Migraine: recognising the pattern and planning care

Migraine can cause disabling headache with symptoms such as nausea and sensitivity to light or sound; some people also experience aura. A doctor assesses the pattern and considers other causes. A sudden severe headache, new weakness, confusion or other unusual neurological symptoms needs urgent assessment, even if you have had migraine before.

Migraine is more than a headache label

The effects can extend beyond head pain. Describe nausea, sensitivity to light or noise, changes before the headache and how long it takes to feel able to function again. Explain what happens on a typical day affected by symptoms rather than relying only on a pain score. Healthdirect's migraine overview

A diagnosis should help make sense of a recurring pattern. It should not become a reason to ignore everything new. If a headache is different from earlier episodes, tell the clinician exactly what has changed: the onset, location, associated symptoms, severity or effect on your usual activities.

Which symptoms mean I should not wait?

Seek emergency assessment for a sudden, extremely severe headache or headache with new weakness, difficulty speaking, confusion, collapse or other signs of serious illness. A headache after significant injury, with fever and neck stiffness, or with concerning new visual symptoms also needs urgent attention. Call 000 for an emergency. Healthdirect's headache warning signs

Do not decide that a new neurological symptom is aura without assessment. If you already have a diagnosis, use the safety instructions in your care plan but seek help when the pattern differs. A routine telehealth appointment cannot safely replace emergency investigation of a potentially serious headache.

Build a useful account of your headaches

Write down roughly when headaches started, how often they occur and whether there are symptom-free days. Include the duration of an episode and the activities you have to stop. If symptoms affect several days, distinguish the main headache from the time spent recovering.

List medicines and other products used, including how frequently they are taken. Bring previous diagnoses, scan reports or specialist letters if available. A clinician needs to understand the whole pattern before deciding whether additional tests or a change in management would be useful.

What belongs in a headache diary?

A simple entry can include the date, time symptoms began, associated symptoms, action taken and functional impact. Record relevant context such as missed meals, disrupted sleep or menstruation if it appears useful, without assuming it caused the episode. A diary is meant to reveal patterns, not create a daily search for blame.

Choose a format you can maintain: a note on your phone, a paper calendar or a short table. Ask your doctor how long to record and which details matter for your situation. The frequent migraine guide discusses using a record when headaches are becoming more disruptive.

Do I need a scan?

A clinician decides whether your history and examination suggest a need for imaging or another investigation. Requesting a scan is understandable when symptoms are worrying, but the useful question is what the test is intended to check and how the result would change care. Healthdirect on headache assessment

Tell the doctor about prior tests before assuming they must be repeated. Equally, a previous normal result does not assess a newly changed headache. Ask whether an in-person neurological examination is needed and how promptly it should happen. Keep the investigation plan separate from any document you need for work or study.

Discuss immediate care and prevention separately

One part of a plan may address what to do during an episode; another may aim to reduce the impact of future episodes. Ask which part you are discussing and how it will be evaluated. A doctor decides what management is appropriate, taking your history, other conditions and preferences into account. Healthdirect's migraine management information

Do not borrow another person's treatment or assume a previous prescription is still suitable. Explain if the existing plan is difficult to follow, does not help enough or causes unwanted effects. Clear feedback gives the clinician a better basis for adjusting the approach than simply saying that nothing works.

Work, study and family life

Describe the tasks affected: looking at a screen, driving, working in bright light, concentrating, attending an examination or caring for someone safely. These details help a clinician assess functional impact and discuss practical adjustments. They also make a certificate conversation more precise if absence is necessary.

Consider preparing a brief explanation for people who support you, including what help is useful during an episode and when they should seek medical assistance. You control what personal information you share. A workplace arrangement and a clinical care plan have different purposes, even when they support the same recovery.

Can an online doctor help?

Telehealth may support history-taking, review and planning, but suitability depends on the symptoms and what examination is needed. The Medical Board's telehealth standards apply whether the appointment is by phone or video. New or concerning symptoms may require a different setting.

At the end of the appointment, confirm who will follow up investigations, when to review the plan and which changes require urgent care. If the appointment is mainly for a certificate, still mention changes in the headache pattern. Paperwork should follow the health assessment rather than replace it.

Questions worth taking to the appointment

Ask whether the current symptoms fit the existing diagnosis, what other causes have been considered and what information would change the plan. Ask how to recognise a concerning change and whether your current use of symptom-relief products needs review. If pregnancy, contraception or another condition is relevant, raise it explicitly.

Leave with a plan you can describe in your own words: what to do during an episode, what to track between episodes and when to seek further assessment. If that remains unclear, ask the clinician to explain it again before the consultation finishes.

A diagnosis needs the pattern

Describe the location and character of pain, associated symptoms, how long attacks last and what you can do during them. Include days affected by symptoms before or after the main headache. A diary can help show a pattern that is hard to remember during an appointment.

Tell the doctor if the headache is new, has changed or is different from your established migraine. A previous diagnosis should not become a reason to ignore a new warning sign. Include any head injury, pregnancy or other relevant change in health.

Know which symptoms need urgent care

A sudden severe headache, new neurological symptoms, confusion, neck stiffness or major vision changes need urgent assessment. Call 000 for an emergency. Do not assume unfamiliar weakness or speech difficulty is a migraine aura. Healthdirect Australia: Migraine

For familiar non-emergency attacks, ask about both immediate management and longer-term prevention. Tell the clinician how often you use symptom-relief products. Increasing use may be a reason to review the overall plan rather than repeatedly requesting more of the same.

If you cannot manage a normal consultation during an episode

Tell the service if light, sound, nausea or pain makes a video call difficult. Ask what appropriate assessment options exist, while keeping urgent symptoms separate from ordinary appointment logistics. If you are seriously unwell or have a new warning sign, seek urgent care.

For a planned review between episodes, prepare notes while you feel able. Include what support you need during an attack and who can help you follow the agreed plan. That discussion can make future decisions clearer without assuming every episode will be identical.

If a support person joins the appointment, explain their role and whether you want part of the conversation alone. Their observations may help, but your own account and preferences remain central.

Discuss your next step with a doctor

Read about Doccio's migraine consultation and book an online doctor appointment for a suitable non-emergency concern. Bring the relevant history, records and questions from this guide. A doctor decides whether advice, treatment, a document, testing or in-person care is appropriate. Check current fees and service information before booking. If symptoms are urgent, use the appropriate urgent or emergency service instead of waiting for a routine appointment.