January 4, 2026

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 missHow to explain migraine in clear, patient-friendly languageStep-by-step management: lifestyle advice, acute treatments, and preventionWhen to escalate, safety-net, and referThis 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 disablingMigraine may occur with or without aura (visual, sensory, or nausea symptoms)Common triggers include alcohol, chocolate, caffeine, stress, and poor sleepMigraine with aura is a contraindication to the combined oral contraceptive pillConservative management focuses on trigger avoidance and lifestyle modificationFirst-line treatment includes simple analgesia (paracetamol, NSAIDs)Triptans (e.g. sumatriptan) can be used for acute attacksPreventative options may include beta-blockers or specialist therapiesAlways safety-net worsening headaches, neurological symptoms, fever, or sudden onset

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