February 20, 2011

True migraines are much more than a headache.  As evidenced by Serene Branson’s episode of gibberish during a recent, on air, news report, (http://www.youtube.com/watch?v=IG7NuH5QTdE), migraines can simulate a stroke.  What most people don’t know is that migraines can actually cause a stroke.

Over the last year, I diagnosed three patients with migraine induced strokes and two of those patients have residual neurologic deficits (loss of function or sensory changes).  Do you have migraines?  There are a multitude of types of headaches, including migraine, tension and chronic daily headaches.  Most people refer to any bad headache as a migraine.  It is important to know what type of headache you have as the treatment and possible consequences of a headache differ depending on cause.

If you are still reading this article, you or a loved one probably have headaches.  Don’t underestimate your headache.  Don’t put off seeing your doctor.  Please don’t learn to live with it or let it control your life.  We have excellent treatments for all types of headaches.  When you see your doctor, he will want to know the following things in order to help classify your headache and provide proper treatment options.

  1. How frequent is your headache?
  2. How severe are your headaches on a 1 to 10 scale?
  3. Where in your head are your headaches?
  4. What is the quality of the pain? Piercing? Stabbing? Throbbing?
  5. Describe the onset.  Does it build in intensity?  Is it sudden and severe?
  6. What makes your headache worse?
  7. What makes it better?
  8. Are there associated changes in your ability to think, speak, feel or move parts of your body?
  9.  What have you taken for your headache?

Treatments for migraines and other headaches are divided into rescue and preventative modalities.  Rescue medications are designed to help you stop a headache after it has started.  Preventative treatments, sometimes called controllers, are designed to stop the headache prior to its onset.  Obviously, in the case of the newscaster, it would have been better to stop her from losing her ability to speak.

If you have headaches, keep a headache diary.  Learn everything you can about your headache by collecting clues.  Read about headaches on WebMD and other reliable sources.  Once you have collected as much knowledge as you can, see your family doctor.  Let your doctor verify the type of headache and discuss treatment options, both for rescue and control.  Certain types of migraines may require consultation with a specialist and your family doc will help you find the right consultant.

One of the best, patient oriented resources I have ever seen is available free at http://headachedrugs.com/pdf/HA2010.pdf.  Dr Lawrence Robbins is a remarkably gifted physician and his headache guide is very comprehensive.  Dr Robbins is the right doctor for those of my patients who need specialty care.


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