Medically reviewed by Dr. Sarim Mir, board-certified neurologist at Mir Neurology.
Call 911 for a “thunderclap” headache — a sudden, severe headache that peaks within seconds, or the “worst headache of your life.” Also seek emergency care for a headache with fever and stiff neck, confusion, weakness, trouble speaking, vision loss, or one that follows a head injury. These can signal a medical emergency.
Almost everyone gets headaches — but a migraine is not “just a headache.” Knowing the difference helps you treat it correctly and recognize when it’s time to see a specialist. Here’s how migraines differ from ordinary headaches, the warning signs to watch for, and when to see a neurologist.
How migraines differ from tension headaches
A typical tension headache feels like dull, band-like pressure on both sides of the head, and you can usually keep functioning. A migraine is often moderate to severe, frequently one-sided, throbbing, and comes with other symptoms — nausea, and sensitivity to light, sound, or smells. Migraines can be disabling in a way ordinary headaches usually aren’t.
Migraine warning signs and phases
Migraines often unfold in phases. Some people get an aura — visual changes like flashing lights or blind spots — before the pain. Others notice early clues hours ahead, such as mood changes, food cravings, or neck stiffness. Recognizing your pattern can help you treat attacks earlier, when treatment works best.
Red-flag headaches that need urgent care
Some headaches need emergency evaluation, not a wait-and-see approach. Seek immediate care for a sudden, explosive “thunderclap” headache, the worst headache of your life, or a headache with fever and stiff neck, confusion, weakness, difficulty speaking, vision loss, or one that begins after a head injury. When in doubt, call 911.
When primary care isn’t enough
It’s time to see a neurologist if your headaches are frequent, worsening, not responding to over-the-counter treatment, interfering with daily life, or changing in pattern. A specialist can confirm whether you have migraine and build a targeted plan. Explore our migraine treatment options.
What a neurology workup involves
A neurologist reviews your headache history and patterns, performs a neurological exam, and may order imaging if red flags are present. The goal is an accurate diagnosis — distinguishing migraine from other headache types — so treatment is targeted rather than trial-and-error.
Treatment options
Migraine care includes both acute treatments to stop an attack and preventive treatments to reduce how often they occur — including options like Botox for chronic migraine. If headaches are disrupting your life, request an appointment or call (301) 797-7600.
Frequently asked questions
How do I know if it’s a migraine?
Migraines are often one-sided and throbbing, moderate to severe, and come with nausea or sensitivity to light and sound — features that distinguish them from a typical tension headache.
When is a headache an emergency?
Call 911 for a sudden “thunderclap” headache, the worst headache of your life, or a headache with fever and stiff neck, confusion, weakness, vision loss, or after a head injury.
Can a neurologist help with migraines?
Yes. A neurologist confirms the diagnosis and creates a targeted plan, including acute and preventive treatments.
What triggers migraines?
Common triggers include stress, missed meals, poor sleep, certain foods, hormonal changes, and weather shifts. Tracking yours helps reduce attacks.
Need to talk to a neurologist about this?
Mir Neurology offers same-week appointments in Hagerstown & Cumberland, MD. No referral needed for most plans.
