Migraines are not ordinary headaches. They are a neurological condition that can shut down a full day — sometimes multiple days — with throbbing pain, nausea, light and sound sensitivity, and visual aura. Over 39 million Americans live with migraines, and Doral's climate and commute patterns often make them harder to manage. At Viva Medical Center, our providers evaluate each patient's triggers, frequency, and severity, then build a treatment plan that includes acute relief for active attacks plus a preventive strategy to reduce how often they happen. Most patients are seen within one week, and same-day visits are available when a severe attack will not lift. Call (305) 209-0001.
What Viva Medical Center Treats
- Episodic migraine (fewer than 15 headache days per month)
- Chronic migraine (15 or more headache days per month, with at least 8 that are migraine)
- Migraine with aura — visual, sensory, or speech disturbance that precedes the headache
- Hemiplegic migraine and other uncommon subtypes
- Medication-overuse headache — when over-the-counter relief has started causing daily headaches
- Post-traumatic headache after concussion or whiplash
How Migraine Evaluation Works at Your First Visit
Diagnosing migraine is a clinical process built around your history, the pattern of your attacks, and exclusion of other headache causes. Imaging is not always necessary but is ordered when the pattern is atypical.
- Detailed headache history — triggers, timing, family history, and what relief has worked
- Neurological exam to identify warning signs that need imaging (new-onset late-life headache, positional, post-trauma)
- Review of medication history to rule out rebound from frequent analgesic use
- Lab work when hormonal, thyroid, or inflammatory causes are suspected
- Referral for brain MRI when clinically indicated
- Headache diary planning so the next visit has objective data on attack frequency and triggers
Acute Treatment for Active Attacks
Acute (also called abortive) treatment is what you take when an attack starts. The right choice depends on severity, how fast it escalates, and whether nausea limits oral medication.
- Over-the-counter analgesics for mild attacks when used sparingly
- Prescription triptans and related acute medication classes for moderate-to-severe attacks
- Newer small-molecule CGRP receptor antagonists for patients who cannot tolerate triptans
- Antiemetic medication when nausea is a major component
- Rescue plans for attacks that do not respond to first-line acute treatment
Preventive Treatment — Reducing Attack Frequency
Preventive medication is taken daily or monthly to reduce how often migraines happen. It is worth considering when you have four or more migraine days per month, or fewer if they are severely disabling.
- Oral preventive medication classes with decades of evidence
- Monthly injectable CGRP monoclonal antibodies for patients who qualify
- Supplements with evidence for migraine prevention (magnesium, riboflavin, coenzyme Q10) at appropriate doses
- Lifestyle anchors — sleep regularity, hydration, meal timing, stress-reduction plans
- Referral to botulinum toxin injections for chronic migraine when medication alone is insufficient
- Follow-up every 8-12 weeks to adjust the preventive plan based on headache diary data
Common Triggers We Help You Identify
- Sleep disruption — too little or too much
- Dehydration and skipped meals
- Weather and barometric pressure changes (common in South Florida)
- Hormonal shifts, especially the days before menstruation
- Certain foods and drinks — aged cheeses, processed meats, red wine, MSG, caffeine withdrawal
- Bright or flickering light, screens, and strong scents
- Stress, and the 'let-down' period right after high-stress events
When to Seek Urgent Evaluation
Most migraines are not dangerous. These specific patterns are a signal to call us the same day or go to the emergency room.
- A sudden, severe headache that reaches maximum intensity within seconds
- A headache with weakness, numbness, trouble speaking, or vision loss that does not resolve
- Headache with fever, neck stiffness, rash, or confusion
- New headache pattern after age 50 that does not match prior history
- Headache after head trauma within the last 7 days
Insurance and Same-Day Access
Viva Medical Center is in-network with most major carriers, so preventive and acute migraine care is typically covered under your neurology or primary care benefit.
- In-network with Oscar Health, Aetna, Cigna, Humana, Medicare Advantage, Ambetter, UnitedHealthcare
- Self-pay rates published for patients without insurance
- Same-day appointments for acute attacks that are not responding to home treatment
- Telehealth follow-ups available for medication adjustments and headache diary review
- Bilingual English and Spanish staff for a clear, unhurried conversation
Frequently Asked Questions
How is chronic migraine different from regular headaches?
Chronic migraine is defined as 15 or more headache days per month for at least three months, with at least 8 of those days meeting full migraine criteria. Regular tension headaches do not usually involve nausea, light sensitivity, or throbbing one-sided pain. If your headaches are disrupting work, sleep, or daily activities more than a few days a month, a neurological evaluation is worth booking.
Do I need a brain MRI for migraine?
Not always. Most migraine diagnoses are made clinically based on your history and exam. MRI is ordered when there are red flags — new-onset headache after age 50, neurological findings on exam, sudden severe onset, or a clear change in pattern. Our provider discusses whether imaging fits your case during the first visit.
Can I get preventive migraine medication at my first visit?
Yes, if your attack frequency supports it and there are no contraindications. Many preventive medications are started at a low dose and titrated up over 4-6 weeks. Newer CGRP monoclonal antibodies are prescribed when oral preventives are not tolerated or do not work; those often require prior authorization which our team handles.
Is migraine treatment covered by insurance?
Yes for almost all of our in-network carriers. Evaluation, follow-up visits, preventive medication, and acute medication are typically covered under the primary care or neurology benefit. CGRP antibodies and botulinum toxin for chronic migraine require prior authorization, which is standard; we submit the paperwork on your behalf.
Can migraine be treated by telehealth?
Follow-ups, medication adjustments, and headache diary review are well-suited for telehealth. The first evaluation is usually in-person so we can perform a neurological exam. Once we have a working plan, most patients transition to telehealth for routine follow-up, which keeps care accessible when an attack makes driving unsafe.
What should I do during an acute migraine attack?
Take your acute medication as early in the attack as possible — waiting rarely helps. Find a dark, quiet room, hydrate, and avoid screens. If the attack is more severe than usual, does not respond to acute medication within two hours, or comes with neurological symptoms you have not had before, call (305) 209-0001 or go to the nearest emergency room.