Red flags & when to go in person for Migraine

Audience: adult

Migraines are a common type of headache that often cause intense pain, sensitivity to light or sound, and nausea. Many people manage migraines at home or with their healthcare provider through telemedicine visits. However, some symptoms may signal a more serious problem that requires in-person medical care. This guide helps you recognize red flags and decide when to seek urgent or emergency care. Telemedicine can support migraine management by providing advice, medication adjustments, and follow-up, but it cannot replace physical exams or urgent testing when needed. Knowing these warning signs helps keep you safe and ensures you get the right care at the right time.

Red flags — go in person / ER

• Sudden, severe headache unlike any before — go to emergency care immediately.
• Headache with fever, stiff neck, confusion, or weakness — seek urgent in-person evaluation.
• New or worsening headache after head injury — get prompt medical assessment.

What telemedicine can do

• Routine migraine symptom review and management
• Medication advice and prescription adjustments
• Education on migraine triggers and lifestyle changes
• Follow-up on stable migraine treatment plans

What telemedicine cannot do

• Evaluation of sudden, severe headaches or new neurological symptoms
• Physical examination to rule out serious conditions
• Urgent diagnostic testing such as brain imaging or lumbar puncture
• Management of headaches with signs of infection or stroke

What is a Migraine?

Migraines are intense headaches that often come with other symptoms like nausea, vomiting, and sensitivity to light or sound. They may last from a few hours to several days and can affect daily activities. Migraines are different from regular headaches and often need specific treatments.

Common Migraine Symptoms

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Red Flags: When to Seek In-Person Care

Certain symptoms may indicate a serious condition that needs urgent medical attention:

How Telemedicine Can Help

Telemedicine visits can help you manage typical migraines by:

However, telemedicine cannot perform physical exams or urgent tests needed for serious conditions.

Preparing for Your Telemedicine Visit

To get the most from your tele-visit:

After Your Telemedicine Visit

Follow your provider's instructions carefully. If advised to seek in-person care, do so promptly. Keep track of your symptoms and any changes. Contact your healthcare provider if your condition worsens or new symptoms appear.

How to prepare for your tele-visit

• Write down your migraine symptoms, including when they started and how severe they are.
• List any new or unusual symptoms, such as vision changes or weakness.
• Have a list of all medications and supplements you are taking.
• Choose a quiet, private space with good internet connection for your tele-visit.
• Prepare questions or concerns you want to discuss with your healthcare provider.

After your tele-visit

• Follow your provider's medication and lifestyle recommendations.
• Monitor your symptoms and note any changes or new warning signs.
• Seek in-person care promptly if red flag symptoms develop.
• Schedule follow-up appointments as advised.
• Keep a headache diary to track frequency and triggers for future visits.

FAQs

Can telemedicine diagnose a migraine?

Telemedicine providers can often assess your symptoms and medical history to suggest if you likely have migraines. However, they cannot perform physical exams or tests needed to rule out other serious causes of headache.

When should I go to the emergency room for a headache?

Go to the emergency room if you have a sudden, severe headache unlike any before, especially if accompanied by fever, neck stiffness, confusion, weakness, or after a head injury. These may be signs of serious conditions requiring urgent care.

Can I get migraine medications through telemedicine?

Yes, telemedicine providers can often prescribe or adjust migraine medications based on your symptoms and history. However, some medications may require in-person evaluation depending on local regulations and your health status.

What triggers migraines?

Common triggers include stress, certain foods or drinks, hormonal changes, lack of sleep, bright lights, and strong smells. Identifying and avoiding your triggers can help reduce migraine frequency.

Is it safe to manage migraines without seeing a doctor in person?

Many people manage migraines with telemedicine support safely. However, if you experience new, severe, or worsening symptoms, or red flags, you should seek in-person medical evaluation promptly.

Sources

1. Migraine — MedlinePlus, U.S. National Library of Medicine / National Institutes of Health.
2. Migraine Overview — Mayo Clinic.
3. Headache: When to Seek Emergency Care — Centers for Disease Control and Prevention (CDC).
4. Migraine Treatment — Merck Manuals: Consumer Version.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If you experience any red flag symptoms or have concerns about your health, seek prompt evaluation by a healthcare professional in person.