Preventive Medications for Migraine Headache:
Therapeutic Medications for Migraine Headache:
Triptans for Migraine Headache
Triptans are order for megrim and cluster headache . Triptan can be give as nasal atomiser or intravenously . Sumatriptan injection are very effective for treatment of clump headaches and start to sound off in less than 15 minutes . Nasal route of Sumatriptan is in force in 30 minutes . In bulk of case , effectiveness of rhinal treatment reduces within 45 min . annoyance assuagement be given to be much better with endovenous treatment than nasal sprays . Newer Triptans with fewer side upshot used are Zolmitriptan ( Zomig ) in oral or nasal atomiser build .
Ergotamine for Migraine Headache
Dehydroergotamine ( DHE ) is prescribe for migraine headache . Most of the affected role reply within 5 hour with no pain . Ergotamine can be prescribed as tablet , suppositories and nasal bone nebulizer .
Capsicum For Treating Migraine Headache
Capsicum originates from hot white pepper . It is used in tension and cluster concern . Capsicum is applied over occipital hide and also inside olfactory organ . It is a safe medicinal drug and usable as over the counter product in chemist’s .
Calcium Channel Blockers To Treat Migraine Headache:
Calcium communication channel blockers influences the calcium channel of smooth heftiness of the descent vessel . Ca channel blocking agent is effective in treating high blood pressure andcoronary vascular disease . sick headache and clustering cephalalgia is secondary to change in diam of cerebral blood vessels . Ca channel blocker causes alteration in diameter of intellectual bloodline vessel resulting in decrease of vexation symptoms . Verapamil is a preferred atomic number 20 duct blocker used for preventative treatment of cluster and migraine headache . medicament should be taken for 2 to 3 weeks to build maximal effects .
Lithium For Migraine Headache
Lithium ( Eskalith , Lithane , Lithobid , Lethonate , Lithotabs ) , ordinarily used for bipolar disorder , may also help prevent cluster headaches or migraine headache . The patient usually receives benefit within 2 weeks of starting to take the drug , and often within the first week . Lithium may be used alone or with other drugs . Lithium can have many side effect include trembling of handwriting , nausea , and increased thirstiness . exercising weight profit is a common side effect with long - term use .
Anti-Seizure Medications For Migraine Headache:
Anti - seizure medications are believe to boil down the occurrent of megrim by calming inflame blood vessels in the brain , which may lead to sick headache pain . However , none of these medications is a curative for sick headache . Antiepileptics are various chemical group of medications used as antiseizures . Some of the medication within this big group has been used to treat headache . In research there were surface area of hyperactivities in brain which were recognise in epilepsy and headache affected role . Antiepileptic medication reduce expanse of irritability by its molecular activeness at emf gate Na channel . Most common used antiepileptic in headache treatment is Topamax , Depakote and Neurontin .
Topamax For Migraine Headache
unwritten tablet is admit everyday as prescribe even if cephalalgia symptoms are absent .
Depakote For Migraine Headache
Depakote ( valproic Elvis ) is useable as capsule , tablet and sirup .
Neurontin For Migraine Headache:
( Gabapentin ) used in post - herpetic neuralgy , diabetic neuropathy and fibromyalgia .
Corticosteroids For Migraine Headaches:
Corticosteroid drug ( also called steroid ) are used in allergic response andautoimmunedisease as anti - inflammatory medicinal drug . Corticosteroids are membrane steady agent , prescribed for headache to keep crossness of cortical and subcortical pith . It enhances the effect of Calan in treatment of headache and often prescribed with verapamil . Prednisone has been try out as poor - term breakthrough pain in the neck meds for clump headache . It is often dictate as pad form Liquid Pred and injection form Decadron .
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) For Migraine Headache:
NSAIDS are anti - inflammatory medication abbreviated as NSAIDs . NSAIDs are used for treatment of headache in combination with other medications . Mild concern are often treat by NSAIDs alone .
painkiller : nonsteroidal anti-inflammatory drug are not efficient in wicked painful sensation and also pain triggered by non - inflammatory etiology .
