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Suggest Treatment For Migraine Problem And Fever

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Posted on Mon, 22 Sep 2014
Question: I have a migraine problem. Started on return from XXXXXXX to XXXXXXX Took Sumatriptan 100 mg Wed night at 2 pm. Thursday was ok but got muscle aches which turned into chills, shivering and headache in afternoon. Temperature went to 101.8. Bad headache again and took another pill at 12 midnight. Friday morning felt fair, but got another spell of chills, shivering and headache at 10 AM. Went home to bed. Temp 101.7. Had to take another Sumatriptan at 5 pm and after calling pharmacist took with Aleve. Usually the Sumatriptan would knock the migraine but did not this time. Are there other migraine medicines I might try. Also, was not bitten by tick in CO and basically healthy there, except for 1 migraine incident which pill cured as normal. Today feeling better, just slight headache and weakness. I am 60 years old, take no other prescription medications, 6 foot tall, 180 lbs. Thanks for any ideas.
doctor
Answered by Dr. Shafi Ullah Khan (1 hour later)
Brief Answer:
Lyme disease or a UTI

Detailed Answer:
Thank you for asking

Migraines are rarely associated with shivering and chills and fever. Recent travel and age of 60 makes the possibilities fo an infection more likely. Urinary tract infection is on the top. a simple urine routine exam would make sure of that. Recent history of travelling makes it more likely.

Next possibility would be some tick bites or mosquitoes bites and malaria suspicion or lyme disease suspicion would be considered but rash would be next thing to look for as lyme without rash is like pie without key lime. Not possible. Also low grade fevers are the cons and discouraging symptom for that.

Consult to an infectious disease specialist would be wise. But first thing first. A urine routine exam would be wise to sort out. Followed by a full blood count to sort out any infection.

Rest as far as migraines are concerned here is a detailed management which is least likely a cause of your recent symptoms.

Migraines are the common cause of recurrent headaches and family history of this issue makes it more likely.
I want you to know that Migraine treatment involves acute (abortive) and preventive (prophylactic) therapy. Patients with frequent attacks usually require both. Measures directed toward reducing migraine triggers are also generally advisable.
Acute treatment aims to reverse, or at least stop, the progression of a headache that has started. Preventive treatment, which is given even in the absence of a headache, aims to reduce the frequency and severity of the migraine attack, make acute attacks more responsive to abortive therapy, and perhaps also improve the patient's quality of life. An overview of migraine treatment is shown in the image below.
Migraineurs should be screened for cardiovascular risk factors, which, if present, should be aggressively treated. Migraineurs with aura should also be counseled on the increased risk of stroke with smoking and oral contraceptive use.
avoid factors that precipitate a migraine attack (eg, lack of sleep, fatigue, stress, certain foods, use of vasodilators).use a daily diary to document the headaches. This is an effective and inexpensive tool to follow the course of the disease.discontinue any medications that exacerbate your headaches. If an oral contraceptive is suspected to be a trigger, you may modify, change, or discontinue its use for a trial period. Similarly, if hormone replacement therapy is a suspected trigger, should reduce dosages, if possible. If headaches persist, consider discontinuing hormone therapy.
Biofeedback, cognitive-behavioral therapy, and relaxation therapy, occipital nerve stimulators,FDA recent approved Cerena Transcranial Magnetic Stimulator (Cerena TMS), are some non pharmacological approaches which help the migraines.
Use some preventive agents (eg, frovatriptan) perimenstrually as most of the migraines in women are associated with menstrual cycles.
SOme CAM (complementary and alternative medicine) techniques have been proved effective too.Biofeedback and behavioral therapy, herb butterbur (Petasites hybridus),riboflavin (vitamin B2), magnesium, and feverfew,coenzyme Q10 (CoQ10),Melatonin,Body work - Eg, chiropractic, massage, and craniosacral therapy,Nutritional/herbal supplements - Eg, vitamins and herbs,Acupressure and acupuncture, yoga etc are some of the level 1 recommendations by XXXXXXX college of neurology for these migrainous headaches.
Some dietary triggers which trigger migraine need to be avoided.Common dietary triggers include the following:
Alcohol - Particularly wine and beer
Caffeine overuse or caffeine withdrawal
Chocolate
Aspartame - eg, NutraSweet and Equal
Monosodium glutamate (MSG) - May be found in Asian food, canned soup, frozen or processed foods, and the seasoning product Accent
Fruits - Citrus fruits, bananas, avocados, and dried fruit
Nuts - Peanuts, soy nuts, and soy sauce
Tyramine, a biogenic amine that accumulates in food as it ages, may provoke migraine. Sources include the following:
Dairy - Aged cheese
Meat - Bacon, sausage, luncheon meat, deli meat, pepperoni, and smoked or cured meat
Pickled foods
Heavily yeasted breads - Eg, sourdough
Vinegars - Especially wine vinegar
Some types of beans
exercise for migraine prevention (40 minutes 3 times weekly for 3 months) has been proved effective.,Tonabersat,Transient receptor potential vanilloid type 1 antagonists,Prostaglandin E receptor 4 receptor antagonists,Serotonin 5HT1(F) receptor agonists and Nitric oxide synthase inhibitors are some of the novel managements for the migraines these days.
I hope you see the depth of it. Discuss all the possible options with your doctor and let them select what is best for you. COnsult your neurologist and hope for the best.

