What to Know About Telehealth for Migraine

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Migraine is a neurological disorder characterized by chronic or occasional (acute) attacks of headache, often accompanied by other symptoms, including dizziness, nausea, and sensitivity to light and sounds. It can be difficult to treat.

People with migraines often need consultations with a neurologist—a specialist in brain medicine. Increasingly, telehealth—the use of technology to conduct video consultations with healthcare providers online—is emerging as an option to help with migraine diagnosis and management.

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Telehealth is more comprehensive than talking to a neurologist on the phone, and it improves access to care. Not only is telehealth a viable alternative for people with migraine, but it also points to the future of care for this and other disorders.

Telehealth and COVID-19

Telehealth appointment use has grown in light of the need to socially distance during the COVID-19 pandemic. For migraine, telehealth allows patients to get help from the comfort of their homes. Keep in mind, though, that hospitals and clinics certainly take precautions to ensure safety during in-person appointments. 

When to Use Telehealth for Migraine

The most critical aspect of migraine diagnosis involves a careful evaluation of medical history and symptoms, which can effectively be covered during a telehealth session. Also, telehealth has a great deal of utility if you have concerns or issues after starting treatment or managing the condition.

So when should you consider this approach? Here’s a breakdown:

  • Symptoms are debilitating: Migraine is a complicated disorder, and it expresses itself differently in different people. Especially if you’re already managing this condition—with lifestyle changes, medications, or other methods—telemedicine can help if your symptoms aren’t getting better or are very debilitating.
  • Your symptoms have changed: Seek out help if the nature of your migraine symptoms has significantly changed or if you’re unsure about how you are feeling. A telehealth appointment with a neurologist can help them determine if what you’re experiencing is expected or if they’re potential signs of some other issue.  
  • You need follow-up: Telehealth appointments are an excellent way for neurologists to perform follow-up after initial consultations and diagnosis. These are opportunities to check with the specialist and assess how well interventions and treatments are working.
  • Getting to the office may be difficult: Accessibility to care is key, which is certainly important in the face of a debilitating condition like a migraine. Not only that, there may not be a specialist in your area. In these cases, telemedicine emerges as a viable option.
  • You need a prescription refill: If you’ve been prescribed medications for migraine, such as triptans (like Imitrex or Zomig) and beta blockers (like Tenormin or Lopressor), you may need a prescription refill. A telemedicine appointment with your doctor will often be sufficient.
  • You need a quicker turnaround: Typically, it’s easier and more convenient to schedule a telemedicine appointment, and you’ll likely be seen sooner with this approach. If time is an issue, it’s an option worth considering.

You May Need to Be Seen in Person If...

Reasons for an in-person visit include:

  • You need vision testing: Some types of migraines and headache-producing conditions affect vision, and vision problems can cause other types of headaches. Fundoscopy, in which the doctor examines the inside of your eye, may be needed. This can only be done in the healthcare setting.
  • Imaging is required: To rule out other causes of headache, you may need to come to a hospital or clinic for imaging. This may involve magnetic resonance imaging (MRI), X-ray, or computerized tomography (CT) scans.
  • You need a spinal tap: Some neurological disorders require testing and assessing the cerebrospinal fluid that surrounds your brain and spine. This requires a spinal tap, also known as “lumbar puncture,” something that can only be done in a clinical setting.
  • Other tests are needed: To rule out infections or other disorders, blood may need to be tested in the laboratory. Migraines and other headache disorders can also impact motor function, so some doctors may need to assess how well you move.

Benefits and Challenges

An important question when it comes to telehealth is: Can it really replace an in-person visit? Another is: Why consider this option?

When it comes to migraine, a growing body of research is finding this approach to be largely beneficial for patients. Not only that, practical considerations make this a good option. Here’s a quick breakdown of its benefits:

  • An effective consultation: A Norwegian study published in Neurology in 2017 noted that telehealth visits and in-person appointments fared similarly in terms of headache outcomes at 12 months afterward. Conditions that required additional testing for diagnosis were effectively caught with this approach, and diagnosis was largely accurate.
  • Better access to expertise: Especially if you live in a rural or less-densely populated area, the nearest neurologist may be far away from you. Telehealth eases that burden, allowing patients to consult with experts that aren’t nearby.
  • Convenient timing: A particular benefit of telehealth for migraine is that it allows those with busy work schedules to schedule off-hour appointments. Not only that, the average telehealth appointment takes less time and eliminates the need for a commute.
  • During an attack: Migraine attacks can sometimes last for days and be very debilitating. In this case, it may be much easier for a patient to talk to a doctor online from the comfort of their own home.
  • Patients are satisfied: Studies looking at telehealth for migraine and other headache conditions have noted patients are just as and even more satisfied with telehealth consultations. Among the reasons noted were the ease of access and the time-efficiency of working this way.

There is some debate in the medical field about whether it would be feasible to switch to an all-telehealth approach to migraine.

