Is It Time To See A Neurologist For Your Headaches
Your family doctor is a great starting point for headache relief. But for chronic headaches that dont respond to treatment, you may need to enlist the help of a neurologist.
The average headache doesnt require a call to a neurologist or even your family doctor. But if you’re experiencing frequent headaches and using medication for them on the regular, thats a different story.
If you have a history of headaches that come once or twice a month and go away when you take an over-the-counter medication such as acetaminophen or ibuprofen, you may not need to seek further treatment, says Sandhya Kumar, MD, a neurologist and headache specialist at Wake Forest Baptist Health in Winston-Salem, North Carolina.
If youre having headaches more than four times a month, especially if they are debilitating and keeping you home from work, you should see a provider for diagnosis and medication, says Dr. Kumar.
Can Migraines Be Prevented
You can’t prevent every migraine. But learning your triggers and trying to avoid them can help. Take a break from activities that might start a migraine, such as using the computer for a long time. If you know that some foods are triggers, skip them. Some people find that cutting back on caffeine or drinking a lot of water can help prevent migraines.
Make a plan for all the things you have to do especially during stressful times like exams so you don’t feel overwhelmed when things pile up. Regular exercise also can reduce stress and make you feel better.
The more you understand about your headaches, the better prepared you can be to fight them.
How Are Migraines Diagnosed
To diagnose a migraine, your healthcare provider will get a thorough medical history, not just your history of headaches but your familys, too. Also, they’ll want to establish a history of your migraine-related symptoms, likely asking you to:
- Describe your headache symptoms. How severe are they?
- Remember when you get them. During your period, for example?
- Describe the type and location of your pain. Is the pain pounding? Pulsing? Throbbing?
- Remember if anything makes your headache better or worse.
- Tell how often you get migraine headaches.
- Talk about the activities, foods, stressors or the situations that may have brought on the migraine.
- Discuss what medications you take to relieve the pain and how often you take them.
- Tell how you felt before, during and after the headache.
- Remember if anyone in your family gets migraine headaches.
Your healthcare provider may also order blood tests and imaging tests to make sure there are no other causes for your headache. An electroencephalogram may be ordered to rule out seizures.
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What Are The Symptoms Of Migraines
The primary symptom of migraine is a headache. Pain is sometimes described as pounding or throbbing. It can begin as a dull ache that develops into pulsing pain that is mild, moderate or severe. If left untreated, your headache pain will become moderate to severe. Pain can shift from one side of your head to the other, or it can affect the front of your head, the back of your head or feel like its affecting your whole head. Some people feel pain around their eye or temple, and sometimes in their face, sinuses, jaw or neck.
Other symptoms of migraine headaches include:
- Sensitivity to light, noise and odors.
- Nausea and vomiting, upset stomach and abdominal pain.
- Loss of appetite.
- Feeling very warm or cold .
- Pale skin color .
- Euphoric mood.
Medical Definition Of Migraine
Note: Migraine tends to occur in more than one member of a family and is of uncertain origin though attacks appear to be associated with dilation of intracranial blood vessels and release of serotonin and other inflammatory substances.
MigraineThe New England Journal of Medicinemigraine: :
called alsoacephalgic migraine, silent migraine
: : migrainesmigrainesFood & Fitness Advisor
called alsosick headache
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What Medicines Help Relieve Migraine Pain
For mild to moderate migraines, over-the-counter medicines that may help relieve migraine pain include:
- an acetaminophen, aspirin, and caffeine combination
People who have more severe migraines may need to try abortive prescription medicines. A medicine called ergotamine can be effective alone or combined with other medicines. Dihydroergotamine is related to ergotamine and can be helpful. Other prescription medicines for migraines include sumatriptan, zolmitriptan, naratriptan, rizatriptan, almotriptan, eletriptan, and frovatriptan.
If the pain wont go away, stronger pain medicine may be needed, such as a narcotic, or medicines that contain a barbiturate . These medicines can be habit-forming and should be used cautiously. Your doctor may prescribe these only if they are needed and only for a short period of time.
Migraines Affect Women Three Times More Than Men
According to the Migraine Research Foundation, 38 million people in the U.S. experience migraines, and 28 million of them are women. âWomen are thought to have a higher incidence of migraine due to the normal fluctuation of hormones related to the menstrual cycle,â explains New York City-based neurologist and headache specialist Dr. Thomas Berk, M.D. âFor many women, this fluctuation can be a significant trigger for their migraines.â
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Weakness On One Side Of The Body
When an arm goes limp, it can be a sign of a migraine.
Some people experience muscle weakness on one side of the body before a migraine attack. This can also be a sign of a stroke, however, so consult a doctor to rule out any other causes.
