Headache Medicine

Headache medicine is the neurology subspecialty for migraine, cluster headache and other headache and facial pain disorders. Most headaches are primary, meaning the headache itself is the disease and scans are normal.

Treatment has advanced considerably with CGRP-targeting drugs and botulinum toxin for chronic migraine. Most people can expect fewer and milder attacks, though not a cure.

Conditions this service looks after

• Migraine with and without aura
• Chronic migraine
• Medication overuse headache
• Tension-type headache
• Cluster headache and other trigeminal autonomic headaches
• Trigeminal neuralgia
• Idiopathic intracranial hypertension
• Headache from low spinal fluid pressure

Tests you may be offered

• Detailed history and headache diary: The diagnosis comes from the pattern; bring at least a month of diary entries.
• Neurological and eye examination: Including a look at the optic discs for swelling.
• MRI brain, with vascular imaging if needed: Only when red flags or unusual features are present.
• Lumbar puncture with pressure measurement: For suspected intracranial hypertension.

Treatments available

• Acute treatment: Triptans, anti-inflammatories and anti-sickness drugs, limited to about 2 days a week; gepants where available.
• Preventive tablets: Propranolol, candesartan, amitriptyline, topiramate or flunarizine.
• Botulinum toxin type A: 31 or more small injections every 12 weeks for chronic migraine.
• CGRP monoclonal antibodies: Monthly or quarterly injections for frequent migraine after other preventives fail.
• Greater occipital nerve block: Short-term relief for cluster headache and during medication withdrawal.
• Oxygen and sumatriptan injection: For cluster attacks, with verapamil as prevention.
• Withdrawal of overused painkillers: Essential before other treatments can work.

When to ask for a specialist opinion

• Headache on 8 or more days a month
• Painkillers needed on more than 2 days a week
• Attacks that have not responded to 2 or 3 preventives
• A new headache after the age of 50, or a clear change in pattern
• Severe one-sided attacks with a watering eye

Travelling to Türkiye for this care

A specialist consultation with a treatment plan, first botulinum toxin session or nerve block fits a short stay. Botulinum toxin and CGRP antibodies are repeated every 1 to 3 months, so they only make sense if you can continue them at home. Check local availability first.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

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