6 How do you treat an acute attack?
When treating a migraine with abortive medications, early intervention is very important. ‘Central sensitisation’ is the condition that causes the severe pain in a migraine, and taking your medications early, when the pain is mild, is the best way to try and avoid this from taking hold.
If the pain is already severe at onset, however, early intervention may not be as effective. Your doctor will advise you that adequate drug dosages should be used along with the appropriate routes of administration, and that this should be combined with anti-nausea medications if you have associated nausea.
7 What is the expectation of regular migraine treatment?
If you allow yourself to expect a complete resolution of migraine through the use of preventive medications, your judgement may become clouded in terms of how effective these medications are in reality. This, in turn, may lead to inadequate trials of medications. Instead, the expectation should be to reduce headache frequency by 50pc and also to reduce the intensity and duration. Headache freedom may be an unrealistic goal early in treatment.
8 What is a medication overuse headache?
A medication overuse headache (MOH) is a chronic daily headache evolving from an episodic migraine, due to overuse of one or more migraine abortive medications. It significantly affects quality of life. The condition tends to develop when using triptans on more than 10 days per month, or when using anti-inflammatory medications on more than 15 days per month. The pain experienced with MOH may be different to that of the typical migraine.
9 What is chronic migraine?
Chronic migraine is defined as headaches occurring on more than 15 days per month, requiring the prescription of preventive treatment. Nevertheless, preventive treatment may also be warranted when migraine attacks occur less frequently but cause significant impairment.
10 Are there other chronic daily headaches aside from migraine?
Hemicrania continua (HC) is a chronic daily headache that may be mistaken for chronic migraine. Features they have in common are the one-sided nature of the condition and superimposed painful exacerbations. HC is also associated with tearing from the eye and a drooping eyelid during painful exacerbations; this is not seen in chronic migraine.