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Setting Headaches Apart

So you've got a headache. But don't take aspirin just yet. The first step to treating a headache is deciding what type it is.

To help us make that determination, Dr. Christine Lay, a neurologist from the Headache Institute at St. Luke's Roosevelt Hospital in New York, visits The Early Show. She offers advice on how to soothe and prevent common headaches, including migraines, sinus, tension and cluster headaches.

The following is Dr. Lay's explanations and recommendations:


A migraine is a recurrent, episodic headache associated with sensitivity to light and sound. It can also be accompanied by nausea. Migraines are often misdiagnosed as sinus headaches because sufferers feel pain across the forehead and the bridge of the nose. But 50 percent migraine headaches also have pain in the sinus region.

Migraine is a clinical diagnosis, which means you have to see a doctor. Typically, patients who are having more than two headaches a month should seek help from a physician, especially if "over-the-counter" (otc) drugs are not working.

Treatment includes changes in a person's lifestyle. For example, a doctor may suggest that migraine patients alter their sleep or eating routines. This is usually coupled with a medicinal approach. A doctor may prescribe acute medications that "turn off" the headache or a preventative drug.

It is possible that many people misdiagnose migraines because they are associated with acute pain. A migraine doesn't have to be acutely painful. However, it is debilitating to some degree because of the loss of attention span.

Doctors sometimes prescribe Topamax, which is taken every day to help prevent migraine headaches.

Sinus Headache
The symptoms of a sinus headache are fevers, chills, nasal discharge, and pressure sensation over the cheek as a result of sinus infection. Unlike a migraine, sinus headaches usually have symptoms typically associated with a cold: fever, chills, and runny nose.

Sinus headaches are a result of a sinus infection. You need to see a doctor who can prescribe antibiotics.

If they are reoccurring, you really need to see a physician.

Tension Headache
Tension headaches are considered "featureless," which means it is just a headache and not accompanied by other symptoms. These might feel like pressure on both sides of the head. It is usually brought on by stress or fatigue. It is different from migraines because it is not debilitating.

They are treated with over-the-counter pain medication like Tylenol or Advil. But tension headaches require treatment if they occur more than 15 days per month; that's considered a chronic daily headache. A doctor might prescribe anti-depression drugs, blood pressure pills, or anti-seizure pills for a chronic headache.

Cluster Headache
Called cluster because it occurs only during certain seasons. For example, a person who suffers from cluster headaches may only get them around daylight savings time or when winter turns to spring.

This headache occurs more often in men than women. It is an excruciating pain around one eye - lasts 15 to 30 minutes. It's so painful it has been called the "suicide headache" because people have been known to want to kill themselves because of the severe pain.

Sometimes it works to try to distract the headache by exposing it to extreme cold. However, the most common treatment is a shot of Imitrex or breathing pure oxygen.

This is the type of headache that is usually treated with preventative measures. Patients who have cluster headaches are prescribed Verapamil, Depakote, Lithium or Imitrex.

Sometimes herbal remedies, vitamins and acupuncture work, but sometimes they don't work. In some cases, the condition may worsen. It's best to talk to a physician before trying any alternative treatment.

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