Headache Information
Migraine is complex neurogenic disorder. Most commonly it is associated with throbbing pain, sensitivity to light and sound, nausea, and often is debilitating. However, there are different types of migraines, even migraine syndromes that occur without pain. Migraines can cause a variety of neurological deficits, including visual disturbances, numbness and tingling, dizziness, weakness and cognitive difficulties. Its important to make sure that such symptoms are not caused by more serious conditions like TIA or seizures. Migraines affect women more frequently than men.
The pain, associated with migraine, is the commonly throbbing, severe, starts on one side of head, but may engage the entire head, often accompanied by neck pain and stiffness.
Chronic daily headache is a headache that occurs more than 15 days in a month for at least 3 months. The pain may last from several hours to several days at a time. This may be a modified migraine.
Silent or Acephalgic migraine is a migraine that occurs without pain. It can present as isolated visual disturbance or complex of neurological symptoms.
Cluster Headache - one of the most painful types of headaches. Has a cyclical pattern, may occur during same time of a year. Bouts of attacks are known as clusters and may last from weeks to months with complete resolution during remission periods. Severe unilateral frontal pain, lasting from minutes to hours, often associated with tearing and swollen eye and runny nose on the same side.
Tension type headache is a mild to moderate pain usually in a band like distribution around the head. May cause daily headache, often associated with neck pain.
Rebound headaches are caused by overuse of pain medication.
Occasionally chronic headache is caused by elevation in intracranial pressure.
In reality most headache sufferers have mixed headache exhibiting symptoms of more than one type of headache. Typically a complex management plan needs to be developed to address individual presentation.
What can we do
A careful review of history and symptoms has to be done to rule out a possibility of a more serious condition, to determine possible triggers.
Trigger Point Injections and Nerve Blocks - offer a safe effective relief for chronic headache and migraines, especially associated with neck pain, that may last from weeks to months.
Botox injections provide an effective relief of chronic headache and migraine for a period of several months. May be applied every three months.
Medications - several classes of medications are used to control migraines. They are split into two categories: abortive and preventive. Abortive medications are used to treat an acute headache and work best if taken in the very beginning of a migraine. Frequent use of abortive medications may lead to development of rebound headache. Abortive medications are taken daily to prevent headaches. Most commonly used preventive medications are antidepressants, antiepileptics, and blood pressure medications.
Physical Therapy will help to alleviate cervicogenic causes of headache.
Avoidance of dietary triggers.
Vitamins and Natural Supplements may help with management of migraines: Magnesium, Riboflavin, B12. Herbal Supplements: Feverfew, Butterburr.
Common Triggers:
Dehydration
Stress
Sleep deprivation
Head injury
Muscle tension
Hormonal changes
Medications
Cough, Sinus disease
Dietary triggers: Cheese, Chocolate, Caffeine, Marinated or Pickled foods, Peanuts, Beans, Nuts, Sour Cream, Milk, Nitrates/MSG, Avocado, Papaya, Citrus fruits, Alcohol (beer, red wine, colored/flavored alcohol)
Tests
MRI of the brain.
Ultrasound of neck arteries.
Bubble study to rule out PFO (patent foramen ovale).
EEG if seizures are suspected.
Lumbar Puncture if elevated intracranial pressure or meningitis is suspected.
The pain, associated with migraine, is the commonly throbbing, severe, starts on one side of head, but may engage the entire head, often accompanied by neck pain and stiffness.
Chronic daily headache is a headache that occurs more than 15 days in a month for at least 3 months. The pain may last from several hours to several days at a time. This may be a modified migraine.
Silent or Acephalgic migraine is a migraine that occurs without pain. It can present as isolated visual disturbance or complex of neurological symptoms.
Cluster Headache - one of the most painful types of headaches. Has a cyclical pattern, may occur during same time of a year. Bouts of attacks are known as clusters and may last from weeks to months with complete resolution during remission periods. Severe unilateral frontal pain, lasting from minutes to hours, often associated with tearing and swollen eye and runny nose on the same side.
Tension type headache is a mild to moderate pain usually in a band like distribution around the head. May cause daily headache, often associated with neck pain.
Rebound headaches are caused by overuse of pain medication.
Occasionally chronic headache is caused by elevation in intracranial pressure.
In reality most headache sufferers have mixed headache exhibiting symptoms of more than one type of headache. Typically a complex management plan needs to be developed to address individual presentation.
What can we do
A careful review of history and symptoms has to be done to rule out a possibility of a more serious condition, to determine possible triggers.
Trigger Point Injections and Nerve Blocks - offer a safe effective relief for chronic headache and migraines, especially associated with neck pain, that may last from weeks to months.
Botox injections provide an effective relief of chronic headache and migraine for a period of several months. May be applied every three months.
Medications - several classes of medications are used to control migraines. They are split into two categories: abortive and preventive. Abortive medications are used to treat an acute headache and work best if taken in the very beginning of a migraine. Frequent use of abortive medications may lead to development of rebound headache. Abortive medications are taken daily to prevent headaches. Most commonly used preventive medications are antidepressants, antiepileptics, and blood pressure medications.
Physical Therapy will help to alleviate cervicogenic causes of headache.
Avoidance of dietary triggers.
Vitamins and Natural Supplements may help with management of migraines: Magnesium, Riboflavin, B12. Herbal Supplements: Feverfew, Butterburr.
Common Triggers:
Dehydration
Stress
Sleep deprivation
Head injury
Muscle tension
Hormonal changes
Medications
Cough, Sinus disease
Dietary triggers: Cheese, Chocolate, Caffeine, Marinated or Pickled foods, Peanuts, Beans, Nuts, Sour Cream, Milk, Nitrates/MSG, Avocado, Papaya, Citrus fruits, Alcohol (beer, red wine, colored/flavored alcohol)
Tests
MRI of the brain.
Ultrasound of neck arteries.
Bubble study to rule out PFO (patent foramen ovale).
EEG if seizures are suspected.
Lumbar Puncture if elevated intracranial pressure or meningitis is suspected.
