Targeting Treatment for Migraines


Targeting Treatment for Migraines

BPPV Head Pain And Vertigo Dizziness. Brain Stroke

Migraines are treatable, not something you just have to suffer through.

In many cases, these often debilitating headaches can be managed with effective medications that stop symptoms during an attack. There are also oral medications that, if taken regularly, can lower the frequency or intensity of migraines. Targeted migraine treatment or therapies, such as Botox injections or lifestyle adjustments, can often yield favorable results too.

Josh Webb, ARNP, primary care provider at WWMG’s Lake Serene Clinic, notes, “It is common for me to see patients who have suffered with migraines for years and never sought treatment, because they thought that there was nothing to be done. In fact, there are many good treatment options.”

Diagnosis is the first step  

For migraines, getting an accurate diagnosis while ruling out other health conditions is the first step in finding relief. A primary care provider can conduct an assessment to help determine the appropriate diagnosis and path for migraine treatment.

Depending upon your family history, personal medical history, pre-existing health conditions, or the specific symptoms that accompany your migraines, sometimes specialty support from a neurologist may also be recommended.

If your child is having migraines, here’s what you need to know.

Causes and triggers of migraines

Migraines affect women more than men, and the causes of them are not well understood. Genetic susceptibility seems to play a role. If your parents suffered from migraines, it is more likely that you may too.

In addition to heredity, brain sensitivity to environmental and lifestyle factors may also contribute. Some factors that can trigger migraines include:

  • lack of sleep
  • stress
  • alcoholic drinks
  • too much caffeine
  • certain foods or food additives
  • and more

When seeking treatment, it is helpful to give your provider objective data. A diary is useful for tracking the frequency, symptoms, and triggers of your migraine attacks.

When to see a neurologist for migraines

It is advisable to seek care with a specialist if multiple migraine therapies fail, if there is a family history of disease affecting the brain, or when there is concern that the headaches may be caused by something else. If you fit these criteria or those described below, a WWMG primary care provider can write you a referral to a neurologist.

Migraines during pregnancy, migraines in patients who have tumors or seizures, and migraines that are associated with symptoms of concern should also be evaluated by a neurologist. Those symptoms may include tremors or clumsiness, confusion, slurred speech, or difficulty understanding others who are speaking.

Patients should be evaluated by a neurologist for migraines that:

  • are located on one side of the head
  • have a pulsating quality
  • have moderate or severe pain intensity
  • are aggravated by routine physical activity, like walking or climbing stairs
  • cause nausea and/or vomiting; and
  • create heightened sensitivity to bright light and/or sound.

As part of the diagnostic process for diagnosing migraines, a neurologist may recommend imaging such as an MRI, specialized blood tests, or other procedures to determine the appropriate course of treatment.

Botox treatment for migraines

For patients with chronic migraines, Botox may help decrease the effect of triggers by temporarily reducing muscle contractions around pain fibers, and can establish a type of anesthetic buffer so that pain signals in the brain are not activated.

Patients who experience more than 20 migraine days per month and have tried at least 2 to 3 oral preventative medications without success may benefit from a treatment protocol of Botox injections every three months.

Where to seek treatment

There is some overlap between the treatment options that may be recommended by a neurologist and those available in primary care, be they migraine medications, Botox, nerve stimulation, other therapies, or non-medicinal alternatives such as lifestyle changes.

For patients who meet the criteria, Botox for migraines is offered at WWMG’s Lake Serene Clinic and at Whitehorse Family Medicine.

If you have occasional to frequent migraines, you don’t just have to suffer through them. Our providers offer support for migraine diagnosis, care, and treatment options to help you manage symptoms and prevent attacks. A WWMG primary care provider will conduct a thorough assessment and recommend treatment options, and refer you out to a neurologist if needed.