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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

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Suffering From Hemicrania Continua. Treated For Continuous Migraines. Developing Intolerance Towards Medicines. Suggestions?

Hi, my daughter is 14 and suffering from hemicrania continua . She was treated for continuous migraine for several months and was given many different preventatives . None helped, most made it worse. Indomethacin was like a miracle, but she seems to build a tolerance to it. It works great for about 2 weeks, then is less effective. She is now on 75 mg 4 times a day, and it is becoming less effective each day. She is also on verapamil 240 mg once a day, it is not helping, just makes her dizzy and nauseous. She also takes omeprazole , carafate, and zofran for her stomache. Iron for anemia. And melatonin to help her sleep, 6 mg I think. What can we try next? Occipital nerve block?
Wed, 3 Apr 2013
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Neurologist,  's  Response
Hello,

Thanks for the query,

Basically there are two types of hemicrania continua 1. Primary- no cause can be found out 2. Secondary- to some problem in the brain. I feel that your daughter needs a MRI scan of the brain to rule out secondary causes which can mimic hemicrania continua. Topiramate is the other medication that may be tried if MRI scan comes out as normal. Generally verapamil may not help and may be withdrawn. If all these procedures and plans fail, you may consult a pain physician who will help you in other interventional methods pf reducing pain like Occipital nerve block.

Hope this clarifies
Best wishes
Dr Gopal K Dash MD, DM, Post-doctoral fellowship (Epilepsy)
Consultant Neurologist and Epilepsy specialist
Narayana Hrudayalaya Hospital, Bangalore
My Blog in the Web site:
http://www.healthcaremagic.com/doctors/dr-gopal-krishna-dash/64344

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Suffering From Hemicrania Continua. Treated For Continuous Migraines. Developing Intolerance Towards Medicines. Suggestions?

Hello, Thanks for the query, Basically there are two types of hemicrania continua 1. Primary- no cause can be found out 2. Secondary- to some problem in the brain. I feel that your daughter needs a MRI scan of the brain to rule out secondary causes which can mimic hemicrania continua. Topiramate is the other medication that may be tried if MRI scan comes out as normal. Generally verapamil may not help and may be withdrawn. If all these procedures and plans fail, you may consult a pain physician who will help you in other interventional methods pf reducing pain like Occipital nerve block. Hope this clarifies Best wishes Dr Gopal K Dash MD, DM, Post-doctoral fellowship (Epilepsy) Consultant Neurologist and Epilepsy specialist Narayana Hrudayalaya Hospital, Bangalore My Blog in the Web site: http://www.healthcaremagic.com/doctors/dr-gopal-krishna-dash/64344