Posts Tagged "migraine headache"

Last updated on July 13th, 2021 at 07:10 am

TMJ DISORDER AND TMJ ASSOCIATED HEADACHE AND FACIAL PAIN.

@Neuralgroover

The temporomandibular joint (TMJ) is the joint that connects the jawbone and the skull. This is one of the most powerful joints in the human body, as it can apply 162 pounds per square inch when a person bites. It is important to realize that the TMJ is a synovial joint. In other words, it is a joint composed of a capsule filled with synovial fluid. Similar to a knee joint (but on a much smaller scale), the synovial fluid keeps the joint lubricated and healthy. However, this can also be the source of various types of dysfunction. There is a condition called TMJ disorder that can contribute to facial pain and headaches. TMJ disorder is fairly common, impacting about 12% of Americans at any given time. Women get TMJ disorder more often than men; in fact, for every male TMJ sufferer, there are 9 female TMJ sufferers.

TMJ disorder tends to be higher among younger people, while women using estrogen or contraceptives tend to experience TMJ disorder more frequently.

 

What Is TMJ Disorder and What Causes It?

Loosely put, TMJ disorder is any type of pain and restricted movement that impacts the jaw joint and surrounding muscles. There are several different causes of TMJ, including

  • Injury to the tooth or jaw
  • Grinding or clenching of the teeth
  • Poor posture
  • Stress
  • Other issues

In some instances, even chewing gum can aggravate an outbreak of TMJ. TMJ disorder can lead to headaches and facial pain.

 

TMJ Disorder and Headaches

When TMJ sufferers have a headache, they often report a headache that is like a tension headache in nature. TMJ associated headaches often recur in one or more regions of the head and face and are accompanied by several different symptoms:

  • Tight face and jaw muscles
  • Face or jaw pain
  • Clicking noises in the jaw when chewing
  • Overall restricted movement of the jaw
  • Changes in how the teeth fit together when biting down

It is important to keep in mind that TMJ discomfort can also be a manifestation of migraine headache attacks. Migraines can also cause referred pain to the TMJ areas, neck, shoulders, sinus areas, and face. So if the TMJ discomfort happens primarily when someone has a migraine type headache or symptoms, it could also just be a referred pain syndrome rather than a true TMJ disorder.

 

Is There a Positive Outlook for TMJ Headaches?

TMJ headaches are incredibly uncomfortable, but there is generally a very good outlook for TMJ headaches. Your doctor may suggest a wide variety of treatments to alleviate the pain and often lifestyle changes and other treatments may be required to eliminate and address TMJ disorder. Treatments aimed at alleviating TMJ disorder itself are generally very successful in reducing the frequency of these types of headaches. Let’s take a look at some of the treatments that are available for TMJ headaches.

Very rarely are TMJ disorders serious and long lasting. In these rare situations, diagnosis and treatment must be sought quickly to manage and resolve the condition. Chronic, severe TMJ disorder is very rare, however, tendons, muscles, and cartilage over time can become damaged leading to arthritis. The good news is that most cases of TMJ disorder go away within about two weeks if the jaw is given the necessary time to rest and the root cause, such as stress, is removed.

Occasionally, TMJ disorder will go away on its own. Self-limiting cases are common and being aware of grinding and clenching can help alleviate TMJ over time if it’s not a severe case.

 

Lifestyle Changes to Address TMJ Associated Headaches and Facial Pain

Some behaviors may cause and trigger flare ups of TMJ disorder, as well as associated headaches and facial pain. Some people may experience this disorder from the type of food that they eat, the stress in their life, and certain jaw movements that they have learned as habits over the years. Some small lifestyle changes can help with TMJ disorder and associated headaches and pain, including:

  • Avoiding foods that are hard or require a great deal of chewing
  • Reducing the stress factors in one’s life to prevent jaw clenching and teeth grinding, which are coping behaviors aimed at dealing with stress.
  • Learning jaw exercises to strengthen the jaw muscles themselves and avoiding things like gum chewing and wide yawning, which can irritate the jaw joint.

Over-The-Counter Solutions for TMJ Associated Headaches and Facial Pain

For the short-term, certain medications may help alleviate the headaches and facial pain caused by TMJ disorders. These include NSAIDS, such as aspirin, ibuprofen, and naproxen. These can help eliminate a headache as an abortive treatment. Additionally, icing your jaw can also help relieve the pain associated with a TMJ headache. Jaw exercises can help with muscle relaxation and pain symptoms. Muscle relaxers are often prescribed in conjunction with NSAIDs in an attempt to lessen the muscle spasm and clenching of the muscles surrounding the TMJ.

Long-Term Treatments for TMJ Associated Headaches and Facial Pain

There are a wide variety of different treatments for TMJ disorder, which can help relieve headaches and facial pain. These include physical therapy, Botox, surgery, and other types of treatments.

Sometimes, there are certain exercises that may help address TMJ associated headaches and facial pain. Patients can learn various exercises, like chin tucks, upward tongue, forward jaw, and resisted closing movements. These help with TMJ pain relief. Generally speaking, these exercises provide a very good therapeutic outlook for patients.

Some patients may also benefit from alternative treatments like acupuncture and massage. Consulting with a medical professional is advised to make sure that any exercises are learned correctly.

Splints and Mouthguards For TMJ Disorder

Splints and mouthguards are a treatment that may help alleviate TMJ associated pain and headaches. These do not directly treat the pain itself, but can help prevent clenching and grinding of the teeth. Some dentists may fit these for patients after a consultation with a health professional. Seeing a TMJ specialist for these types of treatments is recommended to ensure precision of the device, because if it is off even slightly, the pain can intensify. The idea behind splints and mouthguards are that they prevent the grinding and biting that typically occurs during sleep, allowing the jaw to rest. Sometimes, a dentist will work on a long-term bite placement solution, which is often a frequently successful treatment for TMJ disorder.

Other Treatments for TMJ Disorder and Associated Headaches and Facial Pain

There are other techniques to help with TMJ disorder that are surgical and alternative in nature. A TMJ arthroscopy is a minimally invasive surgery that allows the surgeon to remove inflamed tissue and align the jaw correctly.

Another treatment that may also work is Transcutaneous Electrical Nerve Stimulation. This provides an electrical pulse that creates muscle contractions so that your jaw muscles will massage themselves. This helps relieve pain and stiffness, simultaneously improving your overall jaw mobility.

