Migraine attack

Migraine in Munich, acute care in quiet

Migraine is one of the most common neurological disorders. A severe attack typically presents with pulsating, usually one-sided pain, nausea or vomiting, marked sensitivity to light and sound, and worsening on physical activity. Some patients experience an aura with visual or sensory disturbance beforehand. In the acute state any sensory input is unbearable, and leaving the darkened bedroom for a practice is a serious additional burden.

The house call removes that burden. We come to your home in Schwabing, Maxvorstadt, Haidhausen, Sendling or Bogenhausen, examine neurologically and agree on therapy together with you. For status migrainosus (an attack lasting more than 72 hours) intravenous therapy is often useful, and we can provide exactly that on site.

Diagnostic certainty before treatment

Before treating an acute headache as migraine we exclude dangerous differentials. We check pupillary response, eye movements, facial motor function, balance, gross strength and sensation, meningism and vigilance. A history covering onset, course, similar previous attacks, accompanying symptoms and risk factors is part of every visit. If the headache appears atypical (new, different, sudden or with neurological findings) we recommend prompt extended workup, for example at Klinikum rechts der Isar or the LMU Klinikum Großhadern.

Therapy on site

For a typical migraine attack our physician can deliver a proven acute therapy: antiemetics such as metoclopramide intramuscularly or intravenously, combined with NSAIDs or (where tolerated and without contraindications) a triptan. With severe symptoms IV fluids are useful because many patients are dehydrated from vomiting. We stay with you during treatment, document the response and outline a plan with you for the next 24 hours.

How the house call works

On first contact we clarify onset and course of the attack, prior experience with migraine, current medication, neurological findings and pregnancy status. If anything looks atypical or there are red flags we direct you straight to a suitable Munich hospital. Otherwise we dispatch the next available physician, typical arrival in Munich 60 to 90 minutes.

On site we perform the neurological exam in a calm, dimmed setting, administer acute medication and stay with you through the critical onset phase. We issue prescriptions for home follow-up therapy, a sick-leave certificate and, for frequent attacks, a recommendation for a neurology practice for prophylaxis.

Billing and insurance

We bill according to the German private medical fee schedule (GOÄ) via our Privatärztliche Verrechnungsstelle, with typical costs of around 150 to 300 euros depending on effort. House call, neurological exam, injection or infusion and administered medication are itemised separately. German private health insurance and civil-servant Beihilfe schemes typically reimburse these positions in full.

For international guests, for example in a hotel near Marienplatz or in Maxvorstadt, we issue the invoice in English on request. We remain reachable by phone for billing questions after the visit.