When to Seek Care

When to See a Doctor

Migraine is highly treatable. Knowing when to seek care — and what to ask — is the first step toward better management.

🚨 Seek emergency care right now if you have:

A sudden, severe headache unlike anything you have had before — especially with weakness, numbness, confusion, slurred speech, vision loss, fever, stiff neck, or seizure. These can be signs of stroke, brain bleed, or other emergencies.

Red flags that need urgent evaluation

Sudden severe headache — "worst headache of my life"

A headache that comes on suddenly and reaches maximum intensity within seconds to minutes can indicate a brain bleed, aneurysm, or other emergency. Seek emergency care immediately.

New neurological symptoms you have not had before

Sudden weakness, numbness, slurred speech, vision loss, severe confusion, or seizure — these are not typical migraine features and require urgent evaluation.

Fever, stiff neck, or rash with headache

May indicate meningitis or another infection. Especially urgent if recent infection, immune compromise, or unvaccinated status.

Headache after head injury

Any significant headache after a blow to the head — especially with vomiting, confusion, or loss of consciousness — needs evaluation to rule out bleeding.

New headache pattern after age 50

New-onset headaches in older adults can indicate temporal arteritis, vascular problems, or other conditions that need different evaluation than typical migraine.

Worsening pattern despite treatment

A clear, sustained change in headache frequency, severity, or associated symptoms — especially with new neurological findings — warrants re-evaluation.

Headache with eye pain and visual changes

Acute glaucoma can present this way. Especially in older adults or those with risk factors. Needs urgent ophthalmologic evaluation.

Headache during or after pregnancy

Headaches in pregnancy — especially with high blood pressure, vision changes, or upper abdominal pain — can indicate preeclampsia. Seek immediate care.

See your doctor soon if you have:

  • You have more than 4 headache days per month and they are interfering with work, school, or family life
  • You are using over-the-counter pain medications more than 10-15 days per month
  • You have tried multiple preventive medications without adequate benefit
  • Your attacks are becoming more frequent or more severe over time
  • You experience aura symptoms that are prolonged, severe, or new
  • You have severe migraine (15+ headache days per month)
  • You are pregnant or planning pregnancy and have migraine with aura
  • You have new or worsening symptoms between attacks

How to talk to your doctor about migraine

Most doctors genuinely want to help but have limited time. Making the most of your visit increases the chance of getting the right treatment plan.

Track before you go

A 1-3 month headache diary with frequency, severity, associated symptoms, and treatment response is the single most useful thing you can bring.

Be specific about impact

"How does migraine affect your daily life?" is more useful than a severity score. Mention missed work, canceled plans, lost sleep, family impact.

List everything you have tried

Including prescription medications, over-the-counter drugs, supplements, devices, behavioral approaches, and lifestyle changes. Bring actual medication bottles if possible.

Describe your typical attack

One-sided or both? Throbbing or pressure? Light/sound sensitivity? Nausea? Aura? Duration? Triggers you have noticed?

Mention family history

Migraine has a strong genetic component. A family history of migraine strengthens the diagnosis.

Be honest about medication use

Medication-overuse headache is common and treatable, but only if your provider knows what you are actually taking.

Ask about your options

Including non-medication approaches. Procedures like TEMMA exist for patients who have not found relief with standard treatments.

If standard treatments are not enough

For patients with severe migraine who have not found relief with standard medications, TEMMA is a minimally invasive option that targets the underlying migraine pathway.

Learn About TEMMA