 

IF YOU HAVE HEADACHE, MIGRAINE, OR FACIAL PAIN AND ARE LOOKING FOR ANSWERS ON ANYTHING RELATED TO IT, A HEADACHE SPECIALIST IS HERE TO HELP, FOR FREE!

FIRST, LET’S DECIDE WHERE TO START:

IF YOU HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR THE LATEST INFORMATION, HOT TOPICS, AND TREATMENT TIPS, VISIT OUR FREE BLOG OF HOT TOPICS AND HEADACHE TIPS HERE. THIS IS WHERE I WRITE AND CONDENSE A BROAD VARIETY OF COMMON AND COMPLEX  MIGRAINE AND HEADACHE RELATED TOPICS INTO THE IMPORTANT FACTS AND HIGHLIGHTS YOU NEED TO KNOW, ALONG WITH PROVIDING FIRST HAND CLINICAL EXPERIENCE FROM THE PERSPECTIVE OF A HEADACHE SPECIALIST.

 

IF YOU DON’T HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR POSSIBLE TYPES OF HEADACHES OR FACIAL PAINS BASED ON YOUR SYMPTOMS, USE THE FREE HEADACHE AND FACIAL PAIN SYMPTOM CHECKER TOOL DEVELOPED BY A HEADACHE SPECIALIST NEUROLOGIST HERE!

 

IF YOU HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR FURTHER EDUCATION AND SELF-RESEARCH ON YOUR DIAGNOSIS, VISIT OUR FREE EDUCATION CENTER HERE.

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Last updated on July 13th, 2021 at 07:05 am

COMMON FOODS, ADDITIVES, AND OTHER MIGRAINE TRIGGERS.

@Neuralgroover

While the exact cause of migraines remains unknown, the neurovascular theory of migraine is currently most accurate. Regardless of exact mechanism, there are many different triggers that can bring them on. Certain types of foods, beverages, and food additives can trigger migraines. In addition to these triggers, things like excess light, visual stimuli, and noise can also trigger migraines. Let’s take a look at some of the common different triggers that can bring on a migraine.

Foods and Beverages That Can Trigger Migraines

Certain types of foods and lack of eating can cause migraines. As many as 60% of people report that food can trigger migraines. When people report having a migraine to their primary care physician or headache specialist, they often report alcohol, caffeine, and chocolate as being a common trigger for their migraine. Sometimes, foods that we associate as being healthy can also bring on migraines. For example, aged cheeses, fermented foods, and certain types of cured meats can bring on a migraine. Fermented foods, while being great for promoting gut health, contain an amino acid called tyramine, which can trigger migraines. Tyramine is also a common trigger found in aged cheeses.

Beverages containing certain additives such as artificial sweeteners can also cause migraines. For example, diet soda contains both caffeine and aspartame. In certain cases of people who have clinical depression, aspartame can worsen migraine symptoms. Alcohol is also a common migraine trigger. In particular, red wine and white wine may trigger migraines in individuals. Red wine triggers migraines in about 19.5% of people with migraine while white wine may trigger migraines in about 10.5% of people with migraine.

While many people drink coffee, tea, and energy drinks, these beverages are known to bring on migraines and headaches. An additional migraine trigger for these beverages is caffeine withdrawal. Also, over-the-counter medications for headaches and migraines could potentially contain caffeine, which may in some cases make a migraine worse. In general, caffeine can be a double edged sword. Caffeine does have some mild pain relieving properties, and it also causes mild constriction (narrowing) of dilated arteries. Both of these factors can be helpful for some patients with migraine. However, when caffeine is not in the system, headaches can be triggered as a result (caffeine withdrawal headache). A common example of this is in patients that wake in the morning with a headache that improves when they drink their morning coffee. This occurs because as they are sleeping, the caffeine is eliminated from the body. So when they wake, they are in caffeine withdrawal. Thus, why the headache gets better once they get their morning coffee flowing.

Other types of food additives can also trigger migraines. For example, MSG is a very common food additive that may cause migraines. Some studies have found that MSG may bring on a migraine or headache in the face area. Nitrates and nitrites are also common migraine triggers. These are vasodilating agents found in many foods, especially preserved and processed meats such as lunch meats, sausage, smoked foods, pork, bacon, salami, pastrami, hot dogs, corned beef, ham, and, bratwurst. So if you have a child that is getting a lot of headaches and migraines, and eats lunchmeat for lunch, you may want to look into nitrate and nitrite-free lunch meat options.

 

Dehydration and Migraines

People who suffer from migraine report that dehydration is a common trigger. Even the slightest notion of dehydration can fast track the onset of a migraine, causing dizziness, confusion, and the other classic symptoms of a migraine. In some cases, people who drink water after the onset of migraine might notice a decrease in the severity of their symptoms.

 

Lack of Sleep and Migraines

People who do not sleep enough often tend to experience migraines with more frequency and severity. When a person doesn’t sleep enough, the body tends to produce more of a certain type of protein that can cause migraines and pain. Also, during a regular sleep cycle, the body tends to have more REM sleep cycles, which can regulate certain processes in the body. One of the most common things migraine sufferers experience during sleep deprivation is that rest or sleep will often mitigate the severity of their migraine. Getting good sleep plays a big role in not only influencing migraine and headache, but a wide variety of other normal body functions. During the deep restorative stages of sleep, your body is replenishing it’s many neurotransmitters in the brain. Neurotransmitters influence mood, concentration, energy, attention, memory, and a variety of neurologic functions. So, if you are not getting those deep stages of sleep, you become deficient in neurotransmitters, and the result is often worsening headaches, migraines, anxiety, depression, fatigue, poor memory, concentration, and focus. For example, the most common cause of anxiety and depression is serotonin deficiency in the brain. For this reason, many antidepressants work by replacing serotonin levels. Thus, good sleep may be able to bypass the need for replacement by these medications for some patients, in addition to improving headache frequency. The optimal amount of sleep is generally considered to be 8 hours of uninterrupted sleep, which is often easier said than done for many people with today’s hectic schedules.

