Headache Centre

Headaches are one of the most common neurological conditions, a simple disorder that can turn into long term suffering dramatically affecting quality of life. If you are suffering from headaches and are looking for effective medical management to deal with the recurrent painful episodes, Mediclinic City Hospital’s Headache Centre can help.

Overview of the Headache Centre at Mediclinic City Hospital
At Mediclinic City Hospital’s Headache Centre we offer specialised care to patients suffering from headache, tailored to their specific symptoms and concerns. We know that there is not just one type of headache but rather numerous forms of headache and level of pain, each with different and unique characteristics and may require different diagnosis and treatment strategies.

The Headache Centre works with a multidisciplinary team of experts, in close collaboration with neuro-radiologists, ophthalmologists, neurosurgeons, obs/gyns, ENT, rheumatologists, clinical psychologists, physiotherapists and headache-trained nurses, for a holistic and comprehensive evaluation and management of each individual case, having the “Person” and not just the symptom, as the focus of the assessment.

The neurologists of Mediclinic City Hospital’s Headache Centre have highly specialised profiles in management and treatment of headaches, according to the international standards and guidelines of the IHS (International Headache Society), EHF (European Headache Federation) and AHS (American Headache Society).

Signs it is time to visit a headache specialist:

Your headache diagnosis is unclear: if you think you are headache is not diagnosed or your symptoms have changed.
Your headache occurs more often: If you are noticing that your headaches are occurring more frequently than in the past or suspect that you are experiencing chronic migraine.
Your headaches are getting more severe than usual: if you are experiencing change in the intensity of the headache or prolonged pain or auras (unusual neurological symptoms as patterns of shining lights, pins and needles on one side of the face and arm, struggling finding words before/during a migraine).
Your headache is not improving: If your headaches are worsening or not getting better with over the counter drugs or other treatments options and you have exhausted all your treatment options and need a new plan of management.
Impacting your quality of life: if your headache is keeping you from working, sleeping or doing your normal daily activities sometimes affecting also your personal/private life.
If you have a complicated medical problem/history: if you have a complicated medical history or your condition exists with migraine.

Types of headache:

Migraine

It consists of severe and recurrent attacks of headaches that often affect only one side of the head (migraine means "half skull") and that last from a few hours to a few days.
The pain is often described as "hammering" or throbbing and, in many cases, it is accompanied by other symptoms: nausea and vomiting, as well as a discomfort to lights, noises or smells, in a way that forces the individual to go to bed, rest in dark/shady and isolated places, avoiding any physical activity that could aggravate his discomfort.
In a quarter of cases, there are symptoms (migraine with aura) that precede the actual painful crisis: these symptoms can be visual (flashes of light, sparkles, discolouration, milky spots, doubling or sometimes loss of vision), sensory (sensation of tingling and/or falling asleep in a half of the body), difficulty in articulating/findings words and this constitutes the premonitory “aura”.

Tension-type headache

Tension-type headaches are the most common type of headache. Stress and muscle tension are thought to play a role, as are genetics and environment. Symptoms usually include moderate pain on or around both sides of the head, and/or pain in the back of the head and neck. Tension headaches build slowly and are not usually associated with nausea or vomiting. They can be chronic, occurring often or even every day.

Cluster headache

Cluster headache is characterized by sudden-onset severe pain, generally behind one eye. It has the most severe type of pain, excruciating, but is less common than tension type headache and migraine. Cluster headache attacks tend to occur in groups, sometimes daily or multiple times a day. They last 1-3 hours and the pain recurs in the same way each time, every day at the same time, usually in the same month year after year.

Trigeminal neuralgia

It is a rare form of headache, more typical of adults or the elderly and it is very disturbing due to the intensity of pain. Trigeminal neuralgia is characterised by repeated unilateral attacks of pain of very short duration during the day, similar to electric shocks or violent pangs that end abruptly, always localised only to one side of the head. Attacks are always extremely short, from a few seconds to two minutes maximum for each painful attack.

Daily chronic headache

Migraine, over time, can naturally become chronic. In certain cases, one frequent cause of an episodic migraine becoming chronic, is the prolonged and protracted intake of "symptomatic" drugs (i.e., those medicine that should be taken in the acute phase, and not the preventive ones!). Headache reliever drugs work well when taken occasionally, but when taken too frequently, most of them can end up triggering a "rebound" pain-reliever headache and a progressive increase in headaches frequency.

Symptomatic headache

In certain cases, the headache represents a symptom: hence, it is not a pathology in itself, but a signal of an "underlying" problem.
These include minor diseases such as sinusitis, fever, cervical osteoarthritis, head trauma, respiratory diseases, arterial hypertension, eye/ear/tooth disorders and, only rarely, even more serious diseases, such as increased intracranial pressure, meningitis, cerebral hemorrhages or venous thrombosis, vascular malformations like an aneurysm or brain tumours.

Diagnosis of headache:

At Mediclinic City Hospital Headache Centre, a specialised neurologist will work to determine the cause of your headache based on the responses to questionnaires, headache history/diary records and having performed physical and neurological examinations, and eventual assessment of other required tests such as MRI, CT, EEG, blood tests etc.

Treatment options available at Mediclinic City Hospital Headache Centre:

Oral medications, standard of care
Monoclonal antibodies (subcutaneous once every 4 weeks, or intravenous once every 12 weeks)
Ditan and gepants, new generation oral medications
BOTOX, (every 12 weeks)
Nerve blocks
Non-invasive neurostimulation
Non pharmacological treatment with neurofeedback and biofeedback
Specialized physiotherapy