Migraine is a complex neurological disorder affecting approximately 39 million Americans — nearly 1 in 7 people. It is the second leading cause of disability worldwide and the most common neurological disorder seen in primary care. Despite its prevalence, migraine is dramatically undertreated: studies consistently show that the majority of people with migraine have never received a prescription treatment, and many suffer through attacks for years without an accurate diagnosis or effective plan. At Viva Medical Center in Doral, FL, we take migraine and headache disorders seriously. Our board-certified physicians are trained in current headache medicine guidelines, including the 2024 International Headache Society acute treatment recommendations and the latest CGRP-targeted prevention therapies. We handle the majority of headache conditions in-house and coordinate neurology referrals when specialist involvement is indicated. If you are searching for a migraine doctor in Miami or headache treatment in Doral, FL, you are in the right place. We offer bilingual care — English and Spanish — for patients throughout Miami-Dade.
Headache Conditions We Treat
Our team evaluates and manages the full spectrum of primary and secondary headache disorders:
- Migraine without aura — most common migraine type; unilateral pulsating pain with nausea/light sensitivity
- Migraine with aura — preceded by neurological symptoms (visual disturbances, numbness, speech changes)
- Chronic migraine — 15 or more headache days per month for 3+ months
- Tension-type headache — bilateral pressing pain, usually without nausea or light sensitivity
- Cluster headache — severe, strictly unilateral orbital pain in cluster patterns
- Medication overuse headache (MOH) — occurs with pain medication use > 10–15 days/month
- Post-traumatic headache — headache following head or neck injury
- Secondary headache — evaluation and referral for headaches caused by underlying conditions
Acute (Rescue) Treatment Options
For stopping a migraine attack already in progress, current 2024 IHS guidelines support:
- NSAIDs (ibuprofen, naproxen sodium) — effective for mild to moderate attacks
- Triptans — most effective first-line acute prescription treatment; top performers include eletriptan, rizatriptan, sumatriptan, and zolmitriptan
- Combination therapy — oral sumatriptan 50–100 mg plus naproxen sodium 550 mg for superior efficacy
- Gepants (ubrogepant/Ubrelvy, rimegepant/Nurtec) — CGRP antagonists; effective for patients who cannot tolerate or do not respond to triptans
- Lasmiditan (Reyvow) — serotonin receptor agonist; option for patients with cardiovascular contraindications to triptans
- Anti-nausea medications as adjuncts
Preventive Treatment Options
Prevention is recommended when migraines occur 4 or more days per month. Options include:
- CGRP monoclonal antibodies — erenumab (Aimovig), fremanezumab (Ajovy), galcanezumab (Emgality); monthly or quarterly injection; reduce headache frequency by 50%+ in most patients
- Oral CGRP antagonist — atogepant (Qulipta); daily oral prevention option
- Beta-blockers — propranolol, metoprolol; well-established oral preventives
- Anticonvulsants — topiramate, valproate; effective with mood stabilizing properties
- Tricyclic antidepressants — amitriptyline; also helps comorbid sleep and anxiety
- Calcium channel blockers — verapamil; particularly for cluster headache prevention
- Botulinum toxin (Botox) — FDA-approved for chronic migraine (15+ days/month); typically administered by neurologist
- Nutraceuticals — magnesium (400–600 mg/day), riboflavin (B2, 400 mg/day), CoQ10 — supported by evidence as adjuncts
When We Refer to Neurology
While primary care manages most headache conditions effectively, we refer to our neurology partners when:
- Headaches fail to respond to two or more preventive medication classes
- Chronic migraine not controlled with first-line prevention
- Red flag symptoms require specialist evaluation
- Botox injections for chronic migraine are indicated
- Complex aura features need further neurological workup
- Suspected secondary cause (mass, vascular, inflammatory) requires neuroimaging review by specialist