Light, Smell, and Sound Sensitivity Can Also Trigger Migraines

Migraine is a disorder of neurological overactivity and oversensitivity. The neurological wiring in patients with migraine is set at a much lower threshold for triggering a migraine, as compared to someone without migraine. Sometimes, elements in our environment can also be attributed to the onset of migraines. Direct sunlight can be a primary trigger for migraines. Driving by a white picket fence alternating with bright light in between, fluorescent office lighting (which almost universally drives people with migraine insane), flashing strobe lights, or looking at the sun reflecting off a shiny surface are commonly reported visual triggers. While the outdoors and exercise are great for health, wearing a cap or sunglasses and finding a shady area may help alleviate the onset of migraine. Sometimes, direct sunlight can make an existing migraine worse, especially if the migraine was triggered by sleep deprivation, dehydration, or skipping a meal.

Prolonged loud sound can also trigger migraines in some individuals. For example, loud concert music and high decibel noises can trigger a migraine. In addition, some noises can become more bothersome or disturbing for someone experiencing a migraine, such as chewing noises, clocks ticking, and doors opening and closing.

Smells can also be associated with the onset of migraines. About 50% of people report heightened sensitivity to smells when they have a migraine attack. The most common scent trigger for a migraine comes from perfumes, which may be associated with aerosols and additives in the perfume itself. The smell of tobacco and certain types of foods are also common triggers and agitators of migraines that are associated with scent. Although oversensitivity to smell (osmophobia) is not listed in the ICHD3 criteria for migraine diagnosis, it is very specific for migraine and often an easy clue for the diagnosis.

Changes In the Weather and Migraines

Seasonal and weather changes may also have an impact on the onset of migraines. Here are some of the types of changes in weather that may agitate migraine sufferers:

  • Changes in barometric pressure
  • Extreme changes in temperature where it becomes suddenly hot or suddenly cold, such as during season changes
  • Storms, especially where there is thunder and lightning
  • Dry and dusty weather

Another common trigger for migraines that is largely environmental is smoke. People who suffer from migraines report smoke as being a frequent migraine trigger and will avoid camping, barbecues, and other outdoor activities where there is smoke.

Why do changes in the weather cause migraines? People who already suffer from migraines and headaches tend to have a greater sensitivity to environmental changes. It is also common that people who have migraines triggered by environmental sensitivity do not discuss these triggers with their doctor.

 

Hormonal factors

Migraine occurs in 20% of women (1 in 5), and 6% of men (1 in 16). There is a reason for that difference, and it relates to hormonal differences. Before puberty, migraines actually occur more commonly in boys. However, once menarche (menstrual cycles) begins for girls, they take over in migraine frequency from that point on. Menstrual migraine is typically triggered by the drop in estrogen prior to a menstrual cycle. Menstrual migraine and its treatments are discussed in much greater detail here. Perimenopause (entering menopause, menopause, and exiting menopause) is also a common time of life where migraines can become much more frequent and severe for women, due to hormonal fluctuations. Interestingly, during pregnancy migraines improve for many women, and it is not uncommon that they report having no migraines at all during pregnancy (because the drop in estrogen is not occurring every month). Migraines often return shortly after pregnancy ends, and can initially seem more severe. Some women may not notice much improvement during pregnancy, while some can get worse.

 

Stress

Stress is one of the most common migraine triggers, which is unfortunately typically hard to avoid. For some patients, it is the opposite. They may get stress let-down migraines. For example, they get a migraine every time they are dealing with less stress, such as when they go on vacation, or every weekend when they don’t have to get up and go to work. These are particularly cruel types of migraine triggers! There can be other variables involved in migraine triggers in these scenarios too though. For example, if they sleep in longer than normal on the weekend, that can be a trigger for some patients since migraine is often influenced by sleep patterns. The weekend migraine could also relate to caffeine withdrawal if they sleep in and don’t get their normal weekday caffeine as early on the weekend compared to the weekdays.

 

Allergies and Migraines

Migraines and sinus headaches from allergies both have very common symptoms. Generally speaking, a migraine from an allergy will be more intense than a sinus headache and display the classic migraine symptoms such as nausea, throbbing pain, sensitivity to light, and a lengthy headache (up to 3 days and frequently recurring).

People with allergies are ten times more likely to develop migraines than people without allergies. The most common reason for migraines from an allergy is due to histamine release, your body’s overreaction to external and internal triggers that are driving your allergies.

Allergy shots and triptans are common ways to treat allergy-related migraines once they have started. Medications like beta-blockers may prevent allergy-related migraines before they happen.

 

IF YOU HAVE HEADACHE, MIGRAINE, OR FACIAL PAIN AND ARE LOOKING FOR ANSWERS ON ANYTHING RELATED TO IT, A HEADACHE SPECIALIST IS HERE TO HELP, FOR FREE!

FIRST, LET’S DECIDE WHERE TO START:

IF YOU HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR THE LATEST INFORMATION, HOT TOPICS, AND TREATMENT TIPS, VISIT OUR FREE BLOG OF HOT TOPICS AND HEADACHE TIPS HERE. THIS IS WHERE I WRITE AND CONDENSE A BROAD VARIETY OF COMMON AND COMPLEX  MIGRAINE AND HEADACHE RELATED TOPICS INTO THE IMPORTANT FACTS AND HIGHLIGHTS YOU NEED TO KNOW, ALONG WITH PROVIDING FIRST HAND CLINICAL EXPERIENCE FROM THE PERSPECTIVE OF A HEADACHE SPECIALIST.

 

IF YOU DON’T HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR POSSIBLE TYPES OF HEADACHES OR FACIAL PAINS BASED ON YOUR SYMPTOMS, USE THE FREE HEADACHE AND FACIAL PAIN SYMPTOM CHECKER TOOL DEVELOPED BY A HEADACHE SPECIALIST NEUROLOGIST HERE!

 

IF YOU HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR FURTHER EDUCATION AND SELF-RESEARCH ON YOUR DIAGNOSIS, VISIT OUR FREE EDUCATION CENTER HERE.

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Last updated on April 30th, 2021 at 11:13 pm

MIGRAINE HEADACHES EXPLAINED.

