Overview
Headaches are among the most common reasons for a neurology visit and span a wide range — from migraine and tension-type headache to trigeminal neuralgia and occipital neuralgia.
The aim is not only to relieve the attack, but also to reduce its frequency and intensity, grounded in current scientific evidence and without overpromising.
Symptoms & types
Recognising the headache type is the first step towards the right treatment:
- Migraine — moderate-to-severe, throbbing pain, often one-sided, with nausea or sensitivity to light and sound
- Tension-type headache — pressing, bilateral, milder pain
- Cluster headache — very severe pain around the eye
- Neuralgias (trigeminal, occipital) — sharp, electric-shock-like pain
Triggers
Migraine is often triggered or worsened by specific factors; recognising them helps with prevention:
- Stress and changes in routine
- Sleep disturbance or lack of sleep
- Hormonal fluctuations
- Dehydration or skipping meals
- Prolonged screen exposure or bright light
Diagnosis
Accurate diagnosis begins with a detailed history: the character of the pain, its frequency, triggers and impact on daily life.
The aim is to distinguish primary headaches (such as migraine) from secondary causes that require further investigation, and to recognise red-flag features that need urgent assessment or imaging.
Treatment approach
Migraine is treated on two fronts: acute management of the attack and preventive therapy that reduces frequency and intensity. The plan is individualised and may include medication and modification of contributing factors.
For chronic migraine (headache on 15 or more days per month), the approved botulinum toxin (Botox) treatment is available, usually every 12 weeks. For selected headaches and neuralgias, an occipital nerve block is used.
When to see a neurologist
- Emergency: a sudden, very severe 'thunderclap' headache — seek immediate assessment
- A new headache after 50 or a change in your usual pattern
- Headache with fever, neurological symptoms or after an injury
- Headaches that are worsening or not responding to usual measures