Headache & Migraine
There is probably no one in this world who has not suffered from some type of headache in his lifetime. Most types of headaches are fortunately harmless in nature and only a few types of headaches are serious in nature. A headache may be serious if one notices:
• Sudden onset of severe headache
• The headache is becoming worst quickly.
• A new type of headache appearing for the first time especially at old age.
• Headache associated with symptoms like projectile vomitting, visual disturbances, weakness of one or both sides of the body/face, fever etc.
• Headache which increases with forward bending.
If these symptoms are noticed then a C.T or M.R.I scan are required.
Migraine is commonest type of headache requiring a visit to a doctor. It is also the commonest cause of severe headache. Migraine headache are different from other types of headaches because of its typical characteristics. Family history of migraines, age when first attack occurred, frequency and duration of headache also helps to determine if an individual is suffering from migraine or not.
Treatment Options for Migraine
Preventive methods
• Certain medicines and interventional pain procedures are effective. Botulinum toxin injected in scalp or ozone and local anaesthetic injection given at certain specific points may prevent migraine attacks.
Avoidance of trigger factors. The trigger factors include:
• Foods such as cheese, alcohol, chocolate, caffeine, meats, fermented or pickled foods, yeast or protein extracts, onions, nuts etc.
• Medicines such as antibiotics, antihypertensives, H 2 receptor blockers, vasodilators etc.
• Hormonal factors such as mensturation, oral contraceptives, hormonal replacement therapies.
• Lifestyle factors like skipping meals, changes in sleep pattern or stress.
• Environtmenal factors such as weather change, high altitude, time zone changes (for eg. Jet lag).
Abortive : certain drugs are use to abort the attacks of migraine
• Cerebral vasoconstrictors such as ergotamine, dihydroergotamine, sumatriptan etc.
• Non vasoconstrictors such as butorphanol and other narcotic analgesics.
• Interventional pain management: spheno-palatine ganglion block.
General pain management by analgesics such as paracetamol, NSAIDs, tramadol, codeine etc.