@Neuralgroover

Migraines are a very intense type of headache that are often accompanied by other symptoms, including nausea, vomiting, sensitivity to light and sound, as well as neurological symptoms such as visual disturbances, numbness or tingling, speech disturbances (slurred speech, difficulty getting words out), weakness, vertigo, cognitive dysfunction or “cognitive fog”, among other things. Migraines tend to be more prevalent in women than in men, with a 3:1 ratio. A common risk factor for migraines often involves family history, but not for everyone.  People who suffer from migraines report intense feelings of pain, including a pulsating/throbbing sensation. This often occurs on 1 side of the head, but can also involve both sides. Exercise and activity during a migraine will often make it worse. Migraine is usually associated with nausea, and/or sensitivity to light (photophobia) and sound (phonophobia)  Migraines often come in different phases, which are called prodrome, aura, the headache phase, and postodome, but not everyone gets all 4 phases:

  • The prodromal phase of a migraine often marks the beginning of a migraine attack and can happen over a period of a few hours ranging to a few days. Some of the symptoms include irritability and depression; food cravings; yawning and tiredness; and fatigue or muscle stiffness. Some patients report their prodrome as just a difficult to describe feeling that they recognize as an early warning sign of an impending migraine. Not every migraine attack includes the prodromal phase.
  • The aura phase of a migraine doesn’t necessarily always happen in every migraine attack, and only about 25% of patients with migraine get aura. Historically, those that get aura are called “classical migraine”, whereas “common migraine” refers to the more common variety of migraine which isn’t associated with aura. A large number of people who have migraines report that during the aura phase, they experience loss of sight, numbness, and other symptoms. Visual aura (loss of vision, jagged lines, flashing, colors, shapes, wavy lines, kaleidoscope, shimmering, expanding blind spot, etc.) are the most common aura. This is followed by numbness and tingling on 1 side (especially face and arm), and then dysphasia (trouble speaking; slurred speech, getting words out). There are also less common types of aura such as hemiplegic migraine aura (1-sided weakness), and brainstem aura (previously called “basilar migraine”; slurred speech, vertigo, tinnitus, double vision, hearing impairment, decreased level of consciousness, ataxia/imbalance). The aura phase should last between 5-60 minutes per ICHD3 criteria. Hemiplegic migraine can be associated with 1-sided weakness which can last up to 3 days. If the other types of aura last longer than 60 minutes, it is called prolonged or atypical aura, and usually warrants a brain CT or MRI, although it is not too uncommon to see. .
  • The headache phase of a migraine is often the longest and most intense period of a migraine. Symptoms include intensive throbbing, nausea, giddiness, irritability, stiffness, and soreness. According to ICHD3 criteria, an untreated or unsuccessfully treated migraine attack should last 4-72 hours. A headache lasting longer than 72 hours (3 days) is called status migrainosus. It is not uncommon for a refractory migraine to last days and sometimes weeks for some patients.
  • The postdrome phase is the drawing down of a migraine attack. It can last for up to 48 hours and some of the lingering symptoms remain from the other phases of a migraine attack. Patients often report feeling wiped out, fatigued, and sore as if they were “hit by a bus”.

 

According to the American Migraine Foundation, more than 36 million people suffer from migraines (although now estimated to be closer to 39 million), but only one out of three people actually talk to their doctors about their pain.

Statistics About Migraines and Their Prevalence

According to several different sources, migraines are one of the most common types of illness in the world. More specifically, it is ranked as the 3rd most prevalent illness in the world. It is estimated that migraine affects about 39 million Americans, and 1 billion worldwide. For example, 1 in 4 households in the United States have an individual that suffers from migraine attacks. Migraines impact 18-20% of women (1 in 5) and 6% of men (1 in 16) in the United States and they are also fairly common in children.

Migraines are also a common cause for an emergency room visit. In fact, there are more than 1.2 million emergency room visits each year in the United States for someone who is suffering from an acute migraine attack. Patients with migraine have a greater than 1.5 fold increase in office visits, and a greater than 2 fold increase in ER visits and hospital admissions. Migraines can also diminish the quality of life for the people who suffer from them. More than 4 million adults suffer from chronic migraine pain, which is an individual who is experiencing more than 15 days of migraine pain each month. Approximately 3% of patients will transform from episodic migraine to chronic migraine each year. Overall, it is estimated that 3-5% of patients in the United States have chronic migraine. Also, 20% of people who suffer from chronic migraines are disabled. Disability due to migraine peaks between the ages of 15-49 years old, which are peak employment years. Thus, migraine now accounts for the 2nd leading cause of years lived with disability following low back pain! Migraine also accounts for 50% of all neurologic disability. All of this puts a very high price tag on migraine, with an estimated 36 billion dollars spent in migraine costs in the United States each year.

 

Migraines in Children

Migraines are commonly undiagnosed in children. They are more commonplace in adolescent children, but 10% of school-age children suffer from migraines. Half of all migraine sufferers have their first migraine attack before they turn twelve and if a child has one parent who suffers from migraines, they have a 50% chance of developing migraines during their lifetime. Also, boys under the age of twelve tend to have migraines more often than girls, but that trend reverses in adolescence, typically with onset of menarche (which also highlights the hormonal influence on migraine).

 

What Causes Migraines?

There are a number of reasons that people suffer from migraines, but the true cause of them is not fully understood. Genetics and environmental factors play a role. In fact, around ⅔ of migraine cases run in families. Migraines also tend to happen in people who are prone to stress, bipolar disorder, and depression. There are also some common triggers for migraines, including:

  • Drinks, such as alcohol and caffeinated beverages.
  • Work stress or stress at home.
  • Bright lights or strong smells.
  • Drastic changes in one’s sleep cycle.
  • Bouts of overexertion.
  • Changes in the weather or other barometric pressure changes
  • Certain foods and food additives such as MSG, nitrates, aspartame, and other substances such as artificial sweeteners.

 

Migraine Theories:

1) Vascular theory; “vascular headache” (outdated):

a) Lack of blood flow (ischemia) caused by vasoconstriction (narrowing) of the intracranial arteries (arteries inside the brain) caused migraine aura.

b) The vasoconstriction was then followed by rebound vasodilation (dilation) of the arteries. This dilation activated pain receptors on the arteries, and this was the cause of the pulsating headache.

c) This theory has since been disproven and outdated. Studies have also shown that the physical pulsations of the arteries did not correlate to the pulsating sensations of the headache pain.

2) Neurovascular theory (current):

a) Migraine is a neurogenic process with secondary changes in cerebral perfusion (related to neuronal dysfunction and hypometabolism during an attack). In other words, migraine is an electrical neurological event in the brain, not an event triggered by blood flow changes. This electrical event influences changes in brain metabolism such as hypometabolism and hypermetabolism. When the neurons are in a hypometabolism state, they have less oxygen and glucose requirement since they are not as active, and thus there is a lack of blood flow (not due to vasoconstriction of the brain arteries). This can be followed by hypermetabolism in which there is an increase in oxygen and glucose requirements and thus, increase in blood flow (so not necessarily simply rebound vasodilation).

