The Migraine Headache Blog from Headache-Adviser.com

The Migraine Headache Blog will keep you in touch with the world of headache medicine.
As a medical professional and a headache specialist, from me you will get information on new treatments or a "hot topic" in headaches.

You will also get patient scenerios, how they were managed and you can ask the expert your own questions by clicking the button on the nav bar.

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Chronic Migraine or Chronic Tension Type Headache?

Hello, I wrote you earlier: migraine medications and how long for meds to work?. I am still not sure what type of headache I have. It's constant, ~4-5

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Sinus Headache Symptoms?

I've been having an issue with a nagging headache around me left eye, forehead area, and jaw bone. What initially felt like a sinus issue then felt like

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Severe Head and Neck Pain

Age: 50 Female; Never smoked Symptoms: 1. pain in neck & trap muscles burning-diagnosed as arthritis/bone spurs but not severe enough to need surgery;constant

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Recurring Pin Prick Shocks

I am a 46 year old female. I have not smoked in 20 years. I have diabetes type II with good control. I take metformin for this. My blood pressure is controlled

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NuPathe Resubmitting to FDA for Zelrix

The makers of the transdermal patch Zelrix have resubmitted their application to the FDA. Zelrix is transdermal sumatriptan, the same medication in oral Imitrex and in subcutaneous injectable Sumavel Dose Pro.

NuPathe had their application reviewed last year and the FDA had concerned about manufacturing and some other issues. The company met with the FDA and are now planning to target 2012 for a possible launch.

Zelnix will be unique as it will be the only transdermal triptan and could offer a distinct advantage to those with severe nausea and vomiting with their migraines. This patch works via iontophoresis. This means a small electrical current thru ions is set up on the skin, transferring the medication across the patch membrane into the skin. This would also be an advantage if you happen to have a needle phobia and cannot tolerate Imitrex injectable. Like an injectable it will bypass the GI system.

However, historically, transdermal systems do not have as fast of an onset as injectable. But it might be faster than oral, so look for it to be somewhere in between.

Remember..there are always new migraine headache treatments on the horizon.

Visit the rest of the site to find a headache specialist near you.

Mary Kay Betz MS RPA-C

UPDATE:

I received a communication today (1/10/12) from NuPathe and apparently I made an error in the above post. NuPathe has not yet submitted to the FDA, but is planning to do so in the first half of 2012. I am sure all the migraineurs as hoping that this new product will be available soon!

Feverfew Migraine

There is a capsule which contain B2, magnesium and feverfew all in one capsule. Do you know the name of it? I take 200 mg of b2, 125 mg of feverfew and

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Understanding Migraine

Understanding migraine can be difficult for people who have never had a migraine headache. Learn how to explain your migraines to family, friends and co-workers.

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Post-Traumatic Headaches

I am a 39-year old female who has been having chronic daily post-concussive headaches from a mild TBI (traumatic brain injury) for five years after a freak

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Chiropractor Headache

Hi there, I am 38 years old and am female. I went to a chiropractor 3.5 yrs. ago who was not experienced, of course I did not know this at the time.

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The Migraine Personality

Is there such a thing as a migraine personality? The migraine personality was described as a Type A personality but this may not be true.

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Migraine Food Triggers

What are the migraine food triggers? Learn how to avoid headaches with simple diet changes. Are there foods that can prevent your headaches?

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Migraine and CoenzymeQ

Migraine and coenzymeQ are related in several new studies. Coenzyme Q may abort migraine attacks and reduce frequency of migraine headache.

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Use of Opioids Skyrockets in U.S

The Centers for Disease Control (CDC) in the US recently released a statment regarding the use of opioid medications. Apparently prescribing has skyrockted here in the US in 2010 to the point where each and everyone of us could be medicated 24/7 for a month! While some of this is justified, many times it is not.

One area where opioids are inappropriate is in a clear cut case of migraine where there are no contra-indications such as cardiovascular disease. Too many times, providers reach for one of these pain killers, sometimes to appease patient demands, when there are much better treatments available.

