Frequent migraine
Attacks occurring often enough to interfere with work, sleep, social life or normal daily activity.
Clinical Consultation · South Kensington
Migraine & Headache Clinical Consultation
A clinician-led consultation for people experiencing frequent, persistent or disruptive migraine and headache symptoms.
The aim is to understand your headache pattern, frequency, associated symptoms, medication use and impact on daily life before discussing appropriate next steps.
Who is the consultation for?
When should you consider a migraine or headache consultation?
A clinical consultation may be useful if headaches are becoming frequent, difficult to manage, disruptive to work or daily life, or if you are unclear whether the pattern is consistent with migraine.
Increasing headache days
A pattern that appears to be becoming more frequent or persistent over time.
Medication use
Regular reliance on acute headache medication or uncertainty about whether medication use is itself becoming part of the problem.
Migraine with aura
A history of migraine associated with visual, sensory or other neurological symptoms that need to be understood in context.
Uncertain diagnosis
Not every recurrent headache is migraine. Assessment can help clarify the pattern and whether further investigation is appropriate.
Treatment not working well enough
Where previous approaches have not provided sufficient control or you want a more structured review of your options.
What do we review?
The headache pattern
- How many headache days you have each month
- How many have migraine features
- How long attacks last
- Where the pain occurs
- Whether activity makes symptoms worse
Associated symptoms
- Nausea or vomiting
- Light or sound sensitivity
- Aura symptoms
- Neck discomfort
- Fatigue or difficulty concentrating
Medication history
- Current acute medication
- How often you take it
- Preventive treatments previously tried
- Other prescription medication
- Relevant medical history
Impact on daily life
- Days missed from work
- Reduced productivity
- Sleep disruption
- Impact on exercise or travel
- Effect on family or social life
Frequency matters
Episodic vs chronic migraine
One of the most important parts of assessment is establishing how frequently headaches occur.
Episodic migraine
Migraine occurring on fewer than 15 headache days per month is generally described as episodic.
Chronic migraine
Chronic migraine is defined by headache on 15 or more days per month for more than three months, with migraine features on at least eight days per month.
This is why a headache diary is useful.
It is often difficult to accurately remember the true number
of headache days over several months without recording them.
Bring a migraine diary if possible
Even two to four weeks of simple records can make a consultation more useful.
Frequency
Record every headache day, not only the severe attacks.
Symptoms
Note nausea, aura, light sensitivity, sound sensitivity or other associated symptoms.
Medication
Record which medication you take and on how many days each month.
An important part of assessment
Medication-overuse headache
People experiencing frequent migraine understandably tend to use acute headache medication more often.
However, frequent use of some acute medicines can contribute to an increasingly persistent headache pattern known as medication-overuse headache.
The relevant threshold depends on the medicine involved. Your clinician can review this with you during consultation.
Do not stop prescribed medication on your own.
Changes to prescription medication should be discussed with
the clinician responsible for your care.
What happens during the consultation?
Step 01
History
We review your headache history, frequency, symptoms, aura where relevant, medication use and previous treatment.
Step 02
Clinical review
The clinician considers whether the pattern is consistent with migraine, whether there are features requiring further assessment and how much the condition is affecting your life.
Step 03
Next steps
Appropriate management options can then be discussed, including whether referral, further investigation or prescription treatment should be considered.
What happens after assessment?
There is no single management plan for every person with migraine. The next step depends on frequency, severity, previous treatment, medical history and individual preference.
Lifestyle foundations
Sleep regularity, meals, hydration, activity and identifying meaningful triggers can form part of the overall management plan.
Medication review
Current acute and preventive medication may need to be reviewed, particularly where headaches are frequent or medication is being used often.
Prescription options
Where clinically appropriate, prescription-only treatment options may be discussed privately following assessment with a suitably qualified prescriber.
GP or specialist input
Some headache presentations are better managed in collaboration with a GP, neurologist or dedicated headache service.
Further investigation
Imaging or additional investigation is not required for every person with migraine, but may be appropriate where the clinical history suggests it.
Monitoring
A continuing headache diary can help judge whether a treatment plan is genuinely reducing headache frequency or impact.
Working with other clinicians
When might GP or neurology assessment be more appropriate?
Migraine is often diagnosed clinically, but some presentations require broader medical assessment or specialist input.
Referral may be appropriate where:
- The diagnosis is uncertain
- Headaches are changing significantly
- Neurological symptoms are unusual or new
- Headaches remain poorly controlled despite treatment
- There are complex medical conditions or medications
Shared care
Where appropriate and with your consent, information can be shared with your GP or specialist to help coordinate care and avoid fragmented treatment.
Urgent medical attention
When is a headache an emergency?
Most recurrent migraine is not an emergency, but some headache patterns require urgent assessment.
Seek urgent medical help for symptoms such as:
- A sudden extremely severe headache reaching maximum intensity very rapidly
- New weakness, paralysis, marked confusion, collapse or other significant neurological symptoms
- A severe headache following significant head injury
- Headache with fever, marked neck stiffness or a concerning rash
- Loss of consciousness or seizure associated with a severe headache
A major unexplained change from your usual headache pattern should also be medically assessed even where it does not appear to require emergency care.
Do not wait for a private consultation if you have acute
red-flag symptoms. Seek urgent medical assessment instead.
Prescription treatment
How prescription options are handled
Some prescription-only treatments may have a role in the management of appropriately diagnosed migraine.
At Santi, prescription-only treatment is not presented as something to select directly from a website menu.
Where relevant, available options, expected benefits, limitations, possible adverse effects and alternatives are discussed privately after an appropriate clinical assessment with a prescriber.
Migraine Consultation FAQs
Do I need a diagnosis of migraine before booking?
No. The consultation can be useful where the pattern is thought to be migraine but has not been clearly assessed. If the history suggests another type of headache or requires further investigation, the clinician can advise on the appropriate next step.
Should I bring a headache diary?
Yes, if possible. A diary showing headache days, migraine symptoms and medication use can make it much easier to understand frequency and patterns.
What is chronic migraine?
Chronic migraine involves headache on at least 15 days per month for more than three months, with migraine features on at least eight days per month.
Do migraines always involve aura?
No. Many people with migraine never experience aura.
Can frequent painkillers make headaches worse?
Frequent use of some acute headache medicines can contribute to medication-overuse headache. The relevant frequency depends on the medicine being used and should be reviewed clinically.
Should I stop migraine medication before the consultation?
No. Do not stop or alter prescribed medication without advice from the clinician responsible for prescribing it. Bring a list of what you currently take and how frequently you use it.
Will I automatically be offered treatment at the first visit?
No. The purpose of the consultation is first to understand the headache pattern and establish what management pathway is appropriate. Treatment depends on clinical suitability.
Are prescription treatments advertised on this page?
No. Prescription-only options are discussed privately following an appropriate clinical assessment where they are relevant.
Can Santi communicate with my GP or neurologist?
Where appropriate and with your consent, relevant clinical information can be shared to support coordinated care.
Migraine information at Santi
Santi London · South Kensington
Migraine affecting your work, sleep or everyday life?
A structured clinical consultation can help clarify your headache pattern, review what you have already tried and determine which management options or referrals are appropriate.
Santi London · 33 Thurloe Street · South Kensington · London SW7 2LQ
This page provides general information and does not advertise prescription-only medicines. Any prescription treatment is subject to individual clinical assessment and suitability.