Most Prescribed nonsteroidal anti-inflammatory drug : Aspirin , Nuprin ( Motrin , Advil ) and naproxen ( Aleve ) .
Side Effects of NSAIDS : Complications cause by NSAIDs can be devastating if continued for prolong period of time .
Dose Dependent Side Effects : Dyspepsia , ulcer , perforation , upper gastrointestinal bleeding and severe line of descent loss . Combination of St. Joseph and COX 2 inhibitor ( Celebrex ) may block cardio - protective event of aspirin .
NSAIDscombinations with other medicament used in headache . Most sharp attempt of tension - eccentric headaches get better without any intervention . Over - the - heel counter pain in the ass backup such as acetaminophen or non - steroidal anti - seditious drugs ( NSAIDs ) can treat balmy symptoms . Aspirin or ibuprofen ( generic , Advil , other brands ) is usually the first choices , followed by naproxen ( generic , Aleve ) . Some patients may also find helpful medications that combine a pain reliever with caffeine .
Anti-anxiety Medications For Treating Migraine Headache:
Sedatives are used in treatment of headache . Most vernacular indicant to use sedatives or anti anxiety medications are Tension headache and keep recurrent episode . Buspirone ( Buspar ) and Alprazolam are order as antianxiety medications .
Side Effects of Anti-anxiety Medication:
Opioid Medications To Treat Migraine Headache
Opioids are used for treat migraine headaches , which are not responding to NSAIDS and other medication . Acute and brief flack of headache most of the time gets better without any discussion . Patients may develop resistance and tolerance to opioid medicament . Patients are advised relaxation treatment , cognitive behavioural therapy and life-style changes if miscarry to get pain relief withopioids . day-to-day attack of headaches are treat with preventative medication such as NSADs , NSAIDs immix with opioids . All other options of medicine should be tried before introduce opioid medication . Patient drug-addicted on opioids for painfulness relief at time may comport like drug addict . Opioid dependence some time want higher dose and frequent motivation of hurting medicament . These symptoms are because of opioid dependence to achieve pain moderation and separate as Pseudoaddiction . Opioids do get addiction in few patients and treatment of headache with opioids become difficult .
Side Effects of Opioids:
Less Common Side Effects Of Opioids:
Botox Treatment for Migraine Headaches:
Botulinum toxin A ( Botox ) injections are typically used to polish crease in recitation of shaping surgery . Botox is also being studied for discourse of headaches , including the bar of clump headache . Research is still preliminary and there is not sufficient grounds to support its efficacy . Botox is discussion of choice for headache localized over frontal , occipital and cervical ( neck ) part . Headache over parietal ( top of headland ) , temporal region ( side of head above ear ) , between eyes and behind ear does not respond to botox shot .
Frequent Common Side Effects of Migraine Headache:
Melatonins ( N - acetyl-5 - methoxytryptamine):Melatonin is found in animate being , plant , and microbes . Melatonin sold over the counter in USA . In animal enquiry melatonin was investigated against carcinogens . Melatonin prevents innovation of damage of DNA by carcinogen . Impaired DNA otherwise would have initiated Crab ontogeny .
Melatonin has been prescribed for headache and several other diseases . Melatonin is wide used as an antioxidant in disease such as immunodeficiency syndrome , autism , aging , Alzheimer disease , delirium mood disorder , alternative medical specialty , tinnitus , cancer and gallstone .