Nut shell , Seek an infectious disease specialist and let them take care of you.

I hope it helps. Take good care of yourself and dont forget to close the discussion please.

May the odds be ever in your favour.

Regards
Khan


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3613 Questions

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Suggest Treatment For Migraine Problem And Fever

Brief Answer: Lyme disease or a UTI Detailed Answer: Thank you for asking Migraines are rarely associated with shivering and chills and fever. Recent travel and age of 60 makes the possibilities fo an infection more likely. Urinary tract infection is on the top. a simple urine routine exam would make sure of that. Recent history of travelling makes it more likely. Next possibility would be some tick bites or mosquitoes bites and malaria suspicion or lyme disease suspicion would be considered but rash would be next thing to look for as lyme without rash is like pie without key lime. Not possible. Also low grade fevers are the cons and discouraging symptom for that. Consult to an infectious disease specialist would be wise. But first thing first. A urine routine exam would be wise to sort out. Followed by a full blood count to sort out any infection. Rest as far as migraines are concerned here is a detailed management which is least likely a cause of your recent symptoms. Migraines are the common cause of recurrent headaches and family history of this issue makes it more likely. I want you to know that Migraine treatment involves acute (abortive) and preventive (prophylactic) therapy. Patients with frequent attacks usually require both. Measures directed toward reducing migraine triggers are also generally advisable. Acute treatment aims to reverse, or at least stop, the progression of a headache that has started. Preventive treatment, which is given even in the absence of a headache, aims to reduce the frequency and severity of the migraine attack, make acute attacks more responsive to abortive therapy, and perhaps also improve the patient's quality of life. An overview of migraine treatment is shown in the image below. Migraineurs should be screened for cardiovascular risk factors, which, if present, should be aggressively treated. Migraineurs with aura should also be counseled on the increased risk of stroke with smoking and oral contraceptive use. avoid factors that precipitate a migraine attack (eg, lack of sleep, fatigue, stress, certain foods, use of vasodilators).use a daily diary to document the headaches. This is an effective and inexpensive tool to follow the course of the disease.discontinue any medications that exacerbate your headaches. If an oral contraceptive is suspected to be a trigger, you may modify, change, or discontinue its use for a trial period. Similarly, if hormone replacement therapy is a suspected trigger, should reduce dosages, if possible. If headaches persist, consider discontinuing hormone therapy. Biofeedback, cognitive-behavioral therapy, and relaxation therapy, occipital nerve stimulators,FDA recent approved Cerena Transcranial Magnetic Stimulator (Cerena TMS), are some non pharmacological approaches which help the migraines. Use some preventive agents (eg, frovatriptan) perimenstrually as most of the migraines in women are associated with menstrual cycles. SOme CAM (complementary and alternative medicine) techniques have been proved effective too.Biofeedback and behavioral therapy, herb butterbur (Petasites hybridus),riboflavin (vitamin B2), magnesium, and feverfew,coenzyme Q10 (CoQ10),Melatonin,Body work - Eg, chiropractic, massage, and craniosacral therapy,Nutritional/herbal supplements - Eg, vitamins and herbs,Acupressure and acupuncture, yoga etc are some of the level 1 recommendations by XXXXXXX college of neurology for these migrainous headaches. Some dietary triggers which trigger migraine need to be avoided.Common dietary triggers include the following: Alcohol - Particularly wine and beer Caffeine overuse or caffeine withdrawal Chocolate Aspartame - eg, NutraSweet and Equal Monosodium glutamate (MSG) - May be found in Asian food, canned soup, frozen or processed foods, and the seasoning product Accent Fruits - Citrus fruits, bananas, avocados, and dried fruit Nuts - Peanuts, soy nuts, and soy sauce Tyramine, a biogenic amine that accumulates in food as it ages, may provoke migraine. Sources include the following: Dairy - Aged cheese Meat - Bacon, sausage, luncheon meat, deli meat, pepperoni, and smoked or cured meat Pickled foods Heavily yeasted breads - Eg, sourdough Vinegars - Especially wine vinegar Some types of beans exercise for migraine prevention (40 minutes 3 times weekly for 3 months) has been proved effective.,Tonabersat,Transient receptor potential vanilloid type 1 antagonists,Prostaglandin E receptor 4 receptor antagonists,Serotonin 5HT1(F) receptor agonists and Nitric oxide synthase inhibitors are some of the novel managements for the migraines these days. I hope you see the depth of it. Discuss all the possible options with your doctor and let them select what is best for you. COnsult your neurologist and hope for the best. Nut shell , Seek an infectious disease specialist and let them take care of you. I hope it helps. Take good care of yourself and dont forget to close the discussion please. May the odds be ever in your favour. Regards Khan