Neurologist alert: These red flags may point to a hidden neurological problem

If you’ve ever brushed off a throbbing headache as “just stress” or thought that pins-and-needles feeling in your hand was nothing but poor posture—pause for a second. Sometimes, what we write off as minor can actually be your body waving a red flag.

From chronic migraines to sudden numbness, your nervous system has its own way of asking for help—and that’s where a neurologist steps in.Many people delay seeing a specialist because they don’t recognize the early signs of a neurological problem. In fact, a lot of people end up seeing an ENT doctor or taking endless painkillers without real relief—when what they really need is a neurologist’s opinion. Whether it’s mysterious headaches, blurred vision, or slurred speech, your brain could be trying to tell you something important.Headaches are broadly categorized into primary and secondary types:Primary headaches – "Primary" means the headache is the main problem, not a symptom of another disease.Secondary headaches: These happen because of another health problem, like infections, injuries, tumour or even some medications.

Common types of primary headaches migraines

Throbbing or pounding pain, often on one side of your head

• Gets worse when you move or walk.• May come with nausea, vomiting, and sensitivity to light or sound.• Can include an aura—temporary warning signs before the pain starts, such as flashing lights or tingling/numbness in your face or limbs .

Tension headaches

• Feels like a tight band around your head.• Mild to moderate pain on both sides.

Cluster headaches

• Sharp, intense pain around one eye.• Often repeats several times a day.• May cause a teary eye or stuffy nose on the same side.

Other rare types

• Nummular headaches are localized, circular pains on the scalp.Migraine is one of the most common types of headaches, but it often goes unrecognized and untreated.Many people mistakenly believe their headaches are caused by sinus problems and end up visiting an ENT specialist or a general doctor.

There’s also a common myth that migraine can’t be treated — but that’s not true.Some people with migraine may also experience something called an aura — temporary visual changes, numbness, or other unusual sensations that happen before or during the headache.• Aura means early warning signs of a migraine.• Usually appears 5–60 minutes before the headache strikes, but sometimes it goes along with or happens without the headache .• Most common signs include:• Flashing lights or zigzag shapes in your vision.• Numbness or a “pins-and-needles” feeling that starts in a finger or hand and moves up to your face .• Difficulty talking or slurred speech.This type of aura gradually builds, is temporary, and usually fully goes away .

When is numbness an emergency?

If your numbness comes on suddenly, is very strong, or lasts longer than 60 minutes, especially if it’s with weakness, confusion, vision or speech issues—seek medical care right away.

These may be signs of something serious, not just a migraine aura .

How to spot and avoid headache triggers

What to do when you have headaches

• Rest in a dark, quiet place.• Use a cold compress on your head or neck.• Over-the-counter medicines like:• Acetaminophen ( Paracetamol)• Ibuprofen• NaproxenHowever avoid taking pain killers frequently

Preventing headaches

• Stick to regular meals and sleep routines.• Practice stress-relief: deep breathing, yoga, or meditation.• Stay hydrated and active.• Avoid known triggers when you can.If headaches are frequent or very painful and affects quality of life consult talk to a doctor—some people benefit from daily preventive medication.

When you should see a doctor – When to worry

These signs mean a headache could be something serious and needs medical attention right away: Sudden, severe headache (“worst headache of your life”): Could be a sign of bleeding in the brainHeadache with fever, neck stiffness, or confusion: May indicate an infection of brain like meningitisNew headache in someone over age 50: Could be linked to conditions like temporal arteritis or other underlying issuesHeadache after a head injury: Especially if followed by drowsiness, confusion, vomiting, or memory lossHeadache that gets worse over days or weeks: Might be a sign of a brain tumor or pressure in the brainHeadache with vision changes, trouble speaking or thinking clearly, weakness, or numbness especially for the first time: Could be a stroke or related conditionHeadaches that wake you up from sleep or are worse in the morning: May signal increased pressure in the brainNew headache in someone with cancer, HIV, or a weak immune system: Could point to an infection or spread of cancer to the brainThe management of migraine consists of general lifestyle measures, acute treatment, preventive treatment.

General lifestyle measures

Lifestyle measures that can be helpful for preventing attacks include good sleep hygiene, regular exercise, routine meal schedules, adequate fluid intake, and management of migraine triggers, as discussed below. Lifestyle measures may be the most important aspect of migraine managementAcute treatment• Over-the-counter medicines like:• Acetaminophen ( Paracetamol)• Ibuprofen• NaproxenHowever avoid taking pain killers frequently

Preventive treatment

Preventive treatment means taking medication regularly — often daily — to reduce how often you get migraines, how severe they are, or how long they last.It’s different from taking medicine during a migraine attack. Instead, this helps to stop the migraines from happening in the first place.Doctors may suggest it if:• You get frequent migraines (e.g., more than 4–5 days a month) • Your migraines are very disabling• Pain-relief medicines don’t work well or cause side effects• You have menstrual migraines• You are using painkillers too often (which can actually make headaches worse)

Take-home message

• Some migraines come with a warning phase (aura) that may include numbness, but it’s temporary and not dangerous.• Sudden, severe, or lingering numbness could signal something more serious—don’t wait to consult a doctor.• Simple habits—regular meals, sleep, stress control, hydration—go a long way in reducing headache frequency.• Over-the-counter meds can help, but frequent headaches may need proper medical attention and preventive treatment.Migraine isn’t life-threatening, but it can significantly affect your quality of life if not managed properly.Dr. Jyoti Bala Sharma, director - neurology, Fortis Hospital, Noida