Migraine is the most common headache disorder that we encounter in clinical practice. Over 30 million people in the United States experience migraine headaches regularly. Not only migraine is prevalent but it is also an extremely disabling condition. Migraine can affect patients at any age, yet especially heavily it impacts our most productive years between the ages of 20 and 49.
Migraine is considered to be a primary headache disorder, meaning that it is not being caused by a brain tumor, blood vessel abnormalities, infection, etc. There is a genetic predisposition involved that makes patients susceptible to experience migraine attacks whenever they encounter a trigger.
Classical migraine symptoms include moderate to severe, throbbing or pounding pain located in one of the temples, forehead, back of the head, or in the sinuses area. Due to the variability of migraine symptoms we frequently see patients who had been misdiagnosed with “sinus headaches”. The pain may last for a few hours or sometimes days and is usually associated with sensitivity to light and noise as well as nausea or even vomiting. Some patients may experience an aura – a relatively brief episode during which patients may experience visual changes, their vision may get blurry or even double. Patients may also experience numbness or tingling in the face or arm followed by a headache. It is important to recognize that migraine presentation varies from patient to patient.
Diagnosis of a migraine headache is clinical and depends on your history, the symptoms that you experience, and the findings on the physical and neurological examinations. We frequently perform certain blood tests or order neuroimaging (such as MRI or MRA of the brain) to make sure that we are not missing something, yet the diagnosis remains a clinical one, based on the specific clinical presentation.
That is why we spend time asking you questions, listening to your story, and examining you to better understand your symptoms and arrive at the correct diagnosis.
Migraine treatment is a multilayered process. Multiple treatment options are available and may help not only to abort or stop an ongoing migraine attack (acute therapy) but also to reduce migraine/headache frequency overall (prophylactic therapy).
As part of the prophylactic regimen, we may recommend patients adjust their diet, introduce certain vitamins and herbal supplements. We may recommend biofeedback or refer to a physical therapist or acupuncturist. We may also suggest Botox treatment or introduce a novel class of medications - CGRP monoclonal antibodies (Aimovig, Emgality, Ajovy, or Vyepti). Alternatively, we may suggest patients to start taking traditional oral prophylactic medications that we have been using for a couple of decades.
As part of acute therapy, we suggest patients use migraine-specific abortive medication such as triptans, ergotamine-containing medications, certain NSAIDs as well as recently introduced new classes of medications: gepants (Ubrelvy, Nurtec) and ditans (Reyvow).
Some patients may benefit from interventional approaches (trigger points injections, SPG, and other nerve blocks, etc).
There is no universal, “one size fits all” approach in migraine therapy. At Synergy Integrative Headache Center we strongly believe in an individualized and comprehensive approach to migraine management.
We offer our in-person and telemedicine services to all patients in the greater Chicago area and throughout the state of Illinois as well as to patients from all 50 states and those who live abroad!
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