It is often not difficult to ascertain a doctor's competence in treating Migraine and their attitude about Migraine by the evaluation the doctor does, the questions the doctor asks, and the answers to patients' questions a doctor gives.

The top neurologists today admit that Migraine is grossly misdiagnosed, underdiagnosed, misunderstood. For example, according to noted neurologist Dr. Joel Saper, "Migraine is a serious and underestimated health problem . . . patients with Migraine are shunted along an assembly line of misdiagnosis, undertreatment, or frank mismanagement. They are subjected to unnecessary procedures and preventable consequences."



In order to diagnose a patient with Migraine, a doctor should go through an analysis that is similar to the following, and if he does not, go elsewhere. The doctor should ask your family and medical history of Migraine, as Migraine is hereditary, with a positive family history in two-thirds of the cases. The doctor should ask the age of onset, as Migraine surfaces in women at the onset of puberty, and can be triggered by such hormonal events as menstrual cycle. The doctor should ask the type, duration, and location of pain, as Migraine pain is usually throbbing and on one side of the head, while tension headache is bilateral and constant. The doctor should ask about triggers, as tension headache is triggered by such events as stress, while Migraine is triggered by such events as weather patterns, menstrual cycle, and certain foods. The doctor should ask about other symptoms that accompany the head pain, as Migraine is often accompanied by nausea, aura, or sensitivity to light and sound. The doctor should ask what types of medications and vitamin supplements exacerbate the head pain, as Migraine, unlike tension headache, can be exacerbated by vasodilators such as nitrates and medications such as oral contraceptives. The doctor should then conduct both a physical and neurological examination.

As the doctor performs his examination, the patient can engage in conversation with the doctor about the doctor's previous experience with Migraine and other headache patients, the doctor's thoughts on the differences between tension headaches and Migraine, and the doctor's opinion on what causes both. If the doctor says that there are few differences between types of head pain, that mental condition plays a predominant role in all types of head pain, and the treatment is the same for all types of head pain, go elsewhere. You can even start the visit by stating that you have been diagnosed with Migraine disease, have had no luck with previous treatment regiments of other doctors, and you wonder if he can help improve your situation. If the doctor flinches at the word disease or seems otherwise nonresponsive to your condition, go elsewhere.

Even if the doctor diagnoses you with Migraine and prescribes a medication, the doctor should inform you that there are a number of different medications to treat Migraine and that if the medication he prescribes doesn't work for you, to come back to try another type of mediation as some medications work for some people and not others. In addition, some medications are safe during pregnancy and some are not. If the doctor indicates that all medications are alike and therefore the one he prescribes either works or not, go elsewhere, as he may just be prescribing the medication he is most familiar with, not the medication best for you.

Finally, another thing your can do to improve treatment of Migraine is to develop a relationship with a pharmacist who is knowledgeable about new Migraine drugs and Migraine treatment in general. This is important because, for example, some generic drugs specified by insurance plans do not work as well, if at all, on Migraine pain as does the brand-name version, such as is the case with Midrin. Sometimes patients are prescribed a brand-name drug and are unaware that a pharmacist has substituted a generic drug in its place. A pharmacist who is knowledgeable of the particulars of Migraine drugs can prove invaluable.

If you still have questions about your doctor or the right doctor in general, check out this quiz from Teri Robert, our partner at, Is Your Doctor Right for You?

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