Migraine and headache specialists in the Bay Area

What are the symptoms of migraine?

Migraine is more than a bad headache. Symptoms vary from person to person, but they often include:

• Moderate to severe throbbing or pulsing pain, usually on one side of the head
• Nausea or vomiting
• Sensitivity to light, sound or smells
• Tiredness, mood changes or trouble concentrating, before or after an episode

Some people have an aura before the headache: usually vision changes such as dots, zigzags or flashing lights, and sometimes tingling or trouble speaking. An aura typically starts 10 minutes to an hour before the headache and lasts no more than an hour.

When should you see a doctor about headaches?

See a healthcare provider if you have new headache symptoms, if your symptoms are getting worse, or if your treatment causes side effects. Migraine headaches on at least 15 days a month for more than three months are called chronic migraine, and are a reason to see a neurologist.

Call 911 or go to the emergency room if you have the worst headache of your life, a headache after a head injury, or a headache with trouble speaking, weakness, numbness, vision loss, confusion or a seizure.

How is migraine diagnosed at INPM?

Migraine is diagnosed mainly from your history and a neurological exam. Your neurologist will ask when the headaches start, how long they last, what they feel like, what seems to trigger them and what other symptoms come with them. Imaging such as MRI or CT is not usually needed to diagnose migraine; it is ordered when another cause of headache needs to be ruled out.

Keeping a headache journal before your visit helps: note the time, intensity and length of each headache, what you were doing, what you ate, how you slept and which medicines you took.

• TCD bubble studyStroke evaluationLearn more about TCD bubble study
• VNG and balance testingDizziness and vertigoLearn more about VNG and balance testing
• Carotid / transcranial DopplerBlood flow to the brainLearn more about Carotid / transcranial Doppler

What treatment options are available?

Migraine treatment has two goals: relieving symptoms during an episode and preventing future episodes. Acute medicines are taken as soon as symptoms start; preventive medicines are taken regularly to reduce how often and how severely episodes happen. Your neurologist will choose the options that fit your pattern of headaches and your other health conditions. GeneSight® genetic testing may provide additional information to help guide medication selection and dosing when applicable.

At INPM, treatment can also include in-office procedures for headache:

• Botox injectionsChronic migraine, dystonia and muscle spasmsLearn more about Botox injections
• Nerve blocksAnesthetic injections near a nerve to relieve headache and painLearn more about Nerve blocks
• Trigger point injectionsAnesthetic injections into tight muscle knots that trigger painLearn more about Trigger point injections
• IV magnesium infusionMagnesium given through an IV to relieve migraineLearn more about IV magnesium infusion

Who treats migraine at INPM?

• 

  Dr. Amar Anand

  Neurologist · Headache, stroke and neuroimaging

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  Dr. Alexandra Nicholson

  Neurologist · Parkinson’s disease and movement disorders

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  Jessica Beck, PA-C

  Physician Assistant · Traumatic brain injury, migraine, seizures and memory loss

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  Alice Feng, PA-C

  Physician Assistant · Traumatic brain injury, migraine, seizures and memory loss

Where can you be seen?