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Headache and Migraine Treatment

Headaches are one of the most common medical complaints; most people experience them at some point in their life. They can affect anyone regardless of age, race, and gender. 

 

According to a recent study by the American Headache Society, the prevalence and burden of self-reported migraine and severe headache in the US adult population is high, affecting roughly 1 out of every 6 American and 1 in 5 women over a 3-month period.  The World Health Organization (WHO) reports that almost 50% of all adults worldwide will experience a headache in any given 12-month period.

 

 

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Causes

A headache can occur in any part of the head, on both sides of the head, or in just one location.  Different types of headaches cause different symptoms.  Headaches are classified according to distribution of the pain they cause, quality of the head pain, when the headache occurs, and how long each headache attack lasts.  Additionally, the cause of a headache may be further revealed by additional symptoms that accompanies the headache.  Different headaches are associated with different symptoms, which may include (but are not limited to) nausea, vomiting, sensitivity to light or sound, tearing, double vision or other visual changes, dizziness/vertigo, and numbness or tingling. 

 

The International Headache Society (IHS) categorize headaches as primary, when they are not caused by another condition, and secondary, when there is an underlying cause.  The IHS has a third category that accounts headaches due to specific nerve disorders and for headaches of unknown cause.

Primary headaches

Primary headaches are stand-alone illnesses caused directly by the overactivity of, or problems with, structures in the head that are pain sensitive. This includes the blood vessels, muscles, and nerves of the head and neck. 

  • These include:

  • Tension headaches (which are the most common type of primary headache)

  • Migraines (which are the second most common type of primary headache)

  • Trigeminal autonomic cephalgias (including cluster headaches)

  • Exercise/exertional headaches

  • “Brain freeze” or ice-cream headaches

 

Secondary headaches

Secondary headaches are headaches that happen when another condition stimulates the pain- sensitive nerves of the head. In other words, the headache symptoms can be attributed to another cause. A wide range of different factors can cause secondary headaches.

These include relatively benign causes such as:

  • Alcohol and other substances

  • Caffeine withdrawal

  • Dehydration

  • Teeth-grinding at night

  • TMJ

  • Muscle disorder of the head &/or neck

 

These also include serious and potentially life-threatening causes such as:

  • Trauma to the head &/or neck

  • Stroke/TIA

  • Blood clots in the veins of the brain

  • Ruptured or unruptured aneurysm or other vascular malformations

  • Inflammation of the blood vessels of the head/brain

  • Brain tumor

  • Meningitis/Encephalitis

  • Seizure

  • High blood pressure

  • Carbon monoxide poisoning

 

As headaches can be a symptom of a serious condition, it is important to seek medical advice if they become more severe, regular, or persistent. 

 

For example, if a headache is more painful and disruptive than previous headaches, worsens, or fails to improve with medication or is accompanied by other symptoms such as confusion, fever, sensory changes, and stiffness in the neck, you should seek immediate medical care.

 

Neuropathies, facial pains, and other headache disorders 

  • These include causes such as:

  • Occipital neuralgia

  • Trigeminal neuralgia

  • Glossopharyngeal neuralgia

  • Burning mouth syndrome

  • Persistent atypical facial pain

 

Diagnosis

With all of the different possible causes of headache, it is important that people with severe &/or reoccurring headaches be evaluated by a competent medical professional that is experienced in diagnosing and managing headache disorders.  At your initial visit, your healthcare professional will take a careful health history and ask about you to describe your headache and any associated symptoms.  They will then perform a detailed physical exam.  After this, the cause of most headaches is typically apparent.  However, on occasion further testing such as MRI, CT, or blood work has to be obtained to reach definitive diagnosis.

 

Treatment

Some headaches do not require treatment.  Severe, recurrent, &/or chronic headache disorders typically do require treatment.  If treatment is required, the healthcare professionals at Advanced Medical Center will tailor your headache treatment program to meet your individual needs.  We offer traditional, non-traditional, and integrated solutions to get your headaches under control.

 

Our headache specialist has over 15 years of neurology experience and is skilled in the diagnosis and management of all types of headaches. 

As such, we are able to offer our patients a wide variety of treatment options that include:

  • Conventional preventive medications such as topiramate (Topamax), propranolol (Inderal), and amitriptyline (Elavil), etc.

  • Conventional abortive medications to include triptans such as sumatriptan (Imitrex), NSAIDs such as diclofenac (Cambia), and dihydroergotamine (Migranal nasal spray).

  • Cutting edge treatments including CGRP receptor antagonists for preventing migraines including Aimovig, Ajovy, Emgality, & Vyepti and the CGRP receptor antagonists that are approved for the treatment of acute/breakthrough headaches such as Nurtec ODT & Ubrelvy

  • The recently approved 5-HT1F receptor antagonist Reyvow

  • Botulinum toxin (Botox) injections.  Our Botox injector has over 8 years of experience injecting Botox for chronic migraine.

  • Medical neuromodulation devices to prevent & treat Migraine & Cluster headaches. Neuromodulation is drug-free and works via a device that uses electrical currents or magnets to modulate signaling activity that occurs in the brain. Some of these devices can stop attacks that are already underway, while others are used preventatively.  These include Cefaly (an external trigeminal nerve stimulation device, SpringTMS (transcranial magnetic stimulation), and gammaCore (a noninvasive vagus nerve stimulator)

  • Instruction on OTC preparations of minerals, vitamins, &/or herbs that are clinically proven to prevent & treat migraine

  • Occipital nerve blocks and trigger point injections for occipital neuralgia and cervicogenic headaches

  • Needle-free SPG blocks for all types of headaches (including cluster headaches and migraines), trigeminal neuralgia, postherpetic neuralgia, glossopharyngeal neuralgia, burning mouth syndrome, and atypical facial pain

  • Chiropractic treatments

  • Physical therapy

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