A Visit to the Clinic - What to expect                                                    

There are many different types of headache disorders and sorting out the symptoms is necessary in arriving at the correct diagnosis.  To do this the doctor must obtain detailed historical information from the patient concerning the nature of the headaches.  A good clinician is, among other things, a sleuth.  A thorough history is the keystone of diagnosis and all other tests are confirmatory.   Thus, the patient should be well prepared to impart as much information as he or she can regarding their headache complaint.  Although this is not an exhaustive list some specific information to bring to the appointment should include:

• Headache severity – severe/incapacitating or moderate or dull/mild

• Headache duration – minutes, hours, days, etc.

• Headache location – where on the head is the pain located?  One side or both sides; front, back, neck, etc.

• Character of headache pain - throbbing, dull, aching, stabbing, piercing, etc.

•  Associated symptoms – nausea, vomiting; sensitivity to light, sound, odors, movement, position, posture, activity; numbness, tingling or weakness of any part of the body or face, speech disturbances; visual disturbances, etc.

• Any symptoms that might occur prior to the onset of the attack, heralding the attack.

•  Attack triggers – activity, stress, food, situations, weather changes, hormonal fluctuations, medications, etc.

• Prior and current treatments – preventive and/or abortive or symptomatic.

• Current Medications – Bring a list of current medications whether for headache or other medical issues.

• Current and past medical problems. 

The initial consultation may take 45 to 90 minutes depending upon the complexity of the headache complaint.  The doctor might want to obtain ancillary tests including brain or neck imaging such as MRI or CT scans or MR angiogram.  Blood test might also be necessary. 

At the end of the consultation, a diagnosis will be advanced and a treatment plan will be prescribed which may or may not include medications.  All patients are asked to maintain a headache diary to maximize objective documentation of headache events.  This gives the doctor the best advantage at effective treatment and controlling the headaches.  Follow up appointments are scheduled at various time intervals to monitor progress and address any issues that emerge during treatment.  A consultation visit might also simply include a diagnosis and suggested treatment plan to help the referring doctor manage the patient’s headache disorder.