8 September : Q&A with Dr Oliver Lily

I have been suffering from headaches for a long time now. This is often accompanied by dizziness and sickness. My GP can’t get to the bottom of it and has referred me to a neurologist.

I am a little nervous as to what kind of tests I might need to have. What is likely to happen at the first appointment?

Dr Oliver Lily, Consultant Neurologist replies:

Headaches are a common problem and a leading cause of sickness absence and disability in the UK. I am glad your headaches are being taken seriously. However, I am also glad to say that longstanding or chronic headaches rarely have a sinister cause.

Headaches accompanied with dizziness and sickness usually turn out to be migraines. Because there is no easy test for migraine, your neurologist will have to take a very detailed history of the headaches (for example, what triggers them, do they run in the family, are they accompanied by light or noise sensitivity). It may be helpful to keep a headache diary for a few weeks.

After this you will need an eye examination and possibly some kind of brain scan. Once the diagnosis is definite, you may be offered prescription medicine specifically for migraine. You should find this much more effective than ordinary pain-killers which can make these sorts of headache worse.

Although there is still no cure for migraines, we can usually achieve at least a 50% reduction in the number of headache days.

For more information please see www.migraine.org.uk

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