Migraine
With or without aura, episodic or chronic, including menstrual and difficult-to-control patterns.
MG Polyclinic · Maitidevi, Kathmandu
Advanced Headache
& Migraine Carein
Kathmandu
Understand your headache. Plan your care.
Personalised assessment and treatment
planning for migraine, frequent headache and facial pain.
01Detailed
assessment
assessment
02Personalised
care plan
care plan
03Prevention-focused
follow-up
follow-up
Why dedicated care matters
Common does not mean trivial.
40%of people worldwide were living with a headache disorder in
2021
3.1Bpeople affected globally
#3migraine’s rank for neurological disease burden by age-standardised
DALYs in 2021
Source: World Health Organization, 2025.
When headache interrupts your day
The impact can go far beyond pain.
Light, sound, nausea and repeated attacks can make everyday activities difficult. Tell us what your headaches are stopping you from doing.
Light & sound sensitivity
A quieter, darker space may feel more comfortable during an attack.
Recurring attacks
Record headache days and how they affect work, study and family life.
Nausea or vomiting
Associated symptoms help your clinician understand the headache pattern.
Possible aura
Some people have reversible visual or sensory symptoms. New symptoms need assessment.
Symptom information: WHO (2025). Symptoms alone do not establish a diagnosis.
Conditions assessed
The name of the headache matters.
Different headache disorders can look similar but require different decisions. Your consultation begins by classifying the pattern and checking for features that need urgent investigation.
Chronic daily headache
Frequent or near-daily pain, including assessment for medication overuse and mixed patterns.
Tension-type headache
Recurrent pressure or tightness, with attention to frequency, disability and overlapping migraine.
Cluster headache & TACs
Severe one-sided attacks with eye or nasal symptoms that require accurate recognition.
Facial pain & neuralgia
Trigeminal neuralgia and other recurrent facial pain presentations.
Secondary headache review
New, changed or atypical headache assessed for warning features and the need for investigation or referral.
Migraine treatment options
A plan for the attack.
A plan for prevention.
These are options to discuss at your consultation. Suitability, medicine interactions, pregnancy plans, cost and local availability all matter.
Acute treatment
Medicines used to relieve an attack when it occurs. Options can include selected pain relievers, triptans or an acute gepant.
Compare the options →Preventive treatment
A planned treatment to reduce headache frequency or disability. Options include established tablets, CGRP-targeting medicines and Botox for chronic migraine.
Explore Botox assessment →Track & review
Use a diary to record symptoms, medicine use and daily impact. Bring your record to follow-up so the plan can be reviewed with you.
Start a headache diary →Gepants vs established treatments
What changes—and what still needs a conversation?
Acute and preventive medicines have different jobs. This comparison is an overview for adults, not a prescription.
| Question | Gepants CGRP receptor blockers | Established options Several different medicine classes |
|---|---|---|
| Treating an attack | Ubrogepant or rimegepant are adult acute-treatment options. | Selected NSAIDs or paracetamol; triptans such as sumatriptan when appropriate. |
| Preventing attacks | Atogepant: episodic or chronic migraine. Rimegepant: episodic migraine. | Examples include propranolol for episodic migraine and topiramate for episodic or chronic migraine; other choices depend on the person. |
| How they work | Block the CGRP receptor, a target involved in migraine signalling. | Mechanisms vary. Triptans act at serotonin receptors; preventive medicines work through other pathways. |
| What to review | Interactions, liver or kidney disease, pregnancy, allergy, and warnings about high blood pressure or Raynaud’s phenomenon. Side effects vary by drug. | Drug-specific risks and contraindications. Triptans may be unsuitable with certain vascular conditions. Topiramate needs particular pregnancy-risk counselling. |
| Which is better? | There is no universal winner. A treatment that fits your health, goals and ability to access it is the starting point; your response guides follow-up. | |
Ubrogepant
Used for an attack; not a preventive medicine.
UBRELVY prescribing information ↗Rimegepant
The prescribed schedule depends on the treatment goal.
NURTEC ODT prescribing information ↗Atogepant
Daily preventive treatment for adults with migraine.
QULIPTA prescribing information ↗Medicine roles above follow US prescribing information; this does not establish Nepal registration, stock or clinic availability. Discuss access and the locally approved product information with your clinician. Do not start, stop or change medicines from this page.
Sources: Potrebic et al. (2026); American Migraine Foundation: acute treatments (2025) and gepants and ditans; linked prescribing information. The AAN/AHS guideline concerns prevention.
Botox for chronic migraine
Could preventive injections fit your care plan?
OnabotulinumtoxinA (Botox) is a preventive option for adults with chronic migraine. Assessment comes first.
It is not a rescue treatment for an attack. Benefit is monitored over treatment cycles, using headache days and the impact on daily life.