 

b) Migraine aura is a good illustration of this phenomenon. Migraine aura is caused by an electrical wave spreading across the cortex of the brain moving at about 3 mm per minute (not by vasoconstriction as per the older vascular theory). At the front of this spreading electrical wave it causes hypermetabolism and an increase in blood flow. This hypermetabolism causes the “positive” migraine aura features (colors, flashing lights, kaleidoscope, shapes, zig-zags, tingling sensory changes, etc.). Following this electrical wave there is “neuronal depression” and hypometabolism, associated with a decrease in blood flow. This hypometabolism causes the “negative” migraine aura features (loss of vision, black spots, numbness, etc.). Depending on where this wave spreads, you may get different aura symptoms; visual aura as it spreads across the occipital (visual) cortex, sensory/numbness/tingling as it spreads across the parietal (sensory) cortex, dysphasia (trouble speaking, slurred speech) as it spreads across the frontotemporal (speech) cortex, one sided weakness in hemiplegic migraine as it spreads across the frontal (motor) cortex, brainstem symptoms such as vertigo, tinnitus, double vision, hearing loss, imbalance, decreased level of consciousness, slurred speech (previously called basilar migraine, now called migraine with brainstem aura) as it spreads across the brainstem.

 

c) The electrical event of migraine not only causes the changes in metabolism as described above, but the trigeminal nerves are also activated. Think of migraine as an electrical switch that gets turned on in the brainstem. It then turns on and activates the trigeminal nerves. The trigeminal nerves innervate all of the arteries in the brain and through the meninges surrounding the brain. When activated, the trigeminal nerves release a variety of inflammatory proteins (such as CGRP) and neuropeptides. The result of this is 3-fold:

1st, these inflammatory peptides cause neurogenic inflammation around the brain. Think of it like a sterile (non-infectious) meningitis. So, when you’re having a migraine, exercise and activity, moving around, bouncing in a car, etc. often worsen the pain.

2nd, it causes cerebral vasodilation in the brain and meninges. The dilation itself does not cause the pain, but rather it triggers the trigeminal nerves which innervate the arteries, and this sends signals back to the brain that something is going on, which in turn causes more release of inflammatory proteins and causes the migraine to worsen. This is the basis of why it is called the neurovascular theory of migraine.

3rd, it enhances and exaggerates the transmission of pain from the trigeminal nerves, into the brainstem, and into the cortex of the brain where the pain is recognized.

 

At baseline, a patient with migraine who is not having a headache always has a state of neuronal hyperexcitability in the cerebral cortex, especially in the occipital cortex (which is why the majority of aura symptoms tend to be visual aura). So, they have a much lower threshold to a migraine being activated and triggered as compared to someone without migraine. In other words, the neurological system in a patient with migraine can be thought of as always being in a hyperactive, hypersensitive, overdrive state with the “volume turned way up” compared to a person without migraine. Thus, I tell my patients the goal of preventive treatment is to “turn the volume down” and increase the threshold of migraine being triggered so easily.

 

What Are Some Common Treatments for Migraines?

There are two categories of treatment for any type of headache, including migraines. Migraines can be treated through abortive or preventive means. Abortive treatment for any type of headache includes medications such as aspirin, which treats the headache while it’s happening. Preventative treatments are intended to keep a headache or migraine from happening so frequently. Here are some of the different types of treatments for migraines.

 

Abortive Treatment for Migraines

The goal of migraine abortive treatments is to stop individual migraine attacks at onset so the migraine does not reach full severity, ends quickly, and your function is restored and maintained rather than having to go lay down and miss the whole day in bed.  Over-the-counter pain relievers for migraines, such as aspirin or ibuprofen, are fairly commonplace. Some more aggressive abortive treatments include prescription medications like triptans (such as Maxalt) that block pain pathways within the brain. Some people may also receive anti-nausea drugs and opioid prescriptions to deal with more intense migraine symptoms. The migraine specific abortive/acute (as needed) treatments include triptansgepants (Ubrelvy, Nurtec), ditans (Reyvow) or neuromodulatory devices.

Preventative Treatments for Migraines

Medications that lower blood pressure, antidepressants, anti-seizure drugs, CGRP monoclonal antibodies, and even botox are some of the common preventative treatments for migraines. The classification of the preventive medicine typically has nothing to do with its purpose when it is used for migraine. For example, there are specific anti-blood pressure medicines that are good for migraine prevention. However, they do not work for migraine because of blood pressure changes, but rather they affect the electrical pathways of migraine. The same scenario goes for the antidepressant/anti-anxiety and anti-seizure categories. The medicines selected within each of these preventive categories are very specific and based on clinical trials and evidence. In other words, not all medicines within a specific medication class (such as all antidepressants) have evidence for migraine prevention, but rather very specific ones within that class. Medications that are designed to lower blood pressure can sometimes prevent migraines with aura and without aura. Certain types of antidepressants can help prevent migraines, but have some undesirable side effects in some individuals. Anti-seizure drugs, such as Topamax, can reduce the frequency of migraines in some individuals. The preventive migraine treatments should be used until the migraine and headache frequency is significantly improved consistently for several months. As mentioned above, this can be done with a variety of medications which may also include the CGRP monoclonal antibody (mAb) treatments (Aimovig, Ajovy, Emgality, Vyepti), Botox, natural supplements, herbals and vitamins, or neuromodulatory devices.

Alternative Treatments for Migraines

Some other types of treatment for migraines include acupuncture, cognitive behavioral therapy, supplements, essential oils, yoga, meditation, and other techniques designed to enhance relaxation. For some individuals, exercise can decrease the frequency of migraines. In fact, some studies have shown that a routine exercise program can be just as effective as some of the prescription preventive medications used for migraine. Neuromodulatory devices that are FDA cleared for migraine prevention are also available and include sTMS (SAVI, SpringTMS, sTMS mini),  eTNS (CEFALY), and nVNS (GAMMACORE), all of which are discussed in much greater detail here. There are also nutraceuticals and supplements which have good evidence for migraine prevention.

 

Finding Help For Migraines

Migraines remain a poorly understood medical condition, but there are treatments available. Only 4% of people suffering from migraines work with a headache specialist or a pain specialist. It is estimated that preventative treatment could benefit around 25% of people who suffer from severe migraines.

