What To Do About Migraines?
New research on migraines to be presented Thursday at the annual meeting of the American Headache Society shows that only a small percentage of sufferers are getting the help they need to alleviate the misery of these painful headaches.
Dr. Christine Lay, a neurologist at the Headache Institute at St. Luke's Roosevelt Hospital, tells The Early Show co-anchor Rene Syler a lot of people don't have the proper diagnosis.
She explains, "They don't know, because they've been misdiagnosed as tension headaches, or are self-medicating, really not in tune with what's going on. Even if you do have a proper diagnosis, you may not be getting the proper preventive treatment. Those people that have it once a week should be on a preventive drug, yet they aren't."
A migraine is a recurrent, episodic headache associated with sensitivity to light and sound, Lay explains. It can also be accompanied by nausea. A migraine is often misdiagnosed as a sinus headache because there is pain across the forehead and the bridge of the nose, but 50 percent of migraine headaches also include pain in the sinus region.
Dr. Lay notes, "We think that migraine patients inherit a sensitive brain, which then makes them more vulnerable to changes in the weather, hormonal changes in a woman, not sleeping well, skipping meals. Those turn on the migraine."
There are two general approaches to migraine therapy: treatment of a migraine headache once it occurs, and prevention of the onset of the headaches and other neurological symptoms experienced during the attacks. People who get infrequent migraines can treat them as they occur, but in some people, the headaches occur frequently and specialists may recommend preventive daily medication.
Dr. Lay notes, "Many doctors don't know what's available. Many patients don't know, so they don't ask about it. We're seeking for physicians to put patients on preventive therapy, if they're having one headache a week or more."
Preventive medication may not eliminate migraines, which are more common in women, but can reduce the frequency and severity of the attacks. All medications have side effects, but it's a matter of getting the right drugs for the right patient.
Dr. Lay says, "We use anti-seizure medications, the most recent of which is Topiramate. We also use blood pressure pills, anti-depressant pills, and more recently, we're using Botox. It is not FDA-approved for migraines. But we're finding it is very effective."
Besides general discomfort, Dr. Lay says there are other problems associated with not treating migraines properly.
She says, "If it's not treated properly over time, it becomes a real burden for that patient. They stop seeking job opportunities. They go to the emergency room. They use a lot of medications. They're going to the doctor all the time. There is data to suggest that if it isn't treated effectively, these people may end up with chronic daily headaches."
She notes that a doctor may suggest that migraine patients alter their sleep routine or eating habits. This is usually coupled with a medicinal approach. A doctor may prescribe medications that "turn off" the headache or a preventative drug.