Adult Migraine Evaluation & Treatment
Comprehensive specialty migraine evaluation in New Jersey
About an hour for the initial consultation, with a personalized care plan and ongoing treatment built around your specific presentation.
Most migraine sufferers in NJ have spent years working through generic protocols. Triptans for acute attacks. Maybe a beta blocker or topiramate for prevention. Lifestyle advice that's broad enough to be unhelpful. When that approach hits its limits, the question becomes: what next?
Specialty migraine evaluation answers that question. We do the detailed history that PCP-managed care often skips, identify trigger patterns specific to your presentation, review what's been tried and why it didn't work, and build a treatment plan calibrated to where you actually are — not where the standard protocol assumes you are.
Some patients leave the evaluation with a new medication regimen. Others leave with trigger-management work and behavioral strategies that change the picture. Patients who meet chronic migraine criteria may continue to a Botox treatment plan. Whatever the path, it's specific to you.
Why a Specialty Consultation
PCP-managed migraine care has limits. Specialty evaluation reaches further.
Migraine isn't one diagnosis — it's a category. Episodic migraine, chronic migraine, migraine with aura, vestibular migraine, menstrual migraine, hemiplegic migraine. The treatments that work for one type often don't work for another. Specialty evaluation maps which type (or types) you're actually dealing with.
Trigger identification is more than a list. Generic trigger lists (sleep, stress, weather, specific foods) don't tell you which apply to your presentation. Real trigger work is pattern recognition over time — what you ate, what the weather was, what your sleep was like, what your hormonal cycle was doing — for the specific days you had migraines vs. the days you didn't.
Medication strategy is multi-layered. Acute treatment (triptans, gepants, NSAIDs), preventive treatment (beta blockers, anticonvulsants, CGRP inhibitors), rescue treatment (steroids for breakthrough), procedural treatment (Botox for chronic migraine). The right combination depends on frequency, severity, comorbidities, and what's already been tried.
What Happens During Your Migraine Consultation
One ~60-minute visit. Comprehensive intake. Personalized care plan.
Detailed history
We start with the full migraine history — when they started, how the pattern has evolved, current frequency and intensity, associated symptoms (aura, nausea, light/sound sensitivity, post-migraine fatigue), and impact on your daily life. Time spent on this matters; the specifics are what differentiate one type of migraine from another.
Treatment history
Every medication you've tried, every protocol you've been on, every lifestyle modification that's been recommended. What worked, what didn't, what side effects you experienced. We don't want to repeat treatments that have already failed; we want to build forward from where you actually are.
Triggers and patterns
We work through your trigger history together — sleep, hydration, hormonal patterns, specific foods, weather sensitivity, stress patterns. If you've been keeping a migraine diary, bring it. If you haven't, we walk through how to build one.
Diagnostic clarity
Are you dealing with episodic migraine, chronic migraine, or both? Is there an aura component? Are vestibular or hemiplegic features present? We map your presentation against current diagnostic criteria and explain what that means for treatment options.
Personalized care plan
You leave the consultation with a written care plan: medication recommendations (acute and preventive), trigger-management priorities, lifestyle modifications calibrated to your specific patterns, and a follow-up cadence. If chronic migraine criteria are met and you're interested in Botox, we walk through that pathway too.
Initial Migraine Consultation $425
~60 minutes, paid at the visit.
Follow-up Visit $175
$150 grandfathered for existing patients in continuous care.
Tools-included
All consultation work and any clinical assessment tools used are included in the $425. No separate testing fees.
Comprehensive Diagnostic Report $450
Optional add-on (for ADA accommodations, disability claims, or other formal documentation needs).
Treatment Approaches We Use
No single treatment works for every migraine presentation. We use the toolkit appropriate to your case.
Abortive medications
Triptans (sumatriptan, rizatriptan, zolmitriptan, etc.) and gepants (rimegepant, ubrogepant) for stopping migraines that have already started. We help identify which class works best for your presentation and how to use them most effectively.
Preventive medications
Beta blockers (propranolol), anticonvulsants (topiramate), CGRP receptor antagonists (atogepant, rimegepant for prevention), and CGRP monoclonal antibodies (Aimovig, Ajovy, Emgality, Vyepti) for reducing migraine frequency.
Botox for chronic migraine
FDA-approved injectable preventive treatment for adults meeting chronic migraine criteria (15+ headache days per month, 8+ migraine days, for 3+ months). The 31-injection protocol every 12 weeks. Detailed on /migraines/botox-for-chronic-migraines.
Trigger management
Sleep hygiene, hydration, dietary trigger identification, hormonal pattern work, stress management strategies — calibrated to your specific patterns rather than generic recommendations.
Coordination with other providers
Communication with your PCP about medication interactions, OB-GYN about hormonal aspects, mental health providers about stress and mood patterns that affect migraine frequency.
Treatment plan iteration
Migraine treatment is rarely a one-and-done plan. Most patients need follow-up adjustments based on what works and what doesn't. We schedule follow-ups at the cadence your situation needs.
Ongoing Migraine Care
Migraine care isn't an event — it's a relationship. After your consultation, ongoing care typically follows one of a few patterns:
Active titration phase. When you're starting a new medication or protocol, follow-ups every 4-8 weeks while we calibrate dosing and assess response. Most patients see meaningful change within 2-3 follow-ups.
Stable maintenance phase. Once your treatment plan is working, follow-ups every 3-6 months for medication renewals and minor adjustments. We document everything so you don't have to keep re-explaining your history.
Botox maintenance. If you're on the Botox protocol, treatments every 12 weeks at our office. Brief medical check-ins at each treatment visit; longer follow-ups annually or when something changes.
Episodic check-ins. Some patients only need to see us when something changes — new patterns, treatment failure, a major life event affecting migraine frequency. That's fine. We're here when you need us, not on a forced schedule.
Follow-up visits are $175 each (or $150 grandfathered for existing patients in continuous care since launch). Telehealth available throughout NJ; in-person at our Westfield office.
Real Patients, Real Progress
Schedule Your Migraine Consultation
If you're ready for specialty migraine care that goes beyond generic protocols, the next step is booking your initial consultation.
Your Questions About Migraine Evaluation, Answered
How long does the consultation take?
About 60 minutes. The intake is comprehensive — we review the full migraine history, treatment history, trigger patterns, current functional impact, and build a personalized care plan in the same visit.
How much does it cost?
Do I need to bring anything to the consultation?
What if I've already been diagnosed and just need treatment?
Can you handle migraine medications, or do I need to go back to my PCP?
What if I think I might need Botox?
How often will I need follow-up visits?
Can I do consultations by telehealth?
What if my migraines turn out to be something else?
Do you treat migraines outside New Jersey?
