Dealing with migraines?

I had my first migraine when I was 8 years old.

Yes, children can suffer from migraine headaches. I did not know exactly what was going on, or why it happened. All I knew was that my head hurt, and I couldn’t look at a light or have any noise near me. If I had either of those things, my head began throbbing.

It turns out I suffer from episodic or acute migraines, which typically happen a few times a month or less. Chronic migraines occur much more often, about 15 or more days a month.

 I spoke with Nitin Butala, MD, a neurologist with Baptist Neurology, to learn more about this often debilitating condition.

What is a migraine? 

“A migraine is an episodic disorder, the centerpiece of which is a severe headache generally associated with nausea and/or light and sound sensitivity,” said Dr. Butala.

Migraines cause severe pain or sensation in your head, usually just on one side. There is no significant clinical difference between migraines on the right side versus the left side. Management remains the same, but most migraines are predominantly unilateral.

“Migraines can affect anyone. About 12% of the population suffers from migraines, and there are subtypes of migraines,” Dr. Butala said. “Migraine durations vary from person to person. Some complain it lasts an hour, several hours or even multiple days. Common symptoms may include nausea, vomiting and sensitivity to sound and light.”

What triggers a migraine?

Here are some of the most common, according to Dr. Butala:

• Stress
• Lack of sleep
• Eating habits
• Foods and additives (monosodium glutamate, nitrates and nitrites and aspartame)
• Dehydration
• Alcohol
• Excessive amounts of caffeine
• Smoke
• Weather
• Odors
• For females, a change in hormones

Migraines often go undiagnosed or untreated. Dr. Butala said you should seek medical advice if you have a family history of migraines, suffer multiple migraines a month, or if symptoms persist for days. Other indicators:

• A new headache arises
• A change in your headache/migraine pattern
• Medication that reduces the frequency or pain no longer works
• If you are age 50 or older and begin experiencing migraines for the first time

Neuroimaging is not necessary for most patients with migraines. Neuroimaging is usually considered if patients have unexplained or abnormal findings on their neurological examination or complain of headaches that do not fulfill the strict definition of a migraine or other primary headache disorder.

Treatments vary and are designed to prevent a migraine from happening or reduce the pain once it starts. Among the options:

• Medication: Can be taken before or during a migraine (Tylenol, nonsteroidal anti-inflammatory drugs, antiemetics and triptans) or daily medication to help alleviate the severity or frequency (antidepressants, beta-blockers or anti-seizure medications).
• Botox®: With injections into the forehead, temples and back of the neck, Botox patients have seen a decrease in the number of migraines they experience. Injections are typically administered every three months by neurologists or an ophthalmologist.
• Acupuncture: This is a safe method to treat migraines, but it may not work for everyone.
• Vitamins or supplements: There is scientific evidence for butterbur, coenzyme Q10, feverfew, riboflavin (vitamin B2) and magnesium may help decrease the number of migraines a patient may have.
• Massage therapy: Frequent massages have shown success in helping people who suffer from migraines manage their pain.
• Physical therapy: Commonly prescribed to help relax the muscles and trigger points to limit migraines or reduce the pain.

Dr. Butala and other Baptist Health neurologists may refer patients for physical therapy, neuromuscular massage therapy, neurological rehabilitation or acupuncture to treat migraines.

To schedule a neurological rehab, massage therapy or physical therapy consultation, please contact Baptist Health Rehabilitation Services at 904.202.4200. If you are in Nassau County, call Baptist Rehab Services at Baptist Medical Center Nassau at 904.321.3850.