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How is classic migraine and its symptoms treated ?

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Practicing since : 2003
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Hi, i am 30 year old male. From last 3 month i am feeling head heaviness on both side of head. Sometimes on back of the head and feel pain on lower neck. Daily after i wake up, i feel slight headache and head heaviness. Mostly at after noon time i feel sever head heaviness and dizziness. Its become difficult to take lunch. The same feeling i have throught the day.
Three months before, i had check-up like sugar test, lipid profile, CT scaning of head, X-ray of neck. All the results seems to be ok, only the cholestrol and BP was bit high. Now BP is normal.
Please let me know the cause and treatment for the same.
Posted Sun, 29 Apr 2012 in Headache and Migraines
 
 
Answered by Dr. Deepak Anvekar 46 minutes later
Hello,

Thank you for the query.

From the history and the symptoms provided, it seems that you might be having tension headache. ‎

A TENSION HEADACHE is a diffuse, mild to moderate pain felt as a ‎tight band around your head caused as a result of Heightened Emotions, ‎Tension or Stress, Depression and Anxiety, Poor posture, Working in ‎awkward positions or holding one position for a long time and Jaw ‎clenching.

Since you are not having benefit with a NSAID like Naprosyn, and presence of a persistent headache for 2 months weeks straight, needs to be properly evaluated. Hence I ‎would like you to get a complete and helpful history that can help me arrive to a proper diagnosis. ‎

To give a proper and specific advice, it would help me, if you can provide me a few additional ‎details and reply for the following questions. ‎
1. Did the headaches start after an accident, illness or infection?‎

‎2. How long have you had these headaches? (Already mentioned as 4 weeks).‎

‎3. Are the headaches constant or do they come and go?‎

‎4. How often do the headaches occur? (daily, weekly)‎

‎5. Do the headaches occur at a certain time of the day? morning / afternoon/ night‎

‎6. Are the headaches becoming stronger, lasting longer or occurring more frequently?‎

‎7. Do the headaches ever wake you up when you are sleeping?‎

‎8. Does rest or sleep relieve the headache?‎

‎9. Do the headaches stop you from doing things? (watching TV, going outside or doing ‎household work)‎

‎10. Have you missed a particular routine due to the headache ? ‎

‎11. Is the headache pain intense when it starts, or does it start out small and builds up?‎

‎12. Where is the headache located? and may I know the Severity of pain in the scale of 1 - 10 where 1 is least and 10 is highest?‎

‎13. What does the pain feel like? - Throbbing, Pounding, Tightness, Dull, Aching, Pressure ? ‎

‎14. Do you have any associated signs and symptoms like : - ‎
‎ Fever, body aches and pains, ‎
‎ Cough, chest pain, shortness of breath, ‎
‎ Weakness, Numbness in arms or legs
‎ Nausea, vomitting, diarrhea, abdominal pain
Lethargy, Loss of appetite
‎ Loss of weight ‎

‎15. Any history of stress ? ‎

I shall provide specific answers and advice once you have provided the above requested ‎information. ‎
Waiting for your response. ‎

Regards,

Dr Anvekar. ‎
Above answer was peer-reviewed by
 
Follow-up: How is classic migraine and its symptoms treated ? 19 hours later
Thanks for your kind reply.

I didn't have exactly headaches, i usually have head heaviness problem throught out the whole day and some times in between i also feel slight dizziness speacially after breakfast and lunch. Usually at evening times i feel relaxed in comper to morning and afternoon time.

Here below i am answering your question:

1. Did the headaches start after an accident, illness or infection?‎
Ans : No. Suddenly 3 months back one day this effect started. I feel dizziness,anxious and weakness at afternoon time.

‎2. How long have you had these headaches? (Already mentioned as 4 weeks).‎
Ans : Exactly not headaches, i have head heaviness and slight dizziness from last 3 months.

‎3. Are the headaches constant or do they come and go?‎
Ans : They come and Go, but the head heaviess remains throught out the day.

‎4. How often do the headaches occur? (daily, weekly)‎
Ans : Daily.

‎5. Do the headaches occur at a certain time of the day? morning / afternoon/ night‎
Ans : Head heaviness throught the day, afternoon time i feel dizziness along with feel like will fell down on back side. Heaviness and tight feeling on back of head.

‎6. Are the headaches becoming stronger, lasting longer or occurring more frequently?‎
Ans: No.

‎7. Do the headaches ever wake you up when you are sleeping?‎
Ans: No

‎8. Does rest or sleep relieve the headache?‎
Ans: Yes. Whenever i feel sever dizziness and head heaviness. After that normaly i feel sleepy and weakness. I mostly used to sleep at that. And i get relieve.

