Headaches & Migraines
Recurring headaches can interrupt work, sleep and everyday life. A careful neurological assessment can help identify the headache type, rule out concerning causes when needed and guide an individual treatment plan.
Enquire about a consultationWhy do headaches happen?
A headache is pain or discomfort in the head or upper neck. There are several distinct headache disorders, and the pattern of symptoms often helps establish the cause.
Most headaches are not caused by a serious underlying illness. However, new, changing or unusually severe symptoms should be assessed appropriately. Understanding how often headaches occur, where the pain is felt and which other symptoms accompany it helps guide diagnosis.
Different types of headache
Headache types can overlap in their symptoms, but treatment may differ depending on the diagnosis.
Migraine
Often causes moderate to severe headache, nausea or sensitivity to light and sound. Some people experience temporary neurological symptoms called aura.
Tension-type headache
Usually causes a pressing or tightening pain on both sides of the head, typically without the prominent nausea associated with migraine.
Cluster headache
Causes very severe attacks, commonly around one eye, sometimes with tearing, a red eye, a blocked or runny nostril, and marked restlessness.
Medication overuse headache
May develop when medicines taken for headache relief are used too frequently over time, contributing to increasingly frequent headaches.
Headache after injury
Headache can occur after a concussion or other head injury, sometimes alongside dizziness, concentration problems and sleep disturbance.
Other causes
Infections, eye problems and some neurological or medical conditions can cause headache. The need to investigate depends on the overall clinical picture.
Symptoms worth discussing
Tell your clinician about the location, frequency, duration and intensity of the pain and whether it has changed over time. Important associated symptoms include:
- Nausea or vomiting, or sensitivity to light or sound
- Temporary visual disturbances or sensory changes
- Headaches that interrupt work, sleep or daily activities
- Attacks linked to menstruation, sleep or medication use
- Dizziness, neck pain or other neurological symptoms
Know the warning signs
Call 999 or attend A&E urgently for a sudden, exceptionally severe headache, or headache with new weakness, speech difficulties, confusion, seizures, loss of vision, or fever with a stiff neck.
Seek prompt medical advice for headaches that are new or substantially changing, particularly if triggered by coughing or exertion, or accompanied by visual symptoms, jaw pain while chewing or scalp tenderness.
A routine private consultation is not a substitute for emergency care.
How are headaches diagnosed?
Diagnosis usually starts with a detailed history and focused neurological examination. Further tests are considered when the symptoms or examination suggest they may be necessary.
Headache history
Discussing the pattern of pain, associated symptoms, family history, medication use and how headaches affect everyday life. A headache diary is often helpful.
Neurological examination
Checking relevant aspects of nerve and neurological function, alongside a review of any previous diagnoses or investigations.
Further investigations
Brain imaging or other tests may be appropriate for particular warning signs or atypical findings. They are not routinely needed for every migraine or tension-type headache.
Read more about neurological advice and articles, or see frequently asked questions about consultations.
What treatments can help?
Headache treatment depends on the diagnosis, how often attacks occur, medical history and how previous treatments have worked. The aim is to improve symptom control while avoiding unnecessary medication or investigations.
Treatment during an attack
Appropriate acute medicines may include pain relief, migraine-specific medicines or anti-sickness treatment, selected with individual contraindications in mind.
Prevention
For frequent or disabling migraine, preventive medication and selected specialist treatments may be considered when clinically appropriate.
Practical measures
A headache diary, consistent sleep, hydration, regular meals and an individual approach to triggers may help support longer-term management.
Some migraine medications have specific restrictions, including during pregnancy. Any medicines should be discussed with the treating clinician.
How Dr Yasser Falah can help
Dr Falah is a London-based Consultant Neurologist who can assess persistent or troublesome headaches, review previous investigations and consider whether the symptoms fit a recognised primary headache disorder or need further evaluation.
Following the assessment, he can explain the likely diagnosis, discuss suitable management options and advise on whether further tests or specialist referral are necessary.
About Dr Yasser FalahWhat to bring
- A headache diary, if you have one
- A list of medication and how often you take it
- Previous scan reports or consultation letters
- Details of any new or changing symptoms
Find out about consultation fees and clinic locations.
Headache and migraine FAQs
When should I see a neurologist about headaches?
Consider a neurological assessment if headaches are frequent, persistent, changing in pattern, difficult to manage or affecting your daily life. Sudden severe headaches or headaches accompanied by new neurological symptoms need urgent medical assessment instead.
How do I know whether I have migraine?
Migraine often causes moderate to severe headache, sometimes with throbbing pain, nausea or sensitivity to light and sound. Some people experience aura, such as temporary visual changes. A clinician can assess your symptoms and distinguish migraine from other headache disorders.
Will I need an MRI scan for headaches?
Not necessarily. Many headache disorders are diagnosed from the history and examination. A brain scan may be considered when symptoms or examination findings suggest another cause, rather than being routinely needed for reassurance.
Can taking painkillers make headaches worse?
Yes. Frequent use of some medicines for headache relief can contribute to medication overuse headache. Tell your clinician which medicines you use and how often so your treatment plan can be reviewed safely.
What should I record in a headache diary?
Record the date, duration, intensity and characteristics of headaches, associated symptoms, medicines taken and possible triggers. A diary can help establish patterns and assess whether treatment is working.
Are headaches and migraines treatable?
Many people can reduce headache frequency or severity with an accurate diagnosis, suitable acute treatment, preventive options where indicated and practical changes tailored to their individual circumstances.
Related information
Need help with recurring headaches?
Contact London Neurology Specialist to enquire about a consultation with Dr Yasser Falah and discuss whether a neurological assessment is appropriate.
This page is general information and does not replace individual medical advice.