Manage Your Migraines Head On With A Migraine Doctor

Migraine is defined as a headache with two or more of the following characteristics of pain: pulsating, moderate or severe, hinders or makes activities impossible, affects one side of the head (unilateral). If your headaches are inhibiting your daily lifestyle and management by your primary physician is not meeting your needs, you should see a neurologist. A migraine doctor, which can be a neurologist, internist, or pain management physician, is generally more knowledgeable about diagnosing and treating migraines.

A neurologist conducts a thorough evaluation of your family history, medical history, headache symptoms, and triggers. A neurologist can also more precisely identify any anatomical causes of migraine, which could include abnormal growths, pinched nerves, etc. This can help pinpoint effective migraine medication and headache treatment options.

Penn Highlands Neurology offers comprehensive treatment for headaches whether it be from a migraine or another primary headache condition like tension-type headaches. Identification of the type of headache is pivotal in guiding treatment.

During your first appointment with a neurologist, or migraine doctor, you will need to describe your pain and symptoms in as much detail as possible. If you have not kept a headache diary prior to your first appointment, you may be asked to start a headache diary, which can help pinpoint any potential migraine triggers. You will also be asked to provide your medical and family histories, a list of your medications, hobbies, caffeine intake, and assessment of your stress level.

During your first neurologist appointment for migraine, you will likely undergo a physical examination and may also have imaging tests like an MRI or CT scan. You may have an electroencephalogram (EEG), which measures brain waves. Blood tests, urine tests, and eye exams may also be performed to identify any underlying conditions that may be causing your migraine.

The type of migraine medicine and treatment options depends on the type and frequency of headaches you are experiencing. Some patients benefit from lifestyle changes that minimize or eliminate the triggers of their migraines. Migraine triggers can include a range of things like screen time, caffeine, weather, hormones, stress, and certain foods.

Some patients with migraines can control their pain with over-the-counter medications. However, patients who consistently use OTC medications for their migraine can experience rebound headaches.

There are two categories of migraine medication your head ache doctor may pursue based on the type and frequency of your migraines: preventative migraine medication and acute migraine treatment (which is used when you have a migraine occurring).

Preventative migraine medication has advanced considerably in the past few years. Preventative migraine medication can include infusion therapy for migraine, injectable monoclonal antibodies, nerve blocks, and Botox injections.

Acute migraine treatment, also known as abortive treatment, is given when the migraine is present. These treatment options can be used to address the headache pain, side effects of the migraine pain (like nausea), or underlying triggers. A range of pills, nerve blockers, and infusion therapy for migraine–like dihydroergotamine (DHE) infusion or intravenous (IV) therapy–may be recommended for acute migraine.

Penn Highlands Neurology’s migraine doctors offer preventative treatment for chronic migraine, which can greatly reduce and, in some cases, eliminate the onset of migraine. Preventative migraine medicine includes:

• Injectable monoclonal antibodies
• Botox injections
• Infusion therapy for migraine
• Nerve blocks

New breakthrough preventative migraine preventative medications, known as calcitonin gene-related peptide (CGRP) inhibitors or blockers, have been shown to be highly effective for the prevention of migraines. CGRP inhibitors are given as pills or injectable monoclonal antibodies and tend to have fewer side effects. They are not a traditional medication but rather block the excess release of CRGP proteins around the brain, which can cause inflammation and lead to migraines. Monoclonal antibodies typically have to be given monthly or quarterly (every three months). Learn more about migraine treatments in this blog post.

Botulinum toxin (Botox) is a treatment option for some people who suffer from migraine. While it can be an option for people with episodic migraine, Botox is generally used for chronic migraine, which is 15 or more headache days a month. Botox is usually administered every three months.