Now here's the bad part. Recent studies examining the use of opioids in the headache population have shown that after chronic use, the nervous system starts to re-modulate. Receptors in the brain start changing and not only is there less benefit, but perception of pain itself starts to ramp up! This is what we have long suspected, but could not prove until recently. Use of these drugs increases the frequency AND intensity of your headaches.

If you suspect that this is happening to you, discuss with your doctor and ask for a referral to a headache specialist.

Mary K. Betz MS RPA-C

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Holiday Headache

Anticipating a holiday headache? Read tips on how to avoid the headaches during the holiday stress.

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Pain Back of the Head

Pain back of the head may be a form of occipital neuralgia.

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Fogginess Around Eyes

I have experienced this foggy feeling around eyes and head for about 4 months. its not pain, its more pressure and just feels uncomfortable and not normal.

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Cevicogenic headache

I am a 65 year old female who has had head pain for at least 5 years. I cannot call it a headache because it is ranges from a very severe acute pain only

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my 3year old worry some headache

My son is 3 years old had three different episodes of headache lasting for about a second he cries when headache starts and stop crying when it stops he

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Migraines and the Menstrual Cycle

Hello, I am a 21 year old female and have been experiencing increasing occasions of migraines since about the age of 17. First they were every once in

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Familial hemiplegic migraines

I'm 50 years old and for the past 4 years I have suffered with these symptoms and have found through talking with my family that it is a family inherent

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Pressure in head

Main symptoms: pressure in head, mostly around temple area and in the back. When I lay down, pressure seems to be in the temple area and around my forehead/

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How long for preventive meds to work?

Hello, Firstly, it's a great site! Lot of useful information. I suffer from CDH (probably CTTH is subtype, because they evolved from episodic headaches,

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Coital Headache

I experienced a sudden, severe, throbbing headache...right side of head shortly after beginning sex with my wife...this was about a month and a half ago.

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New type of Migraine

I am getting these throbbing headaches on the top, above and on my temple, on the front of my head above my eyebrow, and sometimes behind my eye and/ or

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my husband and his headache

My husband is a fifty year old male with diabetes and now he has seen his primary doctor for symptoms of sharp stabbing pain in his left eye and it radiates

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4 to 5 headaches a week

Is there anything I can do for my frequent headaches? How do I know if they are migraines? They started about 6 months ago and are right above my eyes.

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18 years of migraine headaches

If I could have a dollar for all I and my medical insurance have paid to hospitals, doctors, exams, labs., etc., in trying to find cause and cure for

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Sinus Infection

My girlfriend has been nauseous and has had a headache for 2 weeks now. We went to the doctor because we don't have insurance for her we have to pay out

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Can I Take Topamax While Pregnant?

I recently stopped taking my topamax. I was taking 200 mg. daily and gradually decreased by 50 mg. each week until I stopped completely. I did this because

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Exercise For Migraine

A recent study published by Cephalgia, a headache journal, showed that regular aerobic exercise 3 times a week reduces migraines. The exercise parameter was compared to taking topamax and was just as good as the topamax with the exception of intensity of migraine where the topamax scored better.

So this just reinforces what we have been saying for 10 years in our clinic (yes, it has been that long!). You need to work out 3-4 times a week until you sweat and NO walking the dog does not count. I also hear "well I walk a lot at work". Nope. Doesn't count.

So make a commitment to yourself to start a regular program and please pick something you like to do. You most probably will not continue a program if it is a type of exercise that you hate, like a treadmill. I often tell my patients that they should choose a ball sport, if able, so that they can whack a ball. It will serve not only as a great workout, but also a tension reducer. Think about all the stress in your life and take it out on the ball!

In the study mentioned, the side effects for topamax were the listed ones such as tingling, fatigue, vertigo and constipation. What they did NOT mention is the most common side effect. 67% of people on topamax lose weight on this medication, followed by tingling and word finding difficulty which is usually mild. I rarely see vertigo or constipation, but that is not to say it didn't happen to one or two in the study. Click the link to read more about exercise for migraine.

