Migraine and other headache disorders are among the most common health problems in the world. Migraine affects over 1 billion people worldwide, and although it is three times more common in women, ten percent of children and one in 16 men experience migraine. It has been identified by the Global Burden of Disease study as the 2nd leading cause of years lived with disability. Yet, it remains under-diagnosed and under-treated, leaving patients mismanaged and suffering.
The Centre for Headache is the only academic medical centre in Ontario dedicated to research, education, expert evaluation and individualized treatment plans for patients suffering from migraine, cluster, trigeminal autonomic cephalalgias and many other types of headaches.
Our model of care:
- Education Session is required for most patients prior to the initial consultation. It is scheduled based on the date referral is received. Attendance will not delay the consultation appointment with one of our specialists. This is an opportunity for patients to learn effective headache self-management strategies to enhance their ability to manage their headache disorder. Our research has shown this program decreases headache related disability and Emergency Department visits.
- Initial Consultation where we will develop a Headache Plan of Care to assist patients and their primary care practitioner more effectively manage headaches. Components of the plan will include lifestyle changes, vitamins, medication as well as referrals to support programs as needed.
- Follow up is limited to 1-2 visits and then discharge back to family practitioner or referring doctor for ongoing care.
As a specialty clinic we do not provide long term follow-up, unless specialized procedures are necessary and not available locally. In order to serve patients better, if any concerns arise after discharge, we encourage the primary care provider to call one of our specialists for management advice, rather than re-referring.
Please note that we do not prescribe or recommend opioids or marijuana therapy.
As part of an academic teaching hospital, our clinical team may include students and trainees in various disciplines from nursing, allied health and medical residents and fellows. These individuals receive specialized and hands-on training with direct supervision and expertise from our team.
What to Expect
Please arrive 15 minutes early to register. Bring your health card, family practitioner information, headache diary and a list of current medications and supplements.
At each visit you will need to complete the migraine disability form MIDAS (.pdf). This form helps us better understand the impact of headache on your life. At your first visit, you will need to complete the following forms:
Our appointment times are 60-90 minutes for a new patient and 15-20 minutes for a follow up. Please understand, we do our best to be on time, but the clinic may be running late if a patient issue arises. As the clinic is fully booked, we may not be able to accommodate patients who arrive more than 15 minutes late. If we are not able to work you in, the appointment will have to be rebooked.
Unless there are extenuating circumstances, we require 2 business days’ notice for cancellation or change of appointment.
An individual plan of care is developed and a summary note of your visit will be sent to your family practitioner after each clinic appointment.
Ongoing prescription renewals must be obtained from your family practitioner.
For services not covered by OHIP, physicians charge a fee for prescription refills between appointments, missed appointments, 3rd party forms and other requests.
Christine Lay, MD, FAHS
Dr. Christine Lay is a Professor of Neurology and the founding director of the Headache Program at the University of Toronto, where she holds the Deborah Ivey Christiani Brill Chair for Neurology Research. She completed her residency at Mayo Clinic and her Headache fellowship at Albert Einstein College of Medicine in New York City. In addition to directing and growing the Headache program at U of T, and a very busy patient practice, she is actively involved in research and teaching, and directs the Canadian Headache Society Fellowship in Toronto. She is the Vice Chair of the American Migraine Foundation, is a board member of the American Headache Society, and co-chairs the annual AHS Scottsdale Symposium. Her main areas of interest include advocacy, education and the management of migraine, including hormonal migraine, as well as the health effects of adverse childhood experiences.
Ana Marissa Lagman-Bartolome, MD, FRCPC, FAHS
Dr. Lagman is a Fellow of the American Headache Society and UCNS Diplomate in Headache Medicine, an Assistant Professor at the University of Toronto, Department of Pediatrics (Neurology) and Director of the Pediatric and Adolescent Headache Program. She completed her pediatric neurology residency at the Hospital for Sick Children and a 2-year pediatric and adult headache medicine fellowship.
She joined the Centre for Headache in 2015 and is actively involved in research and teaching. She is an active member and faculty staff of the Canadian Headache Society and American Headache Society as well as a member of the International Headache Society. Her main areas of interest include pediatric and young adult migraine and headache disorders, childhood migraine variants, medication overuse headache, migraine in women, and neuromodulation therapies.
Valerie Lawler, RN (EC) NP-Adult
Valerie completed her Bachelor of Science in Nursing at McMaster University, a Master of Women’s Health at the University of Melbourne in Australia and the Nurse Practitioner program at the University of Toronto. She joined the Centre for Headache in 2009 and provides expert consultation to new and follow up patients and performs procedures such as nerve blocks and onabotulinumtoxinA (Botox®) injections.
Together with Dr. Lay she co-created the Headache Education program for patients and is actively involved in teaching effective headache self-management strategies to enhance patients’ ability to self-manage their headache disorder, decrease headache related disability and improve their quality of life.
Valerie has also published articles, given lectures and participates in clinical research. She is an Adjunct Lecturer at the Lawrence S. Bloomberg Faculty of Nursing at the University of Toronto and is actively involved in teaching.
Kimberly Brigden, RN
Kimberly obtained her Bachelor of Science in Nursing from Ryerson University in Toronto. Her role within the Centre for Headache team is primarily focused on assisting patients with navigating their personalized headache treatment plans and delivering group education sessions. She responds to patient inquires and helps problem-solve issues occurring between appointments.
Together with Dr. Lagman she modified the Headache Education program which she delivers to adolescents and young adults, in addition to the adult education sessions. Her passion is patient education and empowering patients to achieve their goals with Headache self-management techniques. She has completed a quality improvement project on the impact of the Nursing role in patient empowerment and self-health management and is actively involved in teaching nursing students.
Lina Jobanputra, Social Work
Lina has been working as a clinical Social Worker at Women’s College Hospital since 2002. Lina graduated with a Bachelor of Arts degree in Sociology from Wilfrid Laurier University in 2000 and a Master of Social Work degree from the University of Toronto in 2002.
Lina provides assessment and consultation to patients who are adjusting to their health diagnosis and assists them to navigate the healthcare system related to their headache management. In the Centre for Headache Lina co-moderates the Creating Calm group programming. Lina also holds adjunct lecture status with the Faculty of Social Work at the University of Toronto, mentoring Master of Social Work students who are training to enter the field of Social Work.
Claire Sandoe, MD, MSc, FRCPC
Dr. Claire Sandoe completed her medical degree and a Masters of Neuroscience at McGill University, her neurology residency at the University of Toronto, and a fellowship in Headache Medicine at the University of Toronto under the supervision of Dr. Christine Lay. She serves on the Editorial Board of the American Migraine Foundation as well as the Electronic Media Committee of the American Headache Society. She is also the co-director of the University of Toronto Neurology Residency Program Early Mentorship Group, and the University of Toronto Undergraduate Medical Education Foundations Curriculum faculty co-lead for Headache. Her main areas of interest include medical education, hormones and headache, the health effects of adverse childhood experiences, and trigeminal autonomic cephalalgias.
Part-time Clinical Associates:
Suvendrini Lena, MD
William Kingston, MD
Janet Lee-Evoy, MD
Canadian Headache Fellowship
The University of Toronto program is an official clinical fellowship program that provides an opportunity for a physician to obtain advanced training and/or to acquire more specialized expertise. Positions are for 1 year and are held by graduates of Neurology residency programs.
- Patient Resources - Education
- Referring Practitioner Resources
The Centre for Headache is accepting referrals.
Please note: If the referral is from a specialist, we require the name of the primary care practitioner as they will be an integral part of the care team.