Quick Answer
Headache treatment decisions run on how many days a month are affected rather than on severity. Chronic migraine is defined at fifteen or more headache days a month with migraine features on at least eight. Assessed and treated at 1691 W. Horizon Ridge Parkway, Suite 100, Henderson NV 89012.
Part ofThis guide sits beneath headache and migraine, which covers the study itself, how it is performed and what the report should contain.
Headache and Migraine evaluation and management →Key Takeaways
- Frequency rather than severity drives treatment decisions.
- Chronic migraine is defined numerically at fifteen headache days a month with migraine features on eight.
- Recurrent facial pressure treated as sinus disease is frequently migraine.
- Acute medication taken frequently enough can sustain the headaches it was taken to relieve.
- Bring a month of dates to 1691 W. Horizon Ridge Parkway, Suite 100, Henderson NV 89012. That record converts an approximate conversation into a decision.
Migraine
Migraine is a neurological disorder in which attacks of head pain occur alongside other nervous-system symptoms such as nausea, light or sound sensitivity, and visual aura. It is a disorder of how the brain processes sensory input, not simply a bad headache.
What a headache assessment actually establishes
Most headache is a primary headache disorder, meaning the headache is the condition rather than a symptom of something else. The assessment exists to classify it and to identify the minority where that is not true.
Frequency rather than severity drives the decision
This is the single most useful thing to understand. Treatment decisions run on how many days a month are affected, not on how bad the worst day was. Chronic migraine is defined numerically at fifteen or more headache days a month with migraine features on at least eight, and that threshold determines candidacy for several preventive treatments. Most people underestimate their count substantially when reconstructing from memory, which is why a month of dates is worth more than any description.
Separating the types
Migraine, which is episodic, frequently one-sided, often with nausea and sensitivity to light or sound, and worsened by movement. Tension-type, which is typically bilateral and pressing. Cluster headache, which produces severe one-sided pain around the eye with tearing and nasal congestion. And the one most often misattributed: recurrent facial pressure treated as sinus disease, which is frequently migraine, because migraine activates a pathway producing nasal congestion and facial pressure.
What signals something else
A genuinely new headache pattern after fifty. A clear change in character or timing from a long-standing pattern. Headache consistently waking you from sleep or worst on waking. Personality or behavioural change. Progressive week-on-week worsening. None of those means something serious is present; they mean the threshold for investigating drops.
What is an emergency
A headache reaching maximum intensity within seconds. Headache with fever and neck stiffness. Headache with new weakness, numbness, difficulty speaking or vision loss. Those need an emergency department rather than an appointment.
| Also considered | How it is distinguished |
|---|---|
| Tension-type headache | Pressing, bilateral pain without nausea, aura or movement sensitivity. |
| Cluster headache | Strictly one-sided, 15 minutes to about 3 hours, with tearing, nasal congestion or a drooping eyelid, and restlessness rather than stillness. |
| Medication-overuse headache | A pattern change: headaches become more frequent as acute medication use rises, and the history rather than a scan identifies it. |
| Secondary headache | Red flags — sudden 'worst-ever' onset, fever with neck stiffness, new deficit, or onset after head injury — prompt urgent imaging rather than a headache diagnosis. |
What the practice does, and what to bring
01
What brings people in
Frequent or changing headaches, attacks that are no longer controlled by what used to work, or a new headache pattern that needs an explanation.
02
What the evaluation settles
Which headache disorder the pattern fits, whether any red flag needs imaging, and which preventive and acute options are appropriate.
03
What you leave with
A named diagnosis where one can be made, a written acute and preventive plan, and a follow-up interval to judge whether it is working.
Bring a month of dates
Which days you had a headache, roughly how severe, and what you took. That single record converts an approximate conversation into a decision, and its absence is the commonest reason a first appointment ends with a request to return.
Medication overuse checked before a preventive is added
Acute headache medication taken frequently enough can sustain the headaches it was taken to relieve. Common, not a failure of willpower, and it changes the plan: addressing it usually has to come before or alongside a new preventive, because a preventive started on top of an unrecognised overuse pattern works against a headwind.
Treatment options performed here
Botox for chronic migraine and CGRP therapy are both available, on the Botox page and the CGRP page. Where pain localises to a specific nerve on examination, a targeted nerve block may apply. Coverage and prior authorisation are completed before the appointment.
How prevention is assessed
On the change in headache frequency across months rather than on whether it stopped one attack. Abandoning a preventive after two weeks is the commonest way a workable plan gets discarded before it has been tested. Practice guidance is from the American Academy of Neurology.
The first 30, 60 and 90 days
Step 1
First visit
History and neurological examination, a review of records and prior imaging, and a decision on which studies are actually indicated. You leave with the plan, not just a referral.
Step 2
Within 30 days
Indicated in-office studies are performed and interpreted by the neurologist who ordered them, in our AANEM-accredited laboratories. Results are explained in plain language.
Step 3
60 to 90 days
Follow-up to judge whether the plan is working, adjust it, and coordinate with your referring clinician. Where a diagnosis needs time to confirm, this is where it is revisited.
