How to Counsel a Patient on Migraine | OSCE Talk
OSCE Talk4 Tammi

How to Counsel a Patient on Migraine | OSCE Talk

In this episode of OSCE Talk, we cover how to counsel a patient with migraine — a common OSCE and clinical scenario.

We walk through:

  • How migraine typically presents (with and without aura)

  • Common triggers and red flags you must not miss

  • How to explain migraine in clear, patient-friendly language

  • Step-by-step management: lifestyle advice, acute treatments, and prevention

  • When to escalate, safety-net, and refer

This episode builds on our headache history episode and focuses specifically on clear, structured counselling, helping you feel confident explaining migraine to patients in OSCEs and real-life practice.

  • Migraine is usually a unilateral, throbbing headache that can be severe and disabling

  • Migraine may occur with or without aura (visual, sensory, or nausea symptoms)

  • Common triggers include alcohol, chocolate, caffeine, stress, and poor sleep

  • Migraine with aura is a contraindication to the combined oral contraceptive pill

  • Conservative management focuses on trigger avoidance and lifestyle modification

  • First-line treatment includes simple analgesia (paracetamol, NSAIDs)

  • Triptans (e.g. sumatriptan) can be used for acute attacks

  • Preventative options may include beta-blockers or specialist therapies

  • Always safety-net worsening headaches, neurological symptoms, fever, or sudden onset


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