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Whats A Migraine What Does A Migraine Feel Like
A migraine is a common neurological disease that causes a variety of symptoms, most notably a throbbing, pulsing headache on one side of your head. Your migraine will likely get worse with physical activity, lights, sounds or smells. It may last at least four hours or even days. About 12% of Americans have this genetic disorder. Research shows that its the sixth most disabling disease in the world.
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Regular Pain Medications Are Often Taken Incorrectly For Migraine
When someone says they have a migraine, they may be offered an OTC pain reliever by a well-meaning person. However, meds only work if they are taken early enough and at the right dose, and according to Brandes, this often does not happen. â really important because we know that thereâs a peripheral phase of migraine once the migraine starts, and you have about a 20 to 60 minute window when you can get rid of the migraine,â Brandes tells Bustle. If this window is missed, medications wonât do anything to help your pain.
Why Didnt I Need To Learn This Before
Well, for a long time, my migraines were responsive to medication, so I didnt think much about rocking the treatment boat. The neurologist my insurance had recommended at my hospital was fine – she was friendly, easy to communicate with, and most importantly, renewed my prescriptions. In general, I only saw her a few times a year, and honestly, I had many other specialists I spent much more time with.
Last fall, I woke up with an earth-shattering migraine a few days after experiencing a miscarriage. I took my regular medication and then two hours later took another dose. When neither made a dent, I called my doctor’s office and asked for additional support. But, rather than prescribe another medication, or recommend a migraine cocktail via infusion, she was sending me to the emergency room. Why? Because she wanted to rule out swelling of the brain.
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Migraines Can Have An Economic Impact On The Country
âThere are several reasons that migraine results in economic burden,â Aymen tells Bustle. People will often either miss work or decide to try to push through the pain, which causes them to be less efficient at their jobs. âPeople with migraine often struggle to find an effective treatment regimen, which results in frequent urgent care or emergency department visits,â Aymen says.
Diagnostic Tests For Headache
The tests your doctor orders will depend in part on what they suspect could be causing your headaches and whether its a primary headache such as a migraine or tension headache or a secondary headache, which means that its a symptom of another health concern.
Although primary headaches can be painful and debilitating, they arent life-threatening.
Secondary headaches are much rarer and can be the sign of a serious health issue sometimes even one that requires urgent medical attention.
The process of diagnosis may include the following:
Medical history Your doctor will want to know about any other health conditions you have as well as any medications, supplements, or herbal treatments you take.
Family history Be prepared to provide details about any family members who have headaches or migraine at what age their headaches started, and any other health diagnoses they may have. As Goadsby notes, Very often, family members wont know theyve got migraine, but they will know they are prone to headaches. Since migraine has a strong genetic component, a family history of migraine-like symptoms is an indicator that your headaches are also being caused by migraine.
Physical exam Your doctor will examine you, paying close attention to your head, neck, and shoulders, which can all contribute to headache pain in various ways.
Neurological exam A neurological exam may include tests of your vision, hearing, short-term memory, reflexes, sensation, balance, and coordination.
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What Are The Symptoms Of An Ocular Migraine
The most common ocular migraine symptom is a small blind spot that impairs your central vision in one eye.
This blind spot expands, making it difficult to drive safely or read using the affected eye.
In addition to the flickering blind spot, other migraine symptoms include:
- A colorful light ring that is wavy or zigzag and surrounds a central blind spot
- A blind spot that slowly migrates across your field of vision
- A migraine lasting between 4 and 42 hours
- Sensitivity to light or sound
- Vision loss
- Nausea and vomiting
- A headache that feels worse when you move your head
If you have blind spots or other visual symptoms and arent sure whether it’s an ocular migraine or a visual migraine, cover one eye at a time and observe your sense of sight. If the visual disturbance affects one eye only, it is most likely an ocular migraine.
Half Of All Migraineurs Are Never Diagnosed
âOver 50% of people with migraine are either undiagnosed or misdiagnosed,â Strachan notes. âOftentimes patients may disregard their symptoms because they are not considered to be very severe nor occur frequently.â Whatâs more is that many patients who do bring their symptoms to their doctorâs attention may be misdiagnosed as having a sinus disease or tension headache, according to Strachan.
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Whats A Migraine Journal
- Keeping a migraine journal is not only beneficial to you, but it helps your healthcare provider with the diagnosis process. Your journal should be detailed and updated as much as possible before, during and after a migraine attack. Consider keeping track of the following:
- The date and time of when the migraine began specifically when the prodrome started, if youre able to tell its happening. Track time passing. When did the aura phase begin? The headache? The postdrome? Do your best to tell what stage youre in and how long it lasts. If theres a pattern, that may help you anticipate what will happen in the future.
- What are your symptoms? Be specific.