Despite a track record of efficacy, there are some limitations to what can be done—most certainly with the initial appointment—and additional technological advancements may be needed to allow for an even more comprehensive diagnosis.

However, telehealth has already succeeded in making migraine care more accessible, especially for those in underserved areas, those for whom travelling is difficult, and those who have busy schedules.

How to Prepare for a Telehealth Visit for Migraine

As with in-person appointments, it’s important to be properly prepared for your telehealth visit. So how should you go about preparing for this type of consultation for migraine? Here are some quick tips:

  • Understand the technology you’ll be using before the consultation. You’ll get detailed instructions from your provider after you make an appointment; make sure your computer has what it needs.
  • Make sure you have privacy as you get ready for the consultation to prevent interruptions from others. This may mean ensuring children are taken care of or finding a secure location in a shared house.
  • Have a list of all medications you’re taking, both prescribed and over-the-counter, ready to share with your doctor. Don’t forget to include any herbs, vitamins, or supplements you’re taking.
  • Your medical history will be necessary for the doctor to assess. While they may have it already, make sure you can answer questions about your past, as well as any history of migraine issues in your family.
  • Get help if you think you’ll need assistance with the technology or extra support during your appointment.
  • Log your headaches using a headache diary so that you can answer questions about your condition. This includes keeping track of the duration and intensity of headaches, as well as triggers.
  • Share medical information that you may already know, such as your weight and height. If you have a thermometer or any other device for at-home health measuring, have those ready.   
  • Prepare questions to ask about your condition or about any suggested therapies or medications. Don’t hesitate to draw from your doctor’s knowledge.
  • Ensure good connectivity during your appointment. If your home (or office) has limited bandwidth, see if you can’t limit others from using the internet while you’re online.

Will Insurance Cover Telehealth for Migraine?

Depending on your insurance plan, telehealth visits for migraine should be eligible for coverage. There is, however, a great deal of variation based on the individual plan. With the COVID-19 pandemic, Medicare and Medicaid have also expanded the number of telehealth visits that are eligible to be covered.

Following guidance laid out in 2020, these appointments are to be covered in the same manner as in-person visits; however, there is a great deal of variation based on what state you’re in. Before scheduling your appointment, make sure to understand what your plan will cover.

What Happens During a Visit

What can you expect during a telehealth visit for migraine? It very much depends on whether the consultation is an initial appointment or a follow-up. In general, there are some things you can expect. Here’s a quick breakdown:

  • You’ll need to answer questions: Since a physical examination isn’t possible—and since medical status and history are necessary for proper medical evaluation—you’ll need to answer many questions. As noted, come prepared to talk about your symptoms, medications, and other aspects of your health status.
  • You may have to perform tests: While some examinations are impossible to perform using telehealth, other mental function tests can be conducted this way. For instance, some providers can perform visual tests and assess some mental health aspects based on their sessions.
  • Virtual follow-up: Once the neurologist has evaluated you, you can expect an email with notes from the session, as well as any prescriptions that prove necessary. If in-person or additional screening is necessary, you’ll get the information needed to schedule that. You’ll be given contact information and ways to get in touch with your provider.

A Word From Verywell

For as common as migraine is—approximately 12% of the population experience some form of it—the condition is challenging because it’s not well understood and there is no singular treatment for it.

And while telehealth won’t solve everything about delivering care for this condition, it has already revolutionized how this disorder can be taken on. With the help of this technology, getting help and care for the condition is easier than it’s ever been before.  

Consider the emergence of telehealth appointments an additional weapon in the arsenal against migraine. They can bring specialists into your home and streamline the way you get your care. As these technologies continue to evolve, the quality of care delivered online is likely to improve.

 

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Article Sources
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  1. Migraine Research Foundation. Migraine facts. 2021.

  2. American Headache Society. Telemedicine proves value in managing migraine patients. 2015.

  3. Ravitz R. Telemedicine for migraine patients. Association of Migraine Disorders. 2019.

  4. Yancey J, Sheriden R, Koren K. Chronic daily headache: diagnosis and management. Am Fam Physician. 2014;15(89):642-648.

  5. Müller K, Alstadhaug K, Bekkelund S. A randomized trial of telemedicine efficacy and safety for nonacute headaches. Neurology. 2017;89(2):153-162. doi:10.1212/wnl.0000000000004085

  6. Müller K, Alstadhaug K, Bekkelund S. Acceptability, feasibility, and cost of telemedicine for nonacute headaches: a randomized study comparing video and traditional consultations. J Med Internet Res. 2016;18(5):e140. doi:10.2196/jmir.5221

  7. Jay G. Headache and migraine: how to conduct a virtual neurological examination. Practical Pain Management. 2021.

  8. National Institute on Aging. Telehealth: What is it, how to prepare, is it covered? 2020.

  9. Center for Medicare and Medicaid Services. Medicare telemedicine health care provider fact sheet. 2020.

  10. Robblee J. Telemedicine neurologic examination. American Headache Society. 2021.