By: Lauren Sharett, MD, Neurologist, Thibodaux Regional Neurology Clinic
Over 37 million men, women and children suffer from migraines in the United
States. Fewer than 5% have seen a healthcare provider and received an
accurate diagnosis and appropriate treatment.(1)
There are multiple types of migraines and headaches. A migraine typically
presents with severe throbbing or pulsing pain on one side of the head.
It is accompanied by light and sound sensitivity and possibly nausea and
vomiting. A migraine can last up to days with severe pain interrupting
activities of daily living. A migraine is often confused with a sinus
headache. Migraine variants include retinal migraine with vision disturbance
and migraine with brainstem aura. This can present with vertigo alone,
without head pain, and even loss of consciousness.
There is a multitude of other headache types which can also be severe and
impairing. These include tension headache, cluster headache, daily chronic
headache, exertional headache and medication overuse headache.
Neck trauma or degenerative disease can underlie cervicogenic headaches.
Headaches also arise from intracranial processes such as a mass or increased
intracranial pressure, and injury such as concussion.
Many individuals have migraine and headache triggers such as alcohol consumption,
aspartame, too much caffeine, hormonal changes in women and sleep disturbances,
You do not have to live with migraines or other headaches. There are effective
treatments for all migraine and headache types. It is critical to identify
a precise diagnosis to develop a tailored treatment plan for each individual.
Neurologists are experts in this evaluative and customized care plan development.
Migraine treatments are available for both prevention and interruption
of a migraine at the onset. There are a variety of oral medications used
for migraine and other headache type prophylaxis.
More recently a class of medications called CGRP (calcium gene-related
peptide), inhibitors became available. These medicines have transformed
migraine treatment with countless individuals living migraine free after
decades of suffering. CGRP inhibitors block a peptide in the brain thought
to cause pain and inflammation during a migraine attack. These drugs also
work as vasodilators, counter acting blood vessel constriction in the
brain and surrounding membranes that contributes to migraine pain. CGRP
inhibitor medications are available as prophylactics with monthly or quarterly
Botox injections can be an extremely effective migraine headache prophylactic
treatment for individuals who suffer from 15 or more migraine days per
month. This involves a number of injections over the scalp and neck, performed
in the clinic. The number of injection sessions and duration between varies
across individuals. Botox is injected near nerves involved in migraine
pain, and prevents these nerves from releasing pain messengers to the brain.
For abortive treatment there are also a variety of oral and injectable
medication options. Drug choice depends on the migraine or headache type,
side effect profile and contraindications.
Again, every patient needs a tailored treatment plan based on their migraine
or headache type. For example, management for someone suffering from headaches
due to a bulging disc in the cervical spine requires attention to the
Any acute onset, severe headache (the worst headache of your life or thunderclap
headache), requires emergency medical attention. A change in migraine
or headache frequency or character warrants a check-up with your physician.
It is 2021. You do not have to live with migraines and other headache types.
For more information about migraines and headaches, contact us at Thibodaux
Regional Neurology Clinic, 985.493.3090.
(1) Accessed from americanmigrainefoundation.org.