- Note how many hours of sleep you got the night before it happened and your stress level. Whats causing your stress?
- Note the weather.
- Log your food and water intake. Did you eat something that triggered the migraine? Did you miss a meal?
- Describe the type of pain and rate it on a one to 10 scale with 10 being the worst pain youve ever experienced.
- Where is the pain located? One side of your head? Your jaw? Your eye?
- List all of the medications you took. This includes any daily prescriptions, any supplements and any pain medication you took.
- How did you try to treat your migraine, and did it work? What medicine did you take, at what dosage, at what time?
- Consider other triggers. Maybe you played basketball in the sunlight? Maybe you watched a movie that had flashing lights? If youre a woman, are you on your period?
What Are The Types Of Migraines
Migraine without aura The most common type of migraine is one without an aura. Most migraines have no warning sign that they are about to happen. Symptoms can include a pulsing or throbbing pain. With common migraines, the pain can be made worse by physical movement, nausea or vomiting.
Migraine with aura The aura before a migraine can last 10 to 30 minutes. It can signal serious pain is ahead.
Migraine without head painThis kind of migraine is also known as a silent migraine. This kind of migraine can create an aura, visual disturbances and nausea.
Hemiplegic migraineWith this kind of migraine, you can have weakness on one side of the body with visual aura symptoms. Some people have a feeling of âpins and needlesâ or even a loss of feeling on one side of the body.
Retinal migraineThis kind of migraine can affect vision. It can also cause short-term loss of sight in one eye.
Long-term migraineThis type of migraine varies in severity, and each one can be different. This kind of migraine can last more than 15 days.
Ice pick headacheThis type of migraine feels just like the name sounds, as if you are getting stabbed in the head with an ice pick.
Cluster headacheWith this type of migraine, you can have a burning pain around and above the eyes, temples or the back of head. You can also have red or swollen eyes.
Cervicogenic headacheWith this type of migraine, you have pain in your head that is caused by pain in the neck. It can be caused by a wound or sore on the spine.
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How Is A Diagnosis Made
There is no actual test to diagnose migraine. Diagnosis will depend upon your doctor taking your medical history and ruling out other causes for the attacks. To make a firm diagnosis, information from two sources will be used:
When you visit your doctor to talk about your headaches, you should therefore expect to give quite detailed information about your attacks. Keeping a simple migraine diary can be very helpful. This might include details of treatment you have tried in the past which has not helped the attacks.
You may have heard of techniques such as CAT or MRI scans, where a picture is taken of your brain. Although these tests will help rule out other causes of headache, they cannot be used to diagnose migraine. Similarly, an EEG will not help the doctor to make a correct diagnosis of migraine nor do routine blood tests help.
Three Signs You May Need To See A Neurologist For Your Headaches
Headaches are common but some are much more serious than others. How do you know when yours warrants a trip to a neurologist?
The following signs indicate your headaches may be caused by a neurological issue, says Dr. Greg McLauchlin, assistant professor in the Department of Neurology at Baylor College of Medicine.
You take headache medication often
If you get frequent headaches, its tempting to take medication for them regularly. However, McLauchlin says this could be a sign of a more serious condition.
It is important to realize that some over-the-counter medicines can actually make headaches worse if they are taken too frequently, said McLauchlin. Also, over-the-counter medicines can do damage to the stomach, kidneys and liver if taken in excess.
He suggests that anyone who takes over-the-counter medicine to alleviate headaches five or more days out of the month should go see a doctor.
Headaches disrupt daily activities
A visit with your primary care physician is a good place to start for headaches that are not disabling but more of a nuisance. However, immobilizing headaches may warrant a trip to a neurologist.
Patients should see a neurologist for any headache that is disabling, McLauchlin said. This applies to you if you have to stop what you are doing and lie down during a headache.
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Whats The Outlook For People With Migraine
Although migraine is a chronic condition, there can be periods of remission.
There are also a variety of treatments to help prevent migraine attacks and mitigate symptoms when they start to occur. Knowing the triggers of migraine can also help to minimize and prevent migraine attacks and help you manage your condition.
Seeing a neurologist regularly may help you maintain the best treatment for your migraine and to address any issues that might come up.
How Common Are Ocular Migraines
Q: Thank you for the information you have published about ocular migraines. I’ve had numerous episodes over the past five years, but most recently was last week when I was two and a half hours away from my home. It took over an hour for it to totally go away. I appreciate your explanation of the usual symptoms, because it described what I experienced to a “T.”
I had one question, though. Other sources on the Internet say this phenomenon is rare. But you say it is quite common. Is it? B.M.
A: Ophthalmic migraines are not rare, especially if you are a woman under age 40 with a history of migraines. Dr. Slonim
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