Good luck,

Mary Kay Betz MS RPA-C

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Concussion Symptoms

my name is Nicole. i'm 39 years old and just had what they are calling a complex migrane. i have lost my ability to talk. i can write and for the most

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Headaches, Dizziness and Nausea

I am a 29 year old male, never had headaches until 3 months ago. The headaches are constant, everyday with extreme dizziness where it feels like I'm on

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Migraine Medications: Which One To Take?

Many times when I am counseling patients they will ask me about their migraine medications and which one to take at the onset of a headache.

The answer is...it depends on which one of the types of migraines you are having.

I recently attended a headache meeting in California and an interesting concept was discussed, that there are 3 types of migraines a patient should be aware of when choosing their medications for treatment.

1."Wake Up Headache". This is the one that wakes you up in the early hours of the morning and has what we call a 'fast take off phase' to it. You are in moderate to severe pain in less than half an hour, and may start having nausea.

2."Throw Up Headache". Well this is the very severe migraine that has put you in bed and you already have nausea with vomiting.

3."Back Up Headache". This migraine may be more moderate or even mild. The problem is that there is nausea or lack of appetite that occurs. When that happens the gut slows down (gastroparesis) and medications are poorly absorbed. Ever wonder why it took over an hour for your pill to kick in?

In each of these cases, an injectable is the most suitable treatment. Injectables, whether Imitrex, Sumavel or DHE-45, all have a faster onset of action, usually between 10-12 minutes. They also bypass the GI system and will not provoke the nausea.

One of the concepts that has recently been promoted by the National Headache Society is that patients should have a headache tool box. This is a kit you should carry with you that will have one dose of your medications. My sister is a big fan of the small plastic bags that she can slip into her purse. An old eyeglasses case would also work as you could put an injection in there and your pills. Consider keeping one of these kits with you AND one at work.

Caution: Try NOT to leave meds in the glove compartment of your car as excess heat and cold can cause the medication to break down and become far less effective.

Good luck,

Mary Kay Betz MS RPA-C

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Headaches Everyday

Hey, i'm Dallas (guy) and i just turned 15 this September. I have had headaches for a really long time now, maybe 4 years? My headaches usually start

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Headache For One Year

I got up one morning an had a headache an it has never gone away. I have good days an bad. I pack my head in ice a lot to help with pain. Nothing helps

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Severe left side headache

I get a real severe pain on the left side of head, always the same spot and lasting for only 20-30 seconds. It occurs sometimes 5-10 times per day. Had

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Diagnose My Headache

I am a 25yr old female and I'm a hairstylist in Birmingham, AL. I have experienced headaches and fatigue for as long as I can remember. I have been to

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Headache Back Of Head

52 year old female, who has had chronic migraines since 1996. After an ex husband pushed on the occipital area so hard that I passed out for several minutes

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Headache for over 3 months

I traveled to Mexico in June.. Our car there didn't have ac and it was way over 110 degrees. I got a headache there and it's like a pressure in my head

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Constant Headache

I got a headache on my right side of my head. Strong almost weakening. This went on for about 6 days when I decided to go to the hospital. I had a catscan.

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Males and migraines.

Ever since I was a teenager I have been having migraines with all the vision problems and aura. I didn't realize what it was until now. I am in my 20s.

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head injury

i was playing baseball today with my jrotc instructor and i got hit in the head by the baseball really hard and now i feel reaally dizzy and sleepy and

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Constant Unilateral Head pain

Hi, I'm a 57 year old female, who has had a constant 24/7 Unilateral head pain for almost 6 years. It is significantly worse upon waking in the morning.

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Mild chronic headache

I am a 44 year old mom of 2 youngsters. I developed a mild headache around 3 wks ago which felt as if it were 4 or 5 inches into my right ear canal. I

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