Managing Migraine

Making a referral

Most patients with migraine should be dealt with by a health professional in primary care. But in some cases it will be best to make a referral to a headache or migraine specialist. Unfortunately, there are not that many neurologists or GPs who have a special interest in headache and migraine.

If a patient has had migraine for many years and if there are no new or unusual features or symptoms then there is no need to refer them for a brain scan.

Patients may however request a scan, often because they want reassurance that they do not have a brain tumour. Generally however, brain scans do not provide information that is valuable.

If however the history of the patient or through examining the patient there is a suggestion that the migraine or headache could be secondary to underlying pathology a referral should be made.

Dr Anne MacGregor in her book ‘Managing Migraine in Primary Care’ lists what investigations can take place:

• Full blood count and erythrocyte sedimentation rate
• Plain radiography
• Lumbar puncture
• Electroencephalography (EEG)
• CT scanning
• MRI
• Cerebral angiography
• Isotope scanning
• Doppler flow studies

The Migraine Trust has a list of Migraine Clinics and GPs with Special Interest in Headache. A map of migraine clinics can be found in the Information for Sufferers section of this site.