If you suspect that your headaches are migraines, you should see your doctor. Furthermore, any type of headache warrants at least one visit with your doctor to make sure there are no concerns by medical history or examination for any other worrisome causes of your headaches. They may refer you to a neurologist or other type of headache specialist. Oftentimes, a wide variety of tests may be given, including CT scans and MRIs, to see what is contributing to the cause of the migraine. The good news is that migraines can be successfully managed for the majority of patients, and that many people live with them thanks to the treatments that they receive.

 

IF YOU HAVE HEADACHE, MIGRAINE, OR FACIAL PAIN AND ARE LOOKING FOR ANSWERS ON ANYTHING RELATED TO IT, A HEADACHE SPECIALIST IS HERE TO HELP, FOR FREE!

FIRST, LET’S DECIDE WHERE TO START:

IF YOU HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR THE LATEST INFORMATION, HOT TOPICS, AND TREATMENT TIPS, VISIT OUR FREE BLOG OF HOT TOPICS AND HEADACHE TIPS HERE. THIS IS WHERE I WRITE AND CONDENSE A BROAD VARIETY OF COMMON AND COMPLEX  MIGRAINE AND HEADACHE RELATED TOPICS INTO THE IMPORTANT FACTS AND HIGHLIGHTS YOU NEED TO KNOW, ALONG WITH PROVIDING FIRST HAND CLINICAL EXPERIENCE FROM THE PERSPECTIVE OF A HEADACHE SPECIALIST.

 

IF YOU DON’T HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR POSSIBLE TYPES OF HEADACHES OR FACIAL PAINS BASED ON YOUR SYMPTOMS, USE THE FREE HEADACHE AND FACIAL PAIN SYMPTOM CHECKER TOOL DEVELOPED BY A HEADACHE SPECIALIST NEUROLOGIST HERE!

 

IF YOU HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR FURTHER EDUCATION AND SELF-RESEARCH ON YOUR DIAGNOSIS, VISIT OUR FREE EDUCATION CENTER HERE.

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TYPES OF HEADACHES.


Posted By on Mar 16, 2021

Last updated on April 30th, 2021 at 11:14 pm

TYPES OF HEADACHES – 2021

@Neuralgroover

According to the World Health Organization, headaches are a global problem, affecting people of all races, income levels, and regional areas. Headache disorders impact about 50% of people worldwide. Moreover, it is estimated that 50% to 75% of adults aged 18 to 65 have suffered from a headache or a migraine within the last year. A smaller percentage of people worldwide, 1.7% to 4%, have headaches that last for two weeks or longer. Let’s take a look at the four different types of headaches, what causes them, and some common treatments that may relieve them.

The Four Different Types of Headaches

There are, in fact, 150+ different types of headaches. However, the four most common types of headaches are: tension headaches, migraine headaches, sinus headaches, and cluster headaches.

 

What Are Tension Headaches?

Tension headaches typically are moderate to mild in nature and can be best described as feeling like a tight band around one’s head. By and far, these are the most common types of headaches and their origins are not well understood. Common symptoms include a dull, aching, pressure pain in both sides of your head; tightness in your forehead, sides, and back of your head; and muscle soreness in your shoulder, neck, and scalp. They can not be a throbbing pain. If there is any throbbiness to the headache, it takes it out of tension type headache criteria and moves it into migraine criteria. Tension type headaches are not worsened by physical activity, in contrast to migraine which are. Tension type headaches should not be associated with nausea or vomiting, in contrast to migraine which can be. There may be some mild sensitivity to light (photophobia) or sound (phonophobia), but tension type headache should not have both. In contrast, migraine requires both features.

 

What Are Sinus Headaches?

Sinus headaches are usually indicated by pressure around your eyes, cheeks, and forehead. You may also experience a throbbing forehead. However, these features can also be consistent with migraine because in general, any type of throbbing pain places the headache into the migraine category. In fact, there was a large study done in the past in which almost all of the patients with either self-diagnosed or physician-diagnosed sinus headache turned out to actually be migraine headache.  Migraine also activates the sinus pathways and cavities and can cause referred pain into the teeth and TMJ areas. So for many patients, their migraines include a lot of sinus type symptoms. Therefore, it is easy to see how migraine often gets mistaken for sinus headache. For some people with true sinus headache, they feel like a sinus infection. Historically, the existence of true “sinus headaches” has been a debatable topic, and it’s presence generally revolves around whether there is an ongoing sinus infection or not. If there is, this can certainly be a source of headache, and it is typically associated with fevers and drainage (often colored, purulent discharge).  Some common symptoms include:

  • Fatigue
  • A stuffy sensation in your nose
  • Pain and pressure in your cheeks, brows, and forehead.

What Are Cluster Headaches?

Cluster headaches are called as such because they happen over cyclic time frames or “clusters.” These types of headaches can wake you up in the middle of the night and they frequently happen on one side of your head or near an eye. The pain of cluster headaches is severe, and they have been termed “suicide headaches” because of the severity of the pain. Cluster headaches are more rare than other types of headaches. Some symptoms include:

  • Pain that is situated around or behind one eye
  • One-sided pain, versus other headaches where the sensation of pain is often more global
  • Stuffy or runny nose on the side of your head that hurts
  • Red and tearing eye on the side of the head that is impacted
  • Restlessness

What Are Migraine Headaches?

Migraine headaches, according to some patients, are the worst type of headache. These types of headaches are characterized by a throbbing sensation, most commonly one one side of the head, but can also be both sides. Additionally, they often come with nausea, sometimes vomiting, and a sensitivity to light and sound. Migraines come in stages, but not everyone goes through all the stages.

The stages of migraines include:

  • Prodrome: Some mild symptoms that indicate an oncoming migraine attack, including neck stiffness, moodiness, food cravings, and other subtle symptoms. This may occur even a day or more before the attack starts.
  • Aura: Seeing bright lights or various shapes, numbness and tingling, speech disturbances, overall weakness, and other symptoms that happen right before or during the onset of a migraine. About 25% of patients get aura (classic migraine), while 75% get no aura (common migraine).
  • Attack: During a migraine attack, migraine sufferers typically experience the worst symptoms, including pain on one side of the head, nausea, and other symptoms. A migraine attack itself can last for up to 72 hours.
  • Post-Drome: After the migraine, people tend to experience tiredness and sudden head movement can bring on some pain. At this stage, people report excess fatigue, generalized soreness, and commonly report feeling like they were “hit by a bus”.

