The successful treatment of a difficult headache disorder requires some very simple components: a neurologist with experience in headache diagnosis and treatment and a good nursing support system.

A good treatment program includes these items, other services such as physical therapy, psychological services, biofeedback, etc. may be helpful but do not necessarily need to exist under the same roof. For ethical considerations, it is sometimes an advantage to have these services come from a variety of sources, especially when then patient lives a distance from the headache clinic.

It is no more expensive to treat a headache patient than someone with difficult epilepsy or other complex neurological conditions and the fees in a headache program should be in line with the conventional practice of neurology in other settings. It is not appropriate for a neurologist, for example, to charge a patient extra to reinterpret MRI scans or tests performed in other centers. A headache clinic should not be priced high just because the desperate patient will do anything for relief.

By the same token, it is inappropriate for a managed care carrier to limit the number of times that an ethical neurologist can see a headache patient, sometimes frequent visits are needed when the patient is trying to deal with frequent headache crises. It is less expensive for an insurance carrier to pay for a few visits to the specialist each year than to cover expensive emergency room visits.

The patient should be comfortable with the clinic setting, should not feel hurried through the visit and should be able to develop a good one-on-one relationship with the treating physician. It is preferable to see the same physician each visit.

Finding such a center is sometimes difficult, it is helpful to discuss your options with your primary physician or other headache patients who are doing well. Another good option is to contact the National Headache Foundation in Chicago for names.