Oxygen Therapy for Migraine Headache
O pct in atmosphere is 21 % . atomic number 8 therapy can provide from 30 % to 100 % atomic number 8 . pinched oxygen therapy using nasal consonant cannula provide 30 to 40 % oxygen . Tight meet facemask or endotracheal thermionic vacuum tube can deliver up to 100 % atomic number 8 . O therapy has been used in congestive pump failure , continuing obstructive lung disease ( COPD ) , and allergic reaction causing brusqueness of breath , convulsion and hemorrhagic electric shock . Oxygen therapy up to 100 % is used in cluster and tension headache on and often . Patient is advised to inhale atomic number 8 for 15 bit several time a day .
Surgery for Migraine Headache
Muscle Pressure Release and Repositioning Nerves : Several surgical options were strain during last few years . Most accepted surgery is to unloosen the pressure sensation over the nerves make frontal , secular or occipital neuralgic migraine headache . Some of the peripheral arm of cranial and cervical nerves fall out through the muscles and pressure sensation or mite of these heart do neuralgic migraine headache . A neurologist confirms a diagnosis of sick headache by CT scan and symptomatic botox injectant . In addition nerve block is also performed using local anesthetics and corticosteroids . Specific impinging points to generate neurogenic pain trigger peripheral branches of cranial and cervical sensory nerves of head-on , worldly and occipital dermatome . induction site is almost always the contact site where mettle pierce the muscle . Pressure over mettle causes nerve irritation and retrograde activation of fervour of meningeal layers . Meningeal inflammations trip migraine cephalalgia .
Nerve Passing Through Muscles:
Migraine Headache:
OR affect separation of nerves from muscles and repositioning of muscles . After detachment , nerves are incubate with subcutaneous fatty tissue paper . casual cosmetic surgery is performed to prevent external pressure sensation and set surgical complications .
No serious complications were reported and side core for some let in occasional neck severity and skin numbness .
Vascular Pressure Release : final branches of external carotid artery are ligated or cauterise . In few cases cryotherapy is used to freeze the limb . Headache is presented with aureole and pressure over the most painful situation reduce pain .
Brain and Nerve Stimulator to Treat Migraine Headache
Chronic cluster and migraine headaches in few patient are resistant to all treatments . These patients are imprisoned in sign of the zodiac suffering with intense head ache and unable to perform any kind of regular activities . Intense hurting may make for multiple thoughts of self-destruction . These patients are break a trial of stimulator as a last option of discourse . Stimulator is placed over Einstein , vagus nerve nerve or occipital nerve . Pain when preponderantly is located over occipital dermatome then occipital boldness foreplay will be treatment of choice . Cluster headache is treat with arrangement of stimulator over intellectual cerebral cortex , hypothalamus and pneumogastric nerve cheek . These treatments are considered experimental in United States .
Facial Nerve Ablation To Treat Migraine Headache
Migraine vexation associated with facial nerve affaire is deal with gasserian ganglion neurotomy using either radiofrequency heat or chemic neurotomy using glycerol . Percutaneous radiofrequency gasserian ganglion rhizotomy is the treatment that involves destruction of pain fibre in gasserian ganglion by heat from radiofrequency . pain sensation carrying fibers are also often destroyed in few cases using glycerol as a chemical rhizotomy .
Micro Vascular Decompression of Trigeminal Nerve- Treatment is advised if migraine vexation is associated with post herpetic trigeminal neuralgic infliction . Trigeminal nerve pain is seen after Wiley Post herpetic neuralgy and traumatic hurt of trigeminal nerve . inveterate headache pain secondary to trigeminal neuralgia is treated with microvascular decompressing of trigeminal nerve . Blood vessels surrounding trigeminal nerve are selectively ligated or cauterized to extinguish the imperativeness .
Cognitive Behavioral Treatment For Migraine Headache
Cognitive Behavior Therapy ( CBT ) is useful to assist change or modify demeanour problems in - patient agony with chronic vexation .
Principle of Treatment:
Treatment Orientation:
Behavioral Therapies for Migraine Headache
behavioural therapies can be a helpful backup to drug treatment . These approaches can help with hurting management and enable patients to feel more in control of their condition .
Behavioral Approaches Include:
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