What to Expect When You See a Neurologist for Migraine

Here’s what to expect will happen at your appointment with a neurologist, plus some tips for preparing for your visit.

If you have migraine, you’ve likely had frustrating experiences talking with people who don’t quite get what you’re dealing with. This may also include conversations with medical professionals.

As well-meaning as they may be, doctors might not a have strong understanding of migraine if they aren’t migraine specialists — and that’s OK. However, it can mean that you’re left going in circles to try to advocate for yourself and find help.

If this sounds familiar, it may be time to see a neurologist for migraine.

Here’s a rundown of what a neurologist is, what to expect at your appointment, and how to prepare for your visits.

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What is a neurologist, and why should you see one?

A neurologist is a medical doctor who specializes in nervous system disorders and diseases.

To become a neurologist, these doctors go through medical school, complete an internship in internal medicine, and do at least 3 years of training in a neurology residency program, before getting board certified.

If you have migraine, it can be helpful for you to know that neurologists are headache experts. As experts, neurologists are up to date on migraine classification, symptoms, the latest treatments, and current research. And, they’re likely better suited than a nonspecialist to understand your unique situation with migraine.

A neurologist may be able to accurately diagnose your specific type of migraine, develop a treatment plan tailored to you and your experiences, and help you manage symptoms.

What will happen at your appointment with a neurologist?

Going to your first appointment with a neurologist may feel daunting, and that’s totally normal! Understanding what will happen during your visit may help you feel more ready.

With that in mind, here’s a list of what you can expect when you see a neurologist for migraine.

A review of your medical history

Like any doctor’s appointment, a neurology visit will likely start by going over your medical history in detail.

Your neurologist will ask you questions about:

• current medications
• health conditions
• allergies
• any past surgeries or hospitalizations
• lifestyle
• family health history

As a migraine expert, your neurologist will also give particular attention to questions about your migraine history. Your neurologist will ask you to describe your headaches, how they feel, how long you’ve had them, how often you have them, and if there are any triggers or things that make them better.

You will also be asked if you have associated symptoms, like anxiety, dizziness, nausea, fevers, or numbness. Your neurologist might also ask about whether you had childhood migraine symptoms, like motion sickness or nausea.

It’s a good idea to share everything you can think of — even things that may not seem totally relevant. The more thorough and detailed you are, the better!

Bringing your medical history will help your neurologist better understand your overall health and your unique experience with migraine, including any potential genetic links.

A physical exam

Again, like with other doctor’s appointments, your neurology appointment will include a physical exam.

During a physical exam, you can expect similar tests to what your primary care physician does at your yearly physical, including listening to your heart and lungs with a stethoscope, and checking your height, weight, and pulse.

Similarly to taking your medical history, conducting a physical exam will help your neurologist build an understanding of your general health.

A neurological exam

Here’s where things get neurology-specific. Your neurologist will conduct a neurological exam to test how your nervous system and brain are functioning.

While the exact aspects that your neurologist will test may vary depending on your age, medical history, and the specifics of your symptoms and condition, here are some areas that may be included:

• Awareness and interaction with the environment: For example, how clearly you’re able to speak and express your ideas and your awareness of yourself and your surroundings. Your neurologist will likely assess this during your conversations throughout the visit.

• Balance and motor function: They’ll look at things like how you stand and walk, and how your joints move.

• Ability to feel physical sensations: They’ll test if you’re able to feel things touching different parts of your body (hands, arms, legs, etc.), and whether you can correctly identify the sensation you’re feeling (hot, cold, soft, sharp, etc.).

• Reflexes: They’ll test how your muscles react when your knee or Achilles tendon is tapped in specific ways. Reflexes are often tested using a reflex hammer, which you may have experienced at primary care visits.

• Brain nerves: They’ll want to see if you can correctly identify smells and tastes, check your pupils and eye movements, and check your hearing. There are 12 main brain nerves (or cranial nerves), and your neurologist can evaluate each one specifically.

• Coordination: How you walk, or if you’re able to touch something with your eyes closed — like your nose, is something they’ll want to test.

Additional tests

Before diagnosing you, your neurologist may send you for additional testing in order to rule out any other medical issue that could be causing your headache pain and migraine episodes.

Possible tests include:

• Head and brain CT (computed tomography) scan: This shows structural problems, including bleeding, tumors, or strokes.
• Head and brain MRI (magnetic resonance imaging): This test shows more detailed images than CT and can show structural problems, tumors, or signs of an infection.
• EEG (electroencephalogram): This measures brain waves and is often used to show patterns associated with seizures.

It’s entirely possible, however, that your neurologist won’t run additional tests. The decision is based on your particular situation and symptoms, and additional testing may not be necessary for everyone.

A diagnosis

There isn’t one single test a neurologist (or any other doctor) can run to diagnose migraine. Rather, migraine is generally diagnosed based on your own reporting, your medical history, and the elimination of other possibilities.

If your experience and symptoms align with migraine and testing has ruled out other diagnoses, your neurologist will likely be able to give you a migraine diagnosis. They may also be able to determine the exact type of migraine you have — for example, chronic migraine or vestibular migraine, and so on.

A plan for the path forward

Keep in mind that all of this may not happen during just one visit. It might take multiple tests over multiple visits to get to your diagnosis and to experience effective treatment. It may even require going to multiple neurologists.

Try to stick it out — even if the process feels long or frustrating. The goal is to find a dependable neurologist who understands the ins and outs of your particular type of migraine.

From there, your neurologist will help you figure out next steps, determine a treatment plan, and find ways to manage your symptoms.

Treatment options include:

• medical intervention, like prescribing certain migraine medication
• lifestyle changes, like avoiding migraine triggers or testing dietary changes
• alternative medicines, like homeopathic remedies or herbal supplements

How to prepare for your appointment with a neurologist

Preparing for a neurology appointment in advance can help you get the most out of your visit.

Here are some things you can do beforehand to get ready for your appointment:

• Consider sending your medical records to the neurologist in advance, and have a physical copy with you on the day of your visit.
• Be prepared to discuss your medical history in detail.
• Bring a list of all current medications and supplements that you take (over-the-counter and prescription), including dosage and frequency.
• Keep a migraine journal for at least a couple of weeks, noting any daily experiences with migraine and headache pain (including triggers, symptoms, frequency, and severity), then bring this journal to your visit.
• Write down questions you want to ask your neurologist as they come to you, then bring that list to your appointment.
• Feel free to ask a friend or loved one to come to your appointment with you, if that will make you feel more comfortable or help you with processing information.

The bottom line

Neurologists are doctors who specialize in the nervous system and brain, including migraine and headache pain.

While it may seem daunting to go to a specialist, parts of the appointment will likely feel similar to regular doctor’s visits.

At your neurology appointment, you can expect to go over your medical history, do a physical exam, do a neurological exam, and potentially run some other tests as needed, before getting to your diagnosis and discussing treatment.

Seeing a neurologist for migraine may just be the first step in getting an accurate migraine diagnosis, developing a treatment plan, and managing your symptoms.