Your headache isn’t getting better. Let a headache neurologist look at it properly.
Most “untreatable” headaches I see are not rare diseases. They are common conditions that were never named precisely — and therefore never treated correctly. Send me your case and I will tell you plainly what I would do next, and what I would stop doing.
Dr. Tae Ho Guak, MD — Neurologist · 25 years in headache practice · 100,000+ patients · Korea’s #1 individual clinic for triptan and CGRP-antibody (Ajovy · Emgality) prescriptions · Korean Headache Society
- Ask one focused question
- A written answer from Dr. Guak — not a template
- Plain English, with the reasoning shown
- One clarifying follow-up included
- I read your full headache history and records
- A written second-opinion report — likely diagnosis, what was missed, what I would do next
- What to stop — including the medication-overuse trap
- A one-page summary you can hand to your own doctor
- Two follow-up questions included
How it works
- You pay and are taken straight to a short intake form. It asks the questions I would ask in clinic — how your attacks start, where the pain sits, what you’ve already tried, and how many days a month you reach for a pill.
- You attach what you have. Prior notes, imaging reports, a medication list, a headache diary if you keep one. Attachments are optional — the history matters more than the scan.
- I review the case personally. Not an assistant, not an AI summary. If anything is unclear, I email you before writing.
- You receive a written report — what I think this is, why, what I would do next, and what I would stop. Written so that your own doctor can act on it.
What the report actually looks like
Impression. The pattern you describe — unilateral, builds over an hour, light and sound sensitivity, relief with sleep — is migraine, not “sinus headache.” The absence of infection and the response to a triptan support this.
What is likely being missed. You take a combination analgesic on ~15 days a month. That is above the threshold for medication-overuse headache, which explains why your “background” headache became daily.
What I would do next. Withdraw the overused analgesic on a defined schedule; start a preventive with adequate dose and an 8-week trial before judging it; keep a rescue plan that is limited to 2 days per week.
What I would stop. Increasing the acute medication. It is the pattern that is driving this.
Illustrative example, not a real patient.
What this is — and what it is not
If you have red-flag symptoms — a thunderclap headache, fever with a stiff neck, new weakness, numbness, or speech or vision changes, headache after a head injury, or a significant new headache after age 50 — do not use this service. Seek emergency care now.
Not sure yet?
Start with the free material and come back when you’re ready.
- Why your headache isn’t getting better — the diagnoses most often missed
- Free Red-Flag Checklist — the headaches you should never ignore
- Headache Library — 55 clinical articles
- Migraine, Plainly — my Kindle guide ($2.99, free with Kindle Unlimited): what migraine is, how to stop an attack, and the modern preventives that actually work
Questions people ask before booking
Do I need my scans?
No. Headache is diagnosed by the pattern of your symptoms, not by imaging. Send the report if you have one, but the history matters more.
What if my case turns out to be simple?
Then I will say so, plainly, and tell you the one or two things worth changing. A short answer is still an answer.
What if I need more than one question answered?
Choose the $99 second opinion. The $29 tier is deliberately one question — it exists so you can test whether this is useful to you.
Refunds
If your case falls outside what I can responsibly review remotely — for example it needs an urgent in-person examination — I will tell you and refund you in full.
In person, in Korea
If you can visit, I see headache patients at Riche Neurology & Headache Clinic in Bundang, Jeongja-dong. riche.clinic →