Migraines can be read about in much more detail here.

Common Questions About the Various Types of Headaches

What causes the various different types of headaches?

There is not a singular known medical cause for headaches. Primary headaches are when the headache itself is the primary health issue that the sufferer is dealing with. Secondary headaches are those that are caused by a medical condition (such as a brain tumor). Let’s take a look at what the most common causes are for the various types of headaches:

  • Tension headaches: These can be caused by stress, depression, injury, or other issues.
  • Sinus headaches: These headaches are most commonly caused by sinusitis and allergies.
  • Cluster headaches: The exact cause of cluster headaches are unknown, but it may have something to do with biological processes since cluster headaches are cyclical.
  • Migraines: As with other types of headaches, there migraines don’t have a clear cause. Common suspected causes include hormones, diet, dehydration, and other physical or lifestyle factors.

When should you seek medical attention/advice for any type of headache?

You should seek medical attention/advice when you have any type of headache. Sometimes, a headache may be indicative of a larger medical problem. At least one visit with your doctor is recommended for any type of headache because even secondary headaches (caused by a medical condition) can sometimes present as a standard primary type of headache. A visit with your doctor may uncover additional information from a more detailed history during questioning and neurological physical exam. Repeat headaches can impact the quality of your life and should be treated. Sometimes, your regular doctor may not know how to adequately deal with a headache. Some doctors are especially trained to deal with headaches, specifically headache specialists.

What type of headaches should a headache sufferer worry about?

Generally speaking, any type of headache should be a cause for concern. However, there are certain situations where headaches may be indicative of a larger, more serious medical issue. Headaches associated with the following symptoms should be a cause for concern:

  • A high fever, chills, night sweats, neck stiffness
  • The sudden onset of very intense headache pain (thunderclap headache) with peak headache intensity in less than a minute
  • Fainting, disorientation, or loss of balance or equilibrium
  • Weakness on any side of the body or any other neurological symptoms including visual loss or vision changes, double vision, trouble swallowing, numbness, tingling, speech disturbances (slurred speech, trouble getting words out, trouble understanding speech), vertigo, behavioral or personality changes
  • Nosebleeds
  • Pulsatile tinnitus or papilledema (swelling of optic nerve on eye exam)
  • Other issues, such as weight loss, vision issues, jaw cramping, and other factors
  • History of cancer, immunosuppression, HIV
  • New onset headaches under age 5 or over age 50
  • Headaches triggered by Valsalva maneuvers (coughing, straining, laughing, bending forward, exertion, exercise, sexual activity, bearing down such as during a bowel movement)
  • Progressive worsening and changing of headaches into a higher frequency or daily frequency
  • Postural worsening of headache (worsens when standing and improves when lying down, or worsens when lying down, improves when standing up)

What are some common tests for the more serious types of headaches?

Some headaches, such as cluster headaches, are not commonly understood. Other types of headaches may have an underlying cause. If you see a neurologist or other medical specialist, you might experience some of the following tests for them to better diagnose and understand the underlying cause of your headache:

  • Eye & ear exam
  • CT scan
  • MRI scan
  • EEG scan
  • Blood and spinal fluid tests

A headache specialist will often try and get access to your medical records and history so that they can better treat your condition.

Which type of doctor commonly deals with the various types of headaches?

Neurologists are the most common type of specialized doctor that headache sufferers see. However, they will often refer to a headache specialist for more complex headache and facial pain disorders, or if treatments are not helping the patient. General medical practitioners may be able to make a referral and provide some basic treatment, as they are often the first line of headache evaluations. On occasion, an ENT doctor may provide treatment for secondary headaches that are related to sinus and ear issues.

 

IF YOU HAVE HEADACHE, MIGRAINE, OR FACIAL PAIN AND ARE LOOKING FOR ANSWERS ON ANYTHING RELATED TO IT, A HEADACHE SPECIALIST IS HERE TO HELP, FOR FREE!

FIRST, LET’S DECIDE WHERE TO START:

IF YOU HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR THE LATEST INFORMATION, HOT TOPICS, AND TREATMENT TIPS, VISIT OUR FREE BLOG OF HOT TOPICS AND HEADACHE TIPS HERE. THIS IS WHERE I WRITE AND CONDENSE A BROAD VARIETY OF COMMON AND COMPLEX  MIGRAINE AND HEADACHE RELATED TOPICS INTO THE IMPORTANT FACTS AND HIGHLIGHTS YOU NEED TO KNOW, ALONG WITH PROVIDING FIRST HAND CLINICAL EXPERIENCE FROM THE PERSPECTIVE OF A HEADACHE SPECIALIST.

 

IF YOU DON’T HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR POSSIBLE TYPES OF HEADACHES OR FACIAL PAINS BASED ON YOUR SYMPTOMS, USE THE FREE HEADACHE AND FACIAL PAIN SYMPTOM CHECKER TOOL DEVELOPED BY A HEADACHE SPECIALIST NEUROLOGIST HERE!

 

IF YOU HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR FURTHER EDUCATION AND SELF-RESEARCH ON YOUR DIAGNOSIS, VISIT OUR FREE EDUCATION CENTER HERE.

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Last updated on May 13th, 2021 at 01:19 pm

WHEN TO SEE A HEADACHE SPECIALIST AND HOW TO PREPARE TO GET THE MOST FROM THE APPOINTMENT.

@Neuralgroover

Background

I see patients in our headache center from all over the United States and from many other countries. Many patients travel hundreds of miles by car or airplane for these visits, due to the shortage of available headache specialists (about 570 in the US). Many patients are lucky enough to be relatively close to a headache specialist. Whichever scenario you fall into, you want to get the most out of your appointment with a headache specialist in order to get on a better path to less headache or facial pain burden.

 

When to see a headache specialist

So first of all, when should you see a headache specialist? First off, any type of headache, head pain, or facial pain, is reason enough to see a headache specialist. Basically, headache specialists specialize in any type of pain or discomfort involving anywhere in the head or face. They also commonly see patients that may have other neurological symptoms which may not necessarily be associated with headaches, but their doctor wants to rule out a migraine “equivalent” disorder. Some patients can have neurologic symptoms without headache (visual, sensory, speech, vertigo, weakness, nausea/vomiting, abdominal pain), which may actually reflect a painless migraine disorder, such as migraine aura without headache. I have compiled a list below of a few of my thoughts of when your headache or facial pain treatment journey signals that it is time to see a headache specialist.

