Getting a referral to the clinic
In most cases, children and young people are referred to the Headache clinic by their paediatrician or paediatric neurologist.
Referrals are generally accepted if referral has come from a local neurologist, the child or young person has migraine and failed two prophylactic medications and if there is a question about diagnosis. If a patient has had an MRI or CT brain scan previously, this needs to be sent to use either electronically via IEP or on a CD along with the referral letter.
We also see those with rare primary headache disorders such as TAC and also those who require specific treatments such as GONI.
Before the clinic appointment
Once an appointment has been made we ask that you complete a headache diary and fill in a PedMIDAS form . We will also send you some other questionnaires for you and your child to complete. These aim to identify your current concerns and assess quality of life and emotional wellbeing. This can help us to identify any further support that may be helpful to your child and can also form a part of assessing the effect of treatment.
We also ask that you bring with you a list of all headache medications and doses given that you have used to treat your headaches in the past. Your GP should be able to advise you on this if you can't remember.
During the clinic appointment
During the visit to the Headache clinic, your child will be seen by a Paediatric Neurologist with a specialist interest in Childhood Headache and a Clinical Nurse Specialist.
As Great Ormond Street Hospital (GOSH) is a teaching hospital, you may see student nurses and doctors in training, but they will be supervised at all times by a qualified member of staff.
What happens after a clinic appointment?
We always keep other members of your local health care team involved and informed, so we will write a letter after the clinic appointment and send it to your family doctor (GP) and the doctor who originally referred you. This will give details of any changes to treatment, such as medicines. We will also send you a copy to read and keep.
We know that a multidisciplinary approach to treatment of headaches and migraines can be helpful. Following the clinic appointment, your child may be referred to a clinical psychologist from the Paediatric Psychology service, who works as part of the team. They can work with children and their families to support the development of strategies for managing and coping with headaches. This may include identifying and managing triggers, developing relaxation strategies and addressing difficulties such as anxiety. Psychological interventions may be offered through individual sessions or as a group.
The Headache clinic is a specialist service and we aim to help your local service carry on giving you regular care but to be available for advice when needed. How often you need to come to clinic depends on individual needs. Some children and young people will need to visit us again following the initial appointment and others will not.