‎9. Do the headaches stop you from doing things? (watching TV, going outside or doing ‎household work)‎
Ans: Yes. Sometimes watching TV and computer, i feel slight haziness behind my eyes. While walking i feel continuos minor dizziness in between for short interval of time. After that i used to sit down for few moment for being releaxed.

‎10. Have you missed a particular routine due to the headache ? ‎
Ans: Yes.

‎11. Is the headache pain intense when it starts, or does it start out small and builds up?‎
Ans: It start out small and builds up.

‎12. Where is the headache located? and may I know the Severity of pain in the scale of 1 - 10 where 1 is least and 10 is highest?‎
Ans: 8.

‎13. What does the pain feel like? - Throbbing, Pounding, Tightness, Dull, Aching, Pressure ? ‎
Ans: Tightness, Dull, Pressure.

‎14. Do you have any associated signs and symptoms like : - ‎
‎ Fever, body aches and pains, ‎
‎ Cough, chest pain, shortness of breath, ‎
‎ Weakness, Numbness in arms or legs
‎ Nausea, vomitting, diarrhea, abdominal pain
Lethargy, Loss of appetite
‎ Loss of weight ‎
Ans: shortness of breath, ‎Weakness, Numbness in arms or legs and lethargy.

‎15. Any history of stress ? ‎
Ans: No.
 
 
Answered by Dr. Deepak Anvekar 7 hours later
Hello XXXXXXX

It seems that your symptoms could be due to 'Migraine'.

The cause of this condition is abnormal neurotransmitter levels and a sensitive nervous system which reacts to sudden changes in either your body or the environment around you. During a migraine attack, changes in brain activity produce inflamed blood vessels and nerves around the brain. Migraine medication may produce relief by quieting sensitive nerve pathways and reducing the inflammation response.

Let me give you a complete list of signs and symptoms that are seen with Classic migraine.

1. VISION DISTURBANCES - Which may involve any or all of the following:
- A temporary blind spot.
- Blurred vision.
- Eye pain.
- Seeing stars or zigzag lines.
- Tunnel vision.

2. MIGRAINE HEADACHES - can be dull or severe. The pain may be felt behind the eye or in the back of the head and neck.
The headaches usually:
- Are worse on one side of the head.
- Start as a dull ache and get worse within minutes to hours.
- Last 6 to 48 hours.

OTHER SYMPTOMS that may occur with the headache include:
- Chills.
- Increased urination.
- Fatigue.
- Loss of appetite.
- Nausea and vomiting.
- Numbness, tingling, or weakness.
- Problems concentrating, trouble finding words.
- Sensitivity to light or sound.
- Sweating.

4. SYMPTOMS PERSISTING AFTER AN EPISODE :- Symptoms may linger even after the migraine has gone away. This is called migraine "hangover."
Symptoms can include:
- Feeling mentally dull, like your thinking is not clear or sharp.
- Increased need for sleep.
- Neck pain.

With respect to treatment of your condition, "You are on adequate medications".
1. Sibelium - is a medication used as a prophylaxis for common migraine.
2. Ciplar LA : is a medication which is being given for your blood pressure.
3. Naproxyn : is a medication used to control the symptoms as on a short term basis. It is given to control your symptoms.
You should continue with the current medications which will help to reduce your symptoms. In case they seem ineffective, the dose can be increased or changed to a better medication.

In addition since most of the tests including the blood tests and the CT scan are within normal results, there should be nothing serious to be worried about. With time the symptoms will subside and you will get back to your normal self.

Here are some additional measures that can help your symptoms.

1. Use a cold pack, or bag of ice and place it against the pain site or the back of your neck for up to ten minutes. Wait twenty minutes and then repeat if desired.
2. Reduce sensory inputs. Shield your eyes from direct light. Reduce noise and other stimuli. Lay down in a quiet, dark room, if possible.
3. Drink plenty of liquids. This helps avoid dehydration.
4. Use massage. Knead the muscles along your shoulders, neck and back of the skull. Gently rub your head, forehead, temples, facial muscles, and jaw.
5. Taking a nap will help in reduction in symptoms.

In addition, being patient and giving time for treatment to work is important. Also realize that treatment success will ebb and flow. You might need to work with your treating doctor. Time to time the medication dose may need to be titrated according to your requirements.

I hope this answers your questions effectively. In case of any doubts, I am available for the follow ups.

Wish you good health

Regards,

Dr Anvekar.
Above answer was peer-reviewed by
 
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