Neurology, by video or in person
Migraine and Headaches
The signs, the danger signs that mean hospital now, and how to see a doctor by video from anywhere in Nigeria.
Signs to look for
Migraine and Headaches
- A throbbing headache, often on one side, with feeling sick or vomiting (migraine)
- A dislike of light, noise or smells during the attack
- Flashing lights, zigzag lines or blind spots before the headache (migraine with aura)
- A tight band or pressure on both sides of the head (tension-type headache)
- Headaches on most days in someone who takes painkillers often
Most headaches are not dangerous. The two commonest kinds are tension-type headache, a band-like pressure on both sides of the head, and migraine, a throbbing headache, often on one side, that comes with feeling sick and a dislike of light or noise and can last hours to days. Some people with migraine see flashing lights or zigzag lines before the pain, called an aura. A third cause is often missed: taking painkillers on many days a month can itself cause a daily headache, called medication overuse headache. In Nigeria a headache is often blamed on malaria or 'BP'. A blood pressure check is sensible, but high blood pressure rarely causes headache unless it is very high, and a malaria test is needed when there is a fever, not for a headache alone.
Medically reviewed by Dr Debo Odulana, Founder and Chief Executive, Mezo. Last reviewed . This page is general information, not a diagnosis. Care is decided with you after an examination.
Symptoms
- A throbbing headache, often on one side, with feeling sick or vomiting (migraine)
- A dislike of light, noise or smells during the attack
- Flashing lights, zigzag lines or blind spots before the headache (migraine with aura)
- A tight band or pressure on both sides of the head (tension-type headache)
- Headaches on most days in someone who takes painkillers often
- Bouts of severe pain behind one eye, with a red, watery eye and a running nose (cluster headache)
When to See a Doctor
Go to a hospital emergency department now for a sudden, severe headache that peaks within a minute or so, like being hit on the head; a headache with fever and a stiff neck, or with a rash; a headache after a head injury; a headache with weakness, numbness, slurred speech, confusion, a fit or loss of vision; or a new severe headache in pregnancy or soon after delivery, which can be pre-eclampsia. See a doctor if headaches are getting more frequent or severe, wake you from sleep, change with your posture or come on with coughing or straining, start for the first time after the age of 50, or if you take painkillers for headache on many days each month. A doctor can take the history by video and tell you whether you need to be examined.
Treatment options
- A careful history and a blood pressure check, which diagnose most headaches without a scan
- A simple painkiller taken early in a migraine attack, with an anti-sickness medicine if needed
- Triptan medicines for migraine that simple painkillers do not control
- Preventive medicine for frequent migraine, chosen with your doctor
- Stopping overused painkillers, with support, for medication overuse headache
- A headache diary to find triggers such as missed meals, poor sleep, stress and dehydration
- A neurologist's review, and a scan, only when the pattern or the examination calls for it
Common Questions
Do I need a CT scan for my headache?
Most people do not. NICE advises against scanning people with typical migraine or tension-type headache only for reassurance, because the history makes the diagnosis and a scan rarely changes treatment. A scan is done when there are warning signs, or a change the doctor cannot explain.
Can painkillers cause headaches?
Yes. Taking simple painkillers on 15 or more days a month, or triptans or codeine-type painkillers on 10 or more days a month, for three months or more, can cause medication overuse headache. It gets better once the painkillers are stopped, with a doctor's support.
Is my headache from high blood pressure?
Usually not. High blood pressure rarely causes symptoms unless it is very high. It is still worth checking, because it needs treating for its own sake, and a reading of 180/120 or higher with a severe headache needs a hospital now.
Can a doctor treat migraine by video?
Yes, for most people. Migraine and tension-type headache are diagnosed from the history, so a doctor can make the diagnosis, start treatment or prevention, and tell you if anything you describe needs an examination or a scan.
Need Help?
A doctor on a video call, who advises on the right test and treatment, and tells you if you need to be seen in person.
See a doctor by videoIf any of the danger signs on this page applies, go to the nearest hospital now instead.
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The guidelines and patient information this page is checked against. Care in Nigeria follows the same evidence; what differs is the price and where it is done.
- Headaches in over 12s: diagnosis and management (CG150). National Institute for Health and Care Excellence (NICE). Clinical guideline.
- Migraine and other headache disorders. World Health Organization. Fact sheet.
- Migraine. NHS. Patient information.
- Headaches. NHS. Patient information.
Links last checked 29 October 2026.
Medical Disclaimer: This information is for educational purposes only and does not replace professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment.