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Old 11-21-2011, 08:53 AM #1
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Default Migraines and PN??

Hi all, I've developed a recent onset of migraine headaches since the middle of October. Prior to these, I've only had one migraine which occured a couple of years ago. In the past seven days, I've been awakened by them on two days and experienced one in the middle of the day. I've read all the info regarding triggers and I haven't noticed anything in common on the days these have occured. I have been having some of the pain as well even in the absence of the headache and my scalp is experiencing hyersensitivity to no end. I'm scheduled this week for a lip biopsy for Sjogrens but does anyone know if these headaches can accompany that or PN? I've already seen my neuro for this and he is stumped. I'm feeling pretty alone in all of this and this seems to be a constant state for me for over a month now and it doesn't seem to be going away. I've had an MRI of the head in the beginning of 2008 and I've tried topamax before on two occasions for another nerve pain condition I have, but I have alot of reasons for not taking it aside from side effects. I'm feeling pretty beat up by this. If anyone has any info to share, i'd be really grateful.
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Old 11-21-2011, 09:06 AM #2
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Do you use a magnesium supplement? Some migraines respond to fixing magnesium levels.
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Old 11-21-2011, 09:31 AM #3
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Hi EE03,

I have several years of... experience (though I usually think of it as ordeal) with chronic (more than 15/month) migraines. A neuro likely won't have the knowledge/experience; you need to find a migraine specialist, which is usually a neurologist, but I've heard of other specialties going into it as well.

This is going to be a(nother) process, whether it's related to something else you already have or just comorbid. While you're looking for/waiting to see the migraine specialist, start a Headache Log. This is a type of pain journal for headaches, in which you'll keep track of episodes, symptoms, pain levels, locations, triggers, meds taken, what helps & what makes them worse.... Anything & everything you can think of relating to the headaches & episodes.
Google: headache log to get a better idea, and some sample logs you can download/copy. If none of them are quite right for your particular needs, take some ideas and create your own on a spreadsheet (that's what I wound up doing)

Not all migraines have triggers; not all migraines have headaches.
Google: silent migraine

Start researching types of headaches & types of migraines, and see if you can't nail it down somewhat, so when you get to the right specialist, you'll be prepared, ahead of the game, and better able to help the doctor help you (and not have to wait several more months collecting this data ).
Google: headache diagnosis
Google: headache diagnosis questionnaire

I don't blame you for not wanting to use Topamax/Dopamax/Stupamax, though you should know that it usually takes several months for it to be useful for migraine prophylaxis, and there are other medication options for that purpose as well.

In the meantime, you'll also need some type of migraine abortive. Imitrex and Maxalt are two popular (and effective) ones, but there are many more, and while one triptan may not work, don't rule the others out. Imitrex doesn't work for me at all, but Maxalt works very well.
http://www.webmd.com/migraines-heada...ine-treatments

And by all means, look into dietery triggers and treatments, supplements, physical therapy (worked a lot for mine - how's your posture? Sit a lot at a computer?) accupuncture, myofascial triggerpoint therapy, etc. There are many effective treatments besides prescribed medications (but get that headache log started anyway. )

Best wishes,

Doc
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Last edited by Dr. Smith; 11-21-2011 at 09:55 AM.
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Old 11-21-2011, 09:52 AM #4
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Default this sounds a bit like cluster headaches...

They usually occur at night, are intense then go away for a while only to whack you again. They can occur several times a day for months and then never return. I think there is a histamine mechanism involved.

I've had migraine since childhood and members of my family have been in studies since they all started as kids. Possible genetic involvement.

My triggers are odors. Most household cleaners, alcolhol based fragrances, remember Gorgio perfume...an absolute killer, and elevated TSH a thyroid hormone present in hypothyroidism.

Zomig is the only med that could stop a migraine that was "in progress" but it costs sooo much money. My insurance only allows for 20 pills for 90 days.

The residual head soreness where you can't even touch your hair is an after effect of the migraine as is the overwhelming desire to sleep.

My indication of migraine about to start is big time hunger and shakiness. blood sugars do not change, it is a release of adrenalin in my situation.

Chronic migraine is a life stealer.
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Old 11-21-2011, 12:20 PM #5
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Quote:
Originally Posted by mrsD View Post
Do you use a magnesium supplement? Some migraines respond to fixing magnesium levels.
Before these, I've tried using Slow Mag for the muscle spasms I get and it actually made them worse, go figure. I haven't tried it for the migraines though.
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Old 11-21-2011, 12:25 PM #6
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Quote:
Originally Posted by Dr. Smith View Post
Hi EE03,

I have several years of... experience (though I usually think of it as ordeal) with chronic (more than 15/month) migraines. A neuro likely won't have the knowledge/experience; you need to find a migraine specialist, which is usually a neurologist, but I've heard of other specialties going into it as well.

This is going to be a(nother) process, whether it's related to something else you already have or just comorbid. While you're looking for/waiting to see the migraine specialist, start a Headache Log. This is a type of pain journal for headaches, in which you'll keep track of episodes, symptoms, pain levels, locations, triggers, meds taken, what helps & what makes them worse.... Anything & everything you can think of relating to the headaches & episodes.
Google: headache log to get a better idea, and some sample logs you can download/copy. If none of them are quite right for your particular needs, take some ideas and create your own on a spreadsheet (that's what I wound up doing)

Not all migraines have triggers; not all migraines have headaches.
Google: silent migraine

Start researching types of headaches & types of migraines, and see if you can't nail it down somewhat, so when you get to the right specialist, you'll be prepared, ahead of the game, and better able to help the doctor help you (and not have to wait several more months collecting this data ).
Google: headache diagnosis
Google: headache diagnosis questionnaire

I don't blame you for not wanting to use Topamax/Dopamax/Stupamax, though you should know that it usually takes several months for it to be useful for migraine prophylaxis, and there are other medication options for that purpose as well.

In the meantime, you'll also need some type of migraine abortive. Imitrex and Maxalt are two popular (and effective) ones, but there are many more, and while one triptan may not work, don't rule the others out. Imitrex doesn't work for me at all, but Maxalt works very well.
http://www.webmd.com/migraines-heada...ine-treatments

And by all means, look into dietery triggers and treatments, supplements, physical therapy (worked a lot for mine - how's your posture? Sit a lot at a computer?) accupuncture, myofascial triggerpoint therapy, etc. There are many effective treatments besides prescribed medications (but get that headache log started anyway. )

Best wishes,

Doc
Great info Doc. I'm already on the log and I've done a fair bit of reading but I'll be doing more. I'm a vegetarian so my diet is very restricted as it stands and so far nothing has struck me there. I have a followup appt with my neuro and will discuss a migraine specialist with him then. Whatever is causing this, is isn't going away anytime soon apparently.
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Old 11-21-2011, 12:35 PM #7
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Quote:
Originally Posted by JB63 View Post
They usually occur at night, are intense then go away for a while only to whack you again. They can occur several times a day for months and then never return. I think there is a histamine mechanism involved.

I've had migraine since childhood and members of my family have been in studies since they all started as kids. Possible genetic involvement.

My triggers are odors. Most household cleaners, alcolhol based fragrances, remember Gorgio perfume...an absolute killer, and elevated TSH a thyroid hormone present in hypothyroidism.

Zomig is the only med that could stop a migraine that was "in progress" but it costs sooo much money. My insurance only allows for 20 pills for 90 days.

The residual head soreness where you can't even touch your hair is an after effect of the migraine as is the overwhelming desire to sleep.

My indication of migraine about to start is big time hunger and shakiness. blood sugars do not change, it is a release of adrenalin in my situation.

Chronic migraine is a life stealer.
Your description of the head pain is spot on with what I'm experiencing and I have been sleeping a lot following these episodes. I didn't think these fit cluster headaches when I read the descriptions. I just can't seem to shake the ongoing nature of this. The pain continues to linger at a lower level in between the actual headaches. I haven't been given any abortive meds as yet. My GP gave me a shot of toradol which helped for about a day, but then I was right back to still feeling a lower lever of pain.
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Old 11-21-2011, 05:11 PM #8
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Originally Posted by EE03 View Post
I'm a vegetarian so my diet is very restricted as it stands and so far nothing has struck me there.
You might be surprised. Some foods can be relatively quick triggers, while others may require build-up over several meals/days. It depends on how long the actual chemical in the food stays in your system, and/or if the source is from multiple foods containing the same trigger substance. Here's just one page on food & migraines (both headache-causing and headache-fighting); pay special attention to the page on foods with tyramine:
http://www.relieve-migraine-headache...-migraine.html

For others, Google: foods migraine
For others, Google: supplements migraine

Something may ring a bell.

It's also possible, from your description of pain between headaches, that you may have some kind of multiple type complex (2 or more types of headaches at work at different or the same times). I have such a complex called "chronic tension-type headache/migraine complex - sudden onset" which began after a virus. I suffered with it for a couple of years before finding (or even realizing there were) a headache specialist (his entire practice is limited to migraines). He asked me exactly 3 questions, then turned around and pulled out an info sheet from his file. He nailed it that fast! Treatment was another story. Anyhow it turned out my particular headaches were brought on by the cold virus (in my late 40s) re-activating the Epstein-Barr virus from when I had mononucleosis as a teenager. What's weirder still is that within a few weeks of being dxed, my wife learned that a co-worker had the exact same thing. This is where the diagnosis questionnaires & websites can be helpful in getting a leg up.

Doc
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Old 02-22-2012, 02:06 PM #9
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Quote:
Originally Posted by EE03 View Post
Hi all, I've developed a recent onset of migraine headaches since the middle of October. Prior to these, I've only had one migraine which occured a couple of years ago. In the past seven days, I've been awakened by them on two days and experienced one in the middle of the day. I've read all the info regarding triggers and I haven't noticed anything in common on the days these have occured. I have been having some of the pain as well even in the absence of the headache and my scalp is experiencing hyersensitivity to no end. I'm scheduled this week for a lip biopsy for Sjogrens but does anyone know if these headaches can accompany that or PN? I've already seen my neuro for this and he is stumped. I'm feeling pretty alone in all of this and this seems to be a constant state for me for over a month now and it doesn't seem to be going away. I've had an MRI of the head in the beginning of 2008 and I've tried topamax before on two occasions for another nerve pain condition I have, but I have alot of reasons for not taking it aside from side effects. I'm feeling pretty beat up by this. If anyone has any info to share, i'd be really grateful.
i have suffered from migraines all my life. they usally are only on one side. a headache alone can be a trigger for the next one. they are called rebound headaches. i take depakote good luck
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Old 02-22-2012, 06:28 PM #10
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Hi there, you never mentioned what meds you are on just now. Just wondering as I had a problem with migraines and it would appear it was caused by the amitriptyline I had been on, migraine free since stopping (so far anyway!)
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