if you have neurological trouble, you must seek medical advice or go to an emergency department.

When to see your doctor ?

In most cases, these are headaches that recur at regular intervals with a return to normal after each episode, giving the false impression that they are not serious.

It is however essential that the condition be diagnosed as part of a medical consultation solely for this purpose.

It is also important to avoid self-medicating since this may, in some cases, make headaches chronic (i.e. recurrent), or resistant to standard treatment.


When to consult a specialist or ask for a Headache-Migraine consultation ?

  • Difficulty in determining a precise diagnosis for the headaches
  • Unusual headaches or recent development of headaches
  • Chronic, almost daily headaches (more than 15 days per month)
  • Difficulty treating the condition
  • Failure of two migraine attack treatments
  • To get help selecting a disease-modifying treatment for migraines
  • For certain rare forms of headaches, such as cluster headaches, hemicrania continua, trigeminal neuralgia, occipital neuralgia, post-traumatic headaches, and so on.


The consultation time is standard and the first visit includes an in-depth discussion with the doctor and a full physical examination.

Keeping a “headache diary” is essential to confirm the diagnosis and to follow-up on treatment strategies.

Treatment has two objectives:

  • Controlling symptoms during attacks: this treatment must be effective in under two hours, have no troublesome side effects, and must enable the patient to return to their normal activities.
  • Increasing the interval between episodes so that the overall impact on day-to-day life is reduced as much as possible. Treatment is selected on an individual basis, taking into account the various factors that may worsen or enhance headaches. Strategies may include medication and/or drug-free treatment approaches. Patient compliance with treatment is essential. Once appropriate treatment has been started, the treating physician takes over patient care.

 

Links

World Headache Alliance

International Headache Society

European Headache Federation

Société Suisse pour l’Etude des Céphalées

Last modified on December 15th, 2015.

Interview by Dr. Sylvie Chauvet, Pain Specialist.

Our specialists

Centre Médical de Meyrin

Dre Sylvie Chauvet +41 22 719 74 80