Attending from Henderson
The Henderson office is at 1691 W. Horizon Ridge Parkway, Suite 100, just off the 215 Beltway, with parking on site. All six in-office studies are performed and interpreted there, so nothing is sent across to Las Vegas. Green Valley, Anthem, Whitney and Boulder City are generally closer to it than to Flamingo Road. Adults 18 and older.
Think you meet the chronic migraine definition?
Bring a month of dates and what you took. That record is what establishes candidacy.
The Bottom Line
Bring a month of dates. Frequency rather than severity is what determines what can be offered.
Frequently Asked Questions
What counts as chronic migraine?
Fifteen or more headache days a month, with migraine features present on at least eight of them. It is a numerical definition rather than a description of severity, and it determines candidacy for several preventive treatments. Episodic migraine, meaning fewer than fifteen headache days a month, is managed differently, so establishing which side of that line you sit on changes which options are open to you.
Why does frequency matter more than severity?
Because treatment decisions run on how many days a month are affected rather than how bad the worst day was. Most people underestimate their count substantially when reconstructing from memory, which is why a month of dates is worth more than any description. A written record of dates is the only thing that settles the count reliably.
Could my sinus headaches be migraine?
Frequently. Migraine activates a pathway producing nasal congestion, facial pressure and tearing, which are exactly the symptoms people attribute to sinuses. Recurrent sinus headache without infection is uncommon, so episodic attacks with clear intervals point toward migraine. Sinus imaging in these patients is frequently normal, and that is often the point at which migraine is finally considered.
Can painkillers make my headaches worse?
Yes. Acute headache medication taken frequently enough can sustain the headaches it was taken to relieve. It is common and not a failure of willpower, but addressing it usually has to come before or alongside a new preventive. The pattern to watch for is acute medication on more than about ten days a month, sustained across several months.
When is a headache an emergency?
When it reaches maximum intensity within seconds, or comes with fever and neck stiffness, new weakness, difficulty speaking or vision loss. Those need an emergency department rather than an appointment. A sudden severe headache brought on by exertion, or a first severe headache after about age fifty, also warrants urgent assessment rather than a routine appointment.
What should I bring to a first appointment?
A month of dates recording which days you had a headache, roughly how severe it was and what you took, plus your full medication list including anything bought without a prescription. Prior imaging reports, and the names and doses of any preventives already tried, save the most time at a first visit.
How long before a preventive shows an effect?
It is assessed over months rather than weeks, because the measure is a change in headache frequency across a meaningful period. Abandoning a preventive after two weeks is the commonest way a workable plan gets discarded before it has been tested. Dose is usually raised in steps, so a trial is judged at the target dose rather than at the starting one.
Why do you keep asking me to count?
Because the count is the diagnostic threshold. Chronic migraine is fifteen or more headache days a month with migraine features on eight, and candidacy for several preventives follows that number rather than how severe the attacks are. A phone note or a paper calendar both work; the format matters far less than having actual dates.
Where exactly is the Henderson office?
1691 W. Horizon Ridge Parkway, Suite 100, Henderson NV 89012, just off the 215 Beltway, with parking on site. All six in-office studies are performed and interpreted there, so nothing is referred across to the Las Vegas office. Green Valley, Anthem, Whitney and Boulder City are generally closer to it than to West Flamingo Road.
Should I use the Henderson or the Las Vegas office?
Whichever is the shorter drive, since both are fully equipped and hold the same records. West Horizon Ridge Parkway generally suits Green Valley, Anthem and Boulder City; West Flamingo Road suits the west and southwest of the valley. If you can attend either, say so when booking, because availability differs between the two week to week.
How this page was sourced
Practice facts come from Clinical Neurology Specialists directly: that Botox for chronic migraine and CGRP therapy are both available, that Dr. Knirk holds chronic migraine and Botox administration among her focus areas, and that the practice performs no cosmetic injections and runs no interventional pain programme. Clinical context is sourced to the organisations listed below.
The chronic migraine definition quoted is a published diagnostic criterion rather than a practice figure. No response rates, reduction percentages, dosing details or named agents are stated, because response varies between individuals and selection is a clinical decision. No outcome is promised. Scope is adults 18 and older.
Change log
- 2026-07-28 — page published; clinical content reviewed.
- 2026-07-28 — last reviewed against AAN, AANEM and NINDS guidance; internal links and schema verified.
- Review cadence: quarterly, or sooner if guidance changes.
How to cite this page
Clinical Neurology Specialists. “Headache specialist Henderson.” Reviewed 2026-07-28. https://www.cnsnevada.com/conditions/headache-migraine/headache-specialist-henderson/
References
- American Headache Society — classification and clinical guidance for headache disorders.
- American Academy of Neurology — practice guidance on preventive treatment.
- National Institute of Neurological Disorders and Stroke — the reference catalogue of nervous-system disorders.
This page is for general information about a Clinical Neurology Specialists office and is not medical advice, a diagnosis, or a treatment recommendation. It does not create a physician-patient relationship. Adults 18 and older. For an active stroke, a first-time or prolonged seizure, sudden severe headache, sudden weakness, sudden vision loss, or a head injury with loss of consciousness, call 911 or go to the nearest emergency department.