Migraine headaches affect an estimated 36 million Americans, or about 12% of the population, surpassing asthma at 8.3% (25 million) and diabetes at 7.8% (23.6 million). Migraines are much more common in women than in men--about 3 times more common. Nearly 30% of women will experience at least one episode of migraine headaches in their lifetime, most commonly in the third and sixth decades of life. However, migraines can affect anyone at any age and from any ethnic group. In addition to indirect expenses like missed work/school and lost productivity, the American Migraine Foundation estimates that migraines cost Americans more than $20 billion annually. Migraine sufferers are also more likely to experience anxiety, depression, sleep disorders, fatigue, and other pain conditions, and those who experience visual disturbances called “auras” associated with migraines are at an increased risk of heart attack and stroke. Unfortunately, there is no cure for migraines. The best treatment options available only to seek to reduce frequency of attacks or treat an attack once one has begun, and medication use is often limited by side effects and difficulty of administration. The American Migraine Foundation itself labels current treatment options “far from perfect” and concludes, “Undoubtedly, better treatments are needed.” Filling this therapeutic void is the primary objective of NuPathe Inc. (very recently acquired by Teva Pharmaceutical Industries Ltd.) with Zecuity®, a sumatriptan iontophoretic transdermal system.
The exact mechanism of migraine headaches has not yet been elucidated. Gene studies, combined with the high correlation of family history with migraine susceptibility, give considerable evidence for a significant geneti...
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... concern with a fungus-based drug class called the ergotamine derivatives (e.g., dihydroergotamine), which also act as agonists at 5-HT receptors throughout the body and are much less specific than the triptans. Because of this potential for additive effects, administration of triptans and ergotamine derivatives should be separated by 24 hours. Lastly, overuse of acute migraine medications can lead to rebound headache symptoms known as “medication-overuse headache,” though the medications most commonly associated with this are opiates and analgesics, not triptans. Triptan-related medication-overuse headache is much more relegated to populations of men with high headache frequency. Nevertheless, it is still recommended for patients to restrict their intake of acute “rescue” migraine medication, including triptans, to 2 or 3 days per week to avoid rebound headache.
Ramchandran, R. (2014, May 12). Therapeutic use of botulinum toxin in migraine: Mechanisms of action. National Center for Biotechnology Information. Retrieved May 14, 2014, from http://www.ncbi.nlm.nih.gov/pubmed/24819339
Patient is a 19-year-old right-handed white male who presents with his mother for evaluation of frequent headaches. He did not have headaches prior to two grade 1 concussions while playing football in 2012. At that time, he had a normal MRI. He has been having headaches since. He did see Kent Logan, MD in 2012, at which point he was describing weekly headaches with photophobia, phonophobia, and nausea. At that time, according to Dr. Logan's notes, there was no aura with his headaches. He noted that trying one of his mother's Imitrex helped with the headache, so he was given a prescription for 50 mg. He was also diagnosed as having a whiplash injury, at that time. He did undergo physical therapy for his neck. He also was complaining of some short-term memory problems at that time, but neuropsychology testing was negative. He has not followed up with Dr. Logan since then. More recently, his headaches have been increasing in frequency. They are located in the left retrobulbar and super orbital area, but then will spread throughout the left side of the head and then bilaterally. The pain is steady when it is milder, but throbbing when it is worse, and it is worsened with exertion. There is photophobia, phonophobia, osmophobia, nausea. They can last one to two hours. Most often, he does have
In reviewing the medical care provided ,it seems that the patient’s previous medical history clouded her doctor’s decisions. Because of this, none of her doctors opted to dig deeper into other possible reasons for her daily headaches. Many factors that should have been...
Client takes a medication to prevent the migraines. Client reports stress in her life increases the frequency and severity of her migraines. Client reports her maternal aunt and younger sister also experience migraines. Client reports an in-patient hospitalization 3 weeks ago, due to weight loss, food restriction, and depression. Client reports no food restriction since her hospital discharge. Client appears thin but does not present as underweight. Her family’s mental health history was not discussed. This information should be obtained at the next session.
