Your First Visit: What to Expect at our Headache Specialist Clinic in Ottawa

Your path to specialized headache care

Your first visit is a comprehensive medical consultation focused on understanding your headache history, reviewing prior investigations and treatments, and developing a clear, practical plan. Many patients are referred after months or years of persistent or difficult-to-treat headache symptoms.

Our goal at the Ottawa Headache Centre is to confirm the most accurate diagnosis and outline an individualized approach to care, rather than offering a single test or treatment.

Step 1: The referral

We accept referrals for any headache disorder. Each referral is triaged based on clinical urgency.

How to start: Ask your doctor or nurse practitioner to send a referral to our clinic.

Wait times: Once received, we triage your referral according to clinical urgency and we provide your doctor an estimated wait-time. You will be contacted directly to schedule your assessment.

We offer both foundational as well as specialized headache treatment (e.g., CGRP antagonists/monoclonal antibodies, occipital nerve blocks, onabotulinumtoxin-A - Botox® - injections, evidence-based off-label treatment, etc.).

Our clinic offers consultations in English, French, Spanish, and Arabic. To provide accurate and high quality care, for other preferred languages please bring an interpreter if you are able to.

Step 2: Preparing for your visit

After your have been referred to the Ottawa Headache Centre, consider preparing the information that will us determine the most precise diagnosis and treatment plan. This includes:

• completing a headache diary

• having a complete list of the medications you have tried for headache.

What to bring: Please bring your health card and a list of all current and previous medications you have tried for headache.

Language support: We are proud to offer consultations in English, French, Spanish, and Arabic. If you prefer to communicate in another language, please bring a trusted interpreter to your appointment if available.

Headache diary: If you have been tracking your attacks, please bring your most recent logs.

Clinic policies: Explore our clinic FAQ to learn more about what to expect from your visit, clinic policies, and how else to prepare for your appointment.

Step 3: What to expect from your first visit

During your first visit one of our specialists will review your referral notes, and take a detailed history from you. This is the first step in establishing your headache diagnosis. While many patients may have a presumed diagnosis of migraine, a focused history often reveals an alternative headache disorder. It is not uncommon to discover a different (or additional) headache disorder than what was previously thought.

The doctor will perform a focused neurological exam that may include:

• taking your vital signs

• examination of your cranial nerves (i.e., observing the movement of your facial muscles, ocular testing, facial sensation)

• fundoscopic examination of your optic discs (to look for signs of elevated intracranial pressure)

• a motor and sensory examination of your arms and legs, and

• reflexes.

No element of the physical examination is invasive, and blood-work is not taken during this visit.

At the end of your visit, the doctor will summarize the findings and provide you with a precise headache related diagnosis and personalized treatment options.

What do we treat?

We will provide a consultation for any headache disorder; some headache disorders may be more appropriately managed (or co-managed) by a different clinician (e.g., odontogenic causes may require a dentist).

Migraine and primary headache disorders

• Migraine: Episodic and chronic migraine

• Acute and preventive migraine management

• Botox® for migraine and headache disorders

• CGRP based treatments

• Cluster headache and trigeminal autonomic cephalalgias

Headache in special populations

• Pregnancy and lactation

• High vascular risk

• Older adults

• Transition from adolescence to adulthood

Secondary headache and other cranial neuralgic disorders

• Idiopathic intracranial hypertension

• CSF-leak/spontaneous intracranial hypotension)

• Secondary headache disorders

• Cranial neuralgias (trigeminal neuralgia, occipital neuralgia, glossopharyngeal neuralgia, nervus intermedius neuralgia)

What treatments do we offer?

We offer both foundational as well as specialized headache treatment:

• Evidence-based foundational management and specialized off-label treatments for complex cases

• Botox® - injections including evidence-based off-label treatment

• CGRP antagonists/monoclonal antibodies

• Nerve blocks

• Neuromodulation counselling

• Lifestyle counselling

• Blood-patch coordination (as well as other CSF-leak targeted therapies)

What happens next?

If you have been referred to the Ottawa Headache Centre, most patients begin by reviewing what to expect at their first visit and preparing any information that may be helpful. This may include tracking headache symptoms, reviewing past treatments, or noting questions you would like to discuss.

If you are unsure where to start, the Day-to-Day Headache Care section provide practical guidance and tools to support you before and after your appointment.