Chronic Migraine

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What is a Migraine?

“Is a migraine just a headache?” This is a fairly common question that many people have because of how similar the two issues are. While both a headache and a migraine can produce moderate to severe pain in the head, only a migraine produces a number of other symptoms that make dealing with the issue much more difficult. The pain produced by migraines tends to be more intense and debilitating. The pain also typically occurs in one side of the head. People who suffer from migraines may also experience:

• Sensitivity to light
• Nausea
• Vomiting
• Temporary loss of vision
• Pain behind one or both eyes
• Spotted vision

Chronic Migraines

Chronic migraines are defined as migraines that occur at least 15 times per month for a period of more than three months. Of those 15 migraines, at least eight need to be accompanied by the other symptoms of a migraine for the issue to be considered chronic migraine. A person suffering from chronic migraines may experience headaches that they do not consider to be migraines, but these headaches must still be accounted for so that an accurate diagnoses can be made.

It is possible for a person to develop chronic migraines overtime. These individuals will notice that the frequency of their migraines gradually increases until it reaches the point where they are experiencing at lease 15 migraines per month. The development of chronic migraines is broken down into four states.

1. No migraine
2. Low-frequency episodic migraine – 10 or less per month
3. High-frequency migraine – 10 to 14 per month
4. Chronic migraine – 15 or more per month

Treatment Options for Chronic Migraine

A number of treatment options are available for chronic migraines. During your consultation, Dr. Nader Pouratian will ask you questions about your chronic migraines, discuss your treatment options, and recommend the best course of treatment for you.

When seeking treatment for your chronic migraines, make sure that you have an accurate log of the days you experience a migraine or headache. This information is essential and will play an integral part in the formulation of your treatment.

Lifestyle Changes

Before prescribing any medications, Dr. Pouratian may recommend that the patient improve their lifestyle patterns. These can be improved in the following ways:

• Taking meals on time and making sure they are evenly spaced out. The patient must avoid skipping meals.
• Losing weight if the patient is overweight
• Exercising regularly
• Avoiding opiates and smoking
• Setting up a routine for managing stress
• Treating underlying problems such as mood disorders, depression, or sleeping disorders

Pain Medications

There are no medicines available to cure migraines. However, painkillers and drugs for treating the associated symptoms of migraines, such as nausea, can prevent these symptoms from aggravating.

Painkillers are best for mild migraines. Depending on the severity of the headache, the dose might be increased within the duration of the migraine.

Medications usually prescribed include:

• Triptans
• Analgesics
• Ergotamines
• Dopamine Antagonists

Preventive Medicines

Botox is sometimes prescribed to prevent the debilitating effects of chronic migraines. Botox therapy has shown to reduce migraine attacks by 50% in many patients.

CGRP, or calcitonin gene-related peptide, that is present in the central nervous system has been found to contribute to migraines. A new set of drugs called CGRP antagonists are at times prescribed as a preventive treatment for chronic migraines.

Additional options include:

• Beta-blockers
• Calcium channel blockers
• Anti-seizure or anticonvulsant drugs
• Antidepressants
• Dietary supplements (magnesium, vitamin B-2, coenzyme Q10)

Biofeedback Therapy

In certain cases, biofeedback therapy is effective in preventing migraines. The therapy involves attaching electrodes to a patient’s body to register the different impulses or responses within the body. These impulses are displayed on a monitor.

Depending on the responses, certain relaxation techniques may then be suggested to control migraine triggers, such as:

• Breathing exercises
• Muscle contraction relaxation therapy
• Guided imagery therapy
• Mindful meditation

Nerve Decompression

This surgical procedure is an ideal option for patients who have not experienced effective treatment with other methods. Compressed nerves can cause chronic migraines, and nerve decompression relieves the source of this compression.

During nerve decompression, a small incision is made to access the source of compression and remove it. In many cases, the source is scar tissue or pressure from surrounding muscles.

Schedule Your Consultation

Dr. Pouratian can discuss your treatment options for chronic migraine at his Dallas location, including a migraine surgery known as nerve decompression. Contact our office today to arrange an appointment for a consultation.