The factor of mediation over use is a behavior from the over usage of over the counter (OTC) and prescription analgesic medications that may lead to medications overuse headache(MOH). Caffeine and butalbital are very common to cause MOH. In many cases when the medication wears off the patient takes more analgesics, thus this leads to the continual cycle of pain. MOH is seen more common causing migraines although accountable for tension-type headaches as well.
Introduction: Opiates, ergot alkaloids, corticosteroids, dopamine antagonists or NSAIDs and analgesics and their combinations available OTC are other alternatives that can be used for treatment of migraine headaches in a patient other than triptans.
Furthermore, botulinum injection reduces acute, severe headaches in patients who suffer from migraines. It also decreases the signs and symptoms triggered by migraine headaches, such as vomiting, nausea, and auditory sensitivity. This injection is usually given in the head for treatment. Dr. Skorin (2004) relates that the latest medical uses of botulinum injection is in the field of headache therapy and has been found to be effective in migraine and chronic daily headache (p.
Researchers monitored patients in both inpatient and outpatient surgeries, and looked at how many had stokes then how many were readmitted to a hospital over 30 days. Within the 30 day period, results showed patients with migraines were more likely to have a stoke compared to patients without migraines. The patients who did have migraines with aura were at higher risk to those with regular migraines. The readmission rates was 1.3
...along with a few exercises for four to six weeks should help to decrease the intensity and frequency of the patient’s/client’s headaches as a long term outcome. If not, the patient should visit their primary physician to see about other options that might be beneficial.
1. The types of specialists that can help with a migraine diagnosis are doctors who focus on treating people with migraines. These doctors can be internal medicine doctors, family practice doctors, neurologists, or other specialists who see many patients with headache disorders. Most migraine & headache specialists have completed additional training and have additional certification in treating headaches. They may also work in a clinic dedicated to treating headaches. In addition, a neurologist is a doctor trained in diagnosing and treating disorders and diseases of the brain, spinal cord, nerves and muscles. Neurologists examine and treat the nerves in the head and neck as well as diagnose problems with memory, balance, speech, thinking and
Migraines are not as common as many believe, actually, only about 12 percent of the U.S population gets migraines (Reinald Shyti, Boukje de Vries, Arn van den Maagdenberg, 2011). The recurring headache can range anywhere from moderate to severe. There are four stages of symptoms starting with Prodrome symptoms which occur one to two days before a migraine attack. Prodrome symptoms include constipation, mood changes, food cravings, neck stiffness, increased thirst and urination, and frequent yawning. The second stage is Aura which lasts for about 20 to 60 minutes and may occur before or during a migraine. Symptoms of the Aura stage include flashes of light, vision loss, pins and needles sensation in arm or leg, numbness or weakness on face or one side of the body, speech difficulty, hearing noise or music, and uncontrollable jerking. The third stage is the Attack stage that can lasts 72 hours if not treated. Symptoms of the attack stage include pain on one side or both sides of the head, pain that feels throbbing or pulsing, extreme sensitivity to light and sound, nausea, vomiting, blurred vision, and lightheadedness sometimes followed by fainting. The last stage is Post-dromed symptoms which occur after a migraine.
The aura happens before the actual headache begins. When a person has an aura, one can experience flashes of light, blind spots, dizziness, and sensitivity to light. In addition, some people who experience migraines isolate themselves in dark quiet places such as closets and under the covers to help reduce the pain. According to (Estemalik and Tepper 2010) In the U.S., 18% of women suffers compared to 6% of men. Women suffer more from migraines due to the many roles played daily. In a household, women are full-time workers, hold high positions at their employment and juggle family
Migraines may be felt specifically on one side of the head, produce moderate to severe pain, and may be aggravated by physical activity. The patients may experience auras, nausea, vomiting, and sensitivity to light. This was a major precedent when selecting patients for the study.
It seems like this terrible affliction can only be accepted by those struggling. To be fair, lack of treatment is probably most common among those who suffer episodic migraines, not chronic ones.