Ask about Botox assessment →Headache days a month
Chronic migraine: for more than 3 months, with migraine features on at least 8 days each month.
Weeks between treatments
The labelled retreatment interval. Your clinician determines suitability and follow-up.
Standard injection sites
The labelled protocol covers specific head and neck muscles, administered by a trained clinician.
Discuss benefits & risks
Possible effects include neck pain, muscle weakness and eyelid drooping. Seek urgent help for swallowing or breathing difficulty after treatment.
US-labelled eligibility includes headache on 15 or more days per month lasting 4 hours a day or longer. Benefit for episodic migraine is not established in that label. Confirm the local product, procedure appointments and availability with MG Polyclinic.
Sources: ICHD-3: chronic migraine; BOTOX prescribing information.
Your pathway
From “I keep getting headaches” to a plan you can follow.
Care is structured around diagnosis, safety, disability and your treatment goals.
- 01
Map the pattern
Onset, frequency, duration, pain features, aura, associated symptoms, triggers, medicines and impact on daily life.
- 02
Examine & risk-check
Focused medical and neurological assessment, including red flags for secondary headache.
- 03
Name the diagnosis
Clinical classification informed by International Classification of Headache Disorders criteria.
- 04
Build the treatment plan
Acute and preventive strategies selected around comorbidity, safety, preferences and availability.
- 05
Measure & refine
Headache diary, disability tracking and planned review to judge response and adjust care.
Emergency warning signs
Some headaches should not wait for a clinic appointment.
Seek urgent emergency assessment for a sudden “thunderclap” headache, or headache with new weakness, numbness, confusion, seizure, loss of consciousness, fever with neck stiffness, major visual or speech change, or after a significant head injury.
This list is not exhaustive. If you are seriously unwell or unsure, seek emergency care.
Headache-focused physicianKathmandu, Nepal
Meet your physician
Clinical breadth, focused on the person behind the pain.
Dr Shree Narayan Yadav is an Internal Medicine physician working in the Department of Neurology at Bir Hospital, National Academy of Medical Sciences (NAMS), with a focused clinical interest in headache and facial pain.
His background in Internal Medicine and distinction-level MSc training in Rheumatology supports a whole-patient approach—particularly when headache overlaps with systemic disease, medication burden or complex comorbidity.
MD
Internal Medicine
National Academy of Medical Sciences
MSc
Rheumatology · Distinction
University of South Wales, UK
WHS
Headache & Facial Pain Fellowship*
World Headache Society · Interventional training
*Fellowship training in progress. The fellowship award has not yet been completed.
View Dr Yadav’s MG Polyclinic profile ↗Patient voices
A welcoming clinic experience matters.
This testimonial is published on MG Polyclinic’s website and describes the general clinic experience.
Read MG Polyclinic’s published testimonial ↗Staff was very cordial, proper instructions were given, proper pre checkup followup was done.
General clinic feedback. This is not a testimonial about migraine treatment or a promise of results.
Your headache diary
A few notes.
A clearer picture.
Record each day, including headache-free days. Note severity, duration, symptoms, medicines and daily impact. Bring your diary to your appointment.
Download printable diaryQUICK DAILY ENTRY
How was today?
Entries are saved only in this browser on this device. They are not sent to MG Polyclinic. Avoid shared devices and export a copy to keep.
YOUR RECORD
Monthly overview
0days recorded
0headache days
0acute medicine days
Counts cover recorded days only. Missing entries are not counted as headache-free days. This diary does not diagnose migraine.
Your saved entries will appear here.
Diary guidance: American Migraine Foundation (2025). Keep your usual clinical follow-up; the diary is not monitored.
Patient questions
Clear answers before your visit.
Bring a list or photographs of current medicines and, if possible, a record of headache days, duration and associated symptoms.
When should I arrange a headache consultation?+
Book a review when headaches are frequent, changing, difficult to control, associated with repeated pain-medicine use, or affecting work, study, sleep or family life.
Is every severe headache a migraine?+
No. Migraine has a recognisable clinical pattern, but several other primary and secondary disorders can cause severe pain. Diagnosis depends on careful history and examination.
Will I need a brain scan?+
Not everyone does. Imaging is selected according to the history, examination and warning features. When it is indicated, the reason and appropriate test will be discussed.
What should I bring to the appointment?+
Bring previous prescriptions, scans or reports, a current medicine list, relevant medical history, and a headache diary if you have one.
Are gepants and Botox available at this clinic?+
Call MG Polyclinic to confirm current medicine access, procedure arrangements and appointments. The treatment information on this page does not confirm local stock or establish that a procedure is appropriate for you.
Appointments
Take the next step toward clearer headache care.
Call MG Polyclinic to confirm Dr Yadav’s current clinic schedule and book your consultation.