Headaches and Migraines
What are different kinds of Headaches?
There are many different types of headaches. One of the most common is migraine. There are multiple other types including cluster headaches, tension headaches and ice pick headaches. However, there could be other pathologies like high blood pressure, sleep apnea, or some problems with the brain that can cause headaches as well, and needs to be evaluated.
What causes Migraines?
The current theory is that the trigeminal vascular system plays an important role in migraines. Trigeminal ganglion is a nerve cell body which has connections to the meninges (brain covering membrane) and surrounding blood vessels, which releases chemicals like calcitonin gene-related peptide (CGRP). This system is thought to be involved in the migraines. Usually there are no abnormalities seen on MRI of brain.
What are triggers for Migraines?
There are many different triggers for migraines. Most common triggers include skipping meals, particular smells, certain foods, wine, stress, menstrual cycles. Everyone is different, and everyone can have their own different triggers. Hence, we always recommend keeping a headache diary to find triggers which could be avoided.
What are different treatment options for headaches?
There are two main kinds of treatments, preventive medications and abortive medications. Preventive medications are used to prevent migraines. And abortive medications are used to help stop the ongoing migraine episode. However, taking abortive medications too often can cause more rebound headaches. Hence, one should avoid taking over the counter pain medications frequently to avoid rebound headaches.
Typically, some of the seizure medications, blood pressure medications or antidepressants could be used to help prevent migraines. There are also botulinum toxin injections and CGRP receptor antibodies which could be used to prevent migraines as well.
What are botulinum toxin injections?
Botulinum toxin injections (Brand name Botox) are approved for preventing migraines. The injections are given on the forehead, on the side of the head, on the back of the head and also around the shoulder girdle. The injections are typically given every 3 months.
Links to Resources
- National Headache Foundation. https://headaches.org/
- American Migraine Foundation. https://americanmigrainefoundation.org/
- The International Classification of Headache Disorders. https://ichd-3.org/
- Botox for Migraine. https://www.botoxchronicmigraine.com/
Progressive Neurology and Sleep Center serves patients from Hampton Roads area including cities of Chesapeake, Newport News, Norfolk, Portsmouth, Hampton, Outer Banks and surrounding areas.