Migraines is one of the most common complaints in medicine and a common reason for repetitive Emergency Room visits, yet most people who seek help for a headache at ER only get partial relieve or no relieve at all. If you ever had a severe migraine headache, you will never forget the experience and will do whatever it takes to prevent the next attack.
Migraine is a complex recurrent headache disorder which may present in variety of ways. Usually migraine headache is a pounding, throbbing pain involving one side of the head and goes along with visual disturbances such as blurred vision or light spots, light and/or sound sensitivity and nausea. It may vary in severity from moderately uncomfortable to completely debilitating and may last for many hours and even days. It may be preceded by an aura in form of visual disturbances and light sensitivity.
Migraines with aura are called classical migraines and ones without aura are common migraines. There are other types including Chronic Paroxysmal Hemicrania, Ocular Migraine, Chronic Daily Migraines, even painless migraines (Acephalgic) and other migraine variants.
Women are more prone to get migraines then men, approximately 75% of migraine sufferers are women and 70% have a first degree relative with migraines.
Migraines can be confused with other types of headaches: cluster, tension, cervicogenic, sinus headaches, and neuralgias. Chronic headaches may be caused by brain tumors or brain injury. Another important potential cause of migraines is Patent Foramen Ovale (PFO). Foramen ovale is small hole in atrial septum of the heart. It is a normal heart anatomy during gestation prior to birth, but should close shortly after. If it doesn’t, it is called Patent (open) and will allow blood in heart to bypass lungs and travel to brain and coronary arteries. This condition increases risk of strokes. It is important to have a correct diagnosis as treatment methods may vary.
There is no cure for migraines, but there are medications that reduce frequency and severity of migraines. Treatments separate into two major categories: abortive and preventive. Abortive medications are used to treat the migraine when it occurs. These treatments are most effective if taken at the very start of the migraine. Although we need to be careful and not overuse abortive medications, one of the major causes of chronic headaches is the rebound effect secondary to medication overuse. It is not recommended to take abortive medications more than 8-10 times per month. Preventive medications are taken daily and their purpose is to prevent the migraine. Few herbs and supplements have also shown good results in treating migraines.
Some procedural methods are very helpful in treating migraines. Occipital nerve blocks are injections to numb the Greater Occipital nerve that supplies the scalp and help with posterior cephalgias.
Our clinic is equipped to test for PFO and our staff is highly trained and knowledgeable. If we find PFO, we will refer you to a trusted cardiologist for evaluation and repair.