Neurologist & Nuclear Physician
DR REY CASSE
Migraine Management & Injectable Therapies
DR REY CASSE& Adelaide NeuroDiagnostics
Established in 2016 by Dr Rey Casse, Adelaide NeuroDiagnostics provides a comprehensive and high-quality Electroencephalograms (EEG)
Nerve Conduction Study (NCS) and Electromyography (EMG) services.
With over two decades of clinical research and experience Dr Casse has dedicated and devoted himself, and his career to providing rigorous, comprehensive and compassionate care to his patients.
DR REYNOLDS CASSE
DR REY CASSE is a Neurologist, Nuclear Physician and Migraine Specialist. His practice is the LARGEST dedicated headache clinic in South Australia. He offers specialised treatment for Migraines, Cervical Dystonia & Spasticity.
Migraine Management Clinic
Dr Srimal Nawana , our specialist GP who assists Dr Casse with his Migraine Clinics, will meet and consult with you for your first appointment. She will do all the ground work and determine an individualised migraine management plan.
Adelaide NeuroDiagnostics is dedicated to providing high quality care.
Migraine vs Headache ?
MIGRAINES AFFECT OVER 13% OF THE POPULATION & TWO TIMES MORE PREVALENT IN WOMEN
A migraine is a headache that can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It’s often accompanied by nausea, vomiting, and extreme sensitivity to light and sound.
Migraine attacks can last for hours to days, and the pain can be so severe that it interferes with your daily activities.
Migraines can progress through four stages: prodrome, aura, attack and post-drome. Not everyone who has migraines goes through all stages.
A headache is a pain in your head or face that’s often described as a pressure that’s throbbing, constant, sharp or dull. Headaches can differ greatly in regard to pain type, severity, location and frequency.
Headaches are a very common condition that most people will experience many times during their lives. They’re the most common form of pain and are a major reason cited for days missed at work or school, as well as visits to healthcare providers.
While most headaches aren’t dangerous, certain types can be a sign of a more serious condition.
Should I see a Migraine Specialist?
If you have been suffering from migraines without getting much relief, seeing a migraine specialist can help you get a correct diagnosis and make sure you are receiving the proper treatment.
What do I need to DO TO make an appointment?
Prior to any appointment reception will require a valid referral for any Medicare rebate and migraine patient questionnaire completed.
At our migraine clinic we advise our patients to allow referrals a duration period to be triaged and once reception is informed and if you qualify for an appointment, we will get back to you.
Be advised that Dr Casse is no longer taking on any general neurology, with only assisting with EEG and Nerve Conduction Studies. Dr Casse is specialising only in/ and consulting Chronic Migraines, Headaches; Cervical Dystonia and injectable therapy.
How long are the wait times?
All referrals are triaged by Dr Casse, however all new migraine and headache patients will go through our specialist GP first. We will contact you as soon as we can. However, please allow our reception staff a duration period as we receive multiple referrals a day and have to triage them all through our specialist.
What should I expect at the appointment with the migraine specialist?
Expect the specialist to take a comprehensive headache/migraine history. A daily headache diary is an easy way to track your migraine attacks.
Most patients with headaches have normal neurologic and general physical examinations, a thorough history is crucial to determining the etiology of a headache. Dr Casse will take a comprehensive headache history including the symptoms
What do I need to bring to my appointment?
Before your appointment
Prior to any appointment reception will require a valid referral for any Medicare rebate and an acquaintance form completed.
For all patients, please ensure you bring any relevant letters from other specialists, investigations such as blood tests or imaging results to your appointment. Dr Casse will be interested to know what treatments you are currently on (prescribed or over the counter) and which ones you have tried previously.
For new patient headache appointments:
1. Please keep a diary of significant and milder headaches
2. Since headache is often longstanding and complex, please complete this chart of what treatments you have tried and any effects.
What type of Questions will the Migraine Specialist ask?
Routine history taking begins with a set of standard questions that will elicit basic information and, depending on the acuity of onset, the age of the patient and whether he/she presents to in the consulting.
In every headache patient, our worry and the patients fear are that no serious life-threatening cause should be overlooked. It is then important to keep in mind the “red flags,” therefore, Dr Casse will ask the right questions to be able to decide whether the patient could be having a serious secondary headache warranting further investigation.
Any new onset headache or anything that is atypical for a particular type of primary headache should get you worried about the presence of a secondary headache and warrant imaging.
Typical questions may include;
Is this your first or worst headache? How bad is your pain on a scale of 1 to 10
(1 means manageable and 10 means severe)?
- Do you have headaches on a regular basis? Is this headache like the ones you usually have?
- What symptoms do you have before the headache starts?
- What symptoms do you have during the headache?
- What symptoms do you have right now?
- When did this headache begin? How did it start (gradually, suddenly, other)?
- Where is your pain? Does the pain seem to spread to any other area? If so, where?
- What kind of pain do you have (throbbing, stabbing, dull, other)?
- Do you have other medical problems? If so, what?
- Do you take any medicines? If so, what?
- Have you recently hurt your head or had a medical or dental procedure?
How do I know if I qualify for injectable therapy?
If you suffer from chronic migraines, are over 18 years of age, not pregnant, breastfeeding or planning for a pregnancy in the next 3 months you should consider injection therapy. You should also consider the therapy if at least 3 preventative medications provided from your doctor have limiting side effects or have been unable to provide you with significant benefit.
Preventative medications include: Propranolol, Pizotifen, Candesartan, Topiramate, Amitriptyline, Sodium Valpoate & Verapamil. Whilst Triptans are an effective acute migraine treatment they are not a preventative therapy.