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When Is a "Sick" Headache a Migraine?


A bad ("sick" or killer) headache is usually a migraine if underlying organic causes of pain are ruled out.

When a patient presents to a primary care physician with a bad headache and organic cause is ruled out, the diagnosis is usually migraine. But the diagnosis is not always straightforward and treatment can be challenging. Is the headache acute migraine or a medication overuse headache? Are triptans always the first-line choice? Can opioids be used safely?  When should you refer to a specialist?

We’ve invited Susan Hutchinson, MD, to help answer these and other questions. In 4 short podcasts, she offers practical clinical how-to’s on differential diagnosis, medication management, and patient communication.

Here Dr Hutchinson answers the question, “When is a bad headache a migraine?” Dr Hutchinson is a headache specialist and board-certified family practice physician. She is the founder of the Orange County Migraine and Headache Center in Irvine, California.

You can learn more about diagnosis and management of headache here:

What's New in Migraine Therapy? 

Migraine-When the Headaches Keep on Coming

Dr Hutchinson recommends the following Web sites as information resources for providers and their patients:
www.AmericanHeadacheSociety.org (Providers)
www.headaches.org (Patients and Providers)
www.achnet.org  (Educational arm of American Headache Society for migraine sufferers)
www.migraine.com  (Patients; interactive discussion forums, etc)
www.ocmigraine.org (Patients and providers )

Treating Migraine in Primary Care: The Pain Is Worth the Gain


Related Videos
Migraine Management Pearls for Primary Care with Neurologist Jessica Ailani, MD
Migraine-specific therapies belong in primary care setting, Jessica Ailani, MD
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