 

Reasons to see a headache specialist:

-You have a headache, head pain, or facial pain.

-Your doctor tells you, “your headache is all in your head”.

-Your doctor tells you, “there’s nothing else I can do for you”.

-Your doctor says, “I don’t treat much headache, but…”.

-You continue to have frequent headaches despite trying several preventive medications.

-You just don’t feel like you are making any progress despite a couple office visits with your doctor or their NP or PA (or you never even get to see the doctor).

-You don’t feel like your doctor is listening to you or taking your symptoms seriously.

-The doctor spends only a few minutes in the visit, so you feel rushed and unable to discuss all of your concerns.

-Your doctor is googling your symptoms in the office.

-Your doctor recommends that you take opiates/opioids for migraine treatment.

-Your doctor says it is ok to use NSAIDs, OTCs or triptans more than 10 days per month or butalbital/fioricet/fiorinal more than 5 days per month on average for migraine treatment.

-Your doctor says your headache is “because you are depressed”.

-Your doctor does not give you a more specific classification or name for your diagnosis.

 

What information should you gather before the visit?

Unfortunately, we all know how strapped for time most physicians are during office visits due to a variety of factors such as low insurance reimbursement and the need to increase patient volume to compensate for this and break even. So to get the most out of your office visit, making it efficient and helpful, it is important to compile certain information in preparation. Typing out this information and bringing it to your office visit is a great idea. It is also a great idea to keep this as a running file that you can continue adding to in your personal files. This helps to eliminate time wasted in the office that could easily be organized and thought through prior to the visit, allowing more time for the important parts of the office visit; optimizing the diagnosis and treatment plans. Some of this information you may not have available, and that is certainly ok. You may be able to retrieve some of it from records, memory, and your local pharmacist.

Never assume that your local doctor’s office has faxed all of your records ahead of the visit. If that happens, great. However, many times patients are told that the records will be sent, but when we see the patient, we have no records that were sent. So, it is always best to bring all of your records yourself. Furthermore, it is good to have copies of all of your medical records, testing, etc. for your personal files anyway.

 

The following list are items that I have found to be the most useful for patients to have gathered and thought of prior to the visit, allowing the most efficient and useful office visit:

A) Acute/abortive headache or pain treatments (used “as needed”). This information is also needed in order to pursue insurance approvals for various types of treatments such as the newer gepants (Ubrelvy, Nurtec) or ditans (Reyvow).

-All that have been tried (which triptans, NSAIDs, neuromodulation devices, etc.)

-Doses used

-Responses (effectiveness, side effects) of each treatment

 

B) Preventive headache or pain treatments (used daily to lessen headache frequency/severity). This information is also needed in order to pursue insurance approvals for various treatments such as Botox or the CGRP mAb antagonists (Aimovig, Ajovy, Emgality, Vyepti).

-All that have been tried

-Maximum doses used

-Duration that each treatment was used

-Responses (effectiveness, side effects) of each treatment

 

C) Testing

-All CD and radiology reports for all brain MRIs, CTs, and other relevant testing for your headache or pain. Most CDs do not include the radiology report, and you need to request that separately. It is a good idea to have copies of all of these things for your personal files regardless. Bring them all to the office visit for the doctor to review.

-All bloodwork done in the past 5 years. Labs particularly important for headache evaluations include TSH, CBC, CMP, Vitamin D, Vitamin B12, ESR, CRP, ANA, to name a few, but this may vary and include more or less, depending on the specific clinical scenario.

 

D) Think about the clinical features of your headache or facial pain as listed below. These will be important questions that your headache specialist will ask. So, it is good to answer these questions in your head prior to the visit, so you can provide more accurate and thought out answers. This helps to prevent being put on the spot by questions you never really thought about which may result in forgetting some important details. For a free headache and facial pain self-diagnosis tool which incorporates all of these important questions that a headache specialist asks, look here.

-Location of the headache or facial pain

-Frequency of the headache or facial pain attacks

-Duration of the headache or facial pain attacks

-Description and characterization of the headache or facial pain attacks

-Neurological symptoms associated with the headache or facial pain (visual disturbances, numbness, tingling, weakness, speech disturbances, vertigo, etc.)

-Other associated symptoms with the headache or facial pain (nausea, sensitivity to light or sound, one sided autonomic features (runny eye, red eye, runny or congested nose, droopy or puffiness around eye))

 

Conclusions:

If you are able to gather all or much of the above listed information prior to your headache specialist appointment, you’ll be well on your way to a much more efficient and beneficial office visit. As a result, you and your doctor will be able spend more time in the office discussing the most important things rather than spending it trying to look up records or digging through your memory for various details. As a result, your doctor will have more time to better formulate a list of the most likely diagnoses, and best treatment approaches for minimizing the disruption of your headache or facial pain on your life. Good luck!!

 

IF YOU HAVE HEADACHE, MIGRAINE, OR FACIAL PAIN AND ARE LOOKING FOR ANSWERS ON ANYTHING RELATED TO IT, A HEADACHE SPECIALIST IS HERE TO HELP, FOR FREE!

FIRST, LET’S DECIDE WHERE TO START:

IF YOU HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR THE LATEST INFORMATION, HOT TOPICS, AND TREATMENT TIPS, VISIT OUR FREE BLOG OF HOT TOPICS AND HEADACHE TIPS HERE. THIS IS WHERE I WRITE AND CONDENSE A BROAD VARIETY OF COMMON AND COMPLEX  MIGRAINE AND HEADACHE RELATED TOPICS INTO THE IMPORTANT FACTS AND HIGHLIGHTS YOU NEED TO KNOW, ALONG WITH PROVIDING FIRST HAND CLINICAL EXPERIENCE FROM THE PERSPECTIVE OF A HEADACHE SPECIALIST.

 

IF YOU DON’T HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR POSSIBLE TYPES OF HEADACHES OR FACIAL PAINS BASED ON YOUR SYMPTOMS, USE THE FREE HEADACHE AND FACIAL PAIN SYMPTOM CHECKER TOOL DEVELOPED BY A HEADACHE SPECIALIST NEUROLOGIST HERE!

 

IF YOU HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR FURTHER EDUCATION AND SELF-RESEARCH ON YOUR DIAGNOSIS, VISIT OUR FREE EDUCATION CENTER HERE.

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