Migraine Health Article

Support Groups

American Council for Headache Education - www.achenet.org

The National Migraine Association - www.migraine.org

National Headache Foundation - www.headaches.org

Expectations (prognosis)

Every person responds differently to treatment. Some people have rare headaches that require little to no treatment. Others require the use of several medications or even occasional hospitalization.

Complications

Migraine headaches generally represent no significant threat to your overall health. However, they can be chronic, recurrent, frustrating, and they may interfere with your day-to-day life.

Stroke is an extremely rare complication from severe migraines. This risk may be due to prolonged narrowing of the blood vessels, limiting blood flow to parts of the brain for an extended period of time.

Calling your health care provider

Call 911 if:

• You have unusual symptoms not experienced with a migraine before, like speech or vision problems, loss of balance, or difficulty moving a limb
• You are experiencing "the worst headache of your life"

Call your doctor immediately if:

• Your headache pattern or intensity is different
• Your headache gets worse when you lie down

Also, call your doctor if:

• Previously effective treatments no longer help
• Side effects from medication occurs (irregular heartbeat, pale or blue skin, extreme sleepiness, persistent cough, depression, fatigue, nausea, vomiting, diarrhea, constipation, stomach pain, cramps, dry mouth, extreme thirst, or others)
• You are likely to become pregnant -- some medications should not be taken when pregnant

Prevention

• Avoid smoking
• Avoid alcohol
• Exercise regularly
• Get enough sleep each night
• Learn to relax and reduce stress -- try progressive muscle relaxation (contracting and releasing muscles throughout your body), meditation, biofeedback, or joining a support group

If you get at least three headaches per month, your doctor may prescribe medication for you to prevent recurrent migraines. Such prescription drugs may include:

• Beta-blockers such as propranolol (Inderal)
• Antidepressants, including tricyclics like amitriptyline (Elavil) or selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac, Sarafem), paroxetine (Paxil), or sertraline (Zoloft)
• Anticonvulsants such as valproic acid (Depacon, Depakene), divalproex sodium (Depakote), or topiramate (Topamax)
• Calcium channel blockers such as verapamil

References

Morantz C. Practice Guideline Briefs. Am Fam Physician. Mar 2005; 71(5); 1019-899.

Schroeder BM . AAFP/ACP-ASIM release guidelines on the management and prevention of migraines.  Am Fam Physician. Mar 2003; 67(6): 1392, 1395-7.

Noble J, ed. Textbook of Primary Care Medicine. 3rd ed. St. Louis, MO: Mosby; 2001.

Marx JA, Hockberger RS, Walls RM, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, MO: Mosby; 2002.

Goetz CG, Pappert EJ. Textbook of Clinical Neurology. 2nd ed. Philadelphia, PA: Saunders; 2003.