FAQs on Migraine Headache Treatment in Las Vegas

A migraine headache is a throbbing, intense pain that usually occurs on one side of the head (unilateral). However, a migraine headache can affect both sides of the head (bilateral). These headaches can occur frequently and impact daily activities.

Who gets migraine headaches?

Migraine is more common among persons aged 15 to 55 years, and women are affected three times as often as men. Migraines do get better with age, becoming less severe and less frequent.

Are migraine headaches common?

Migraines affect around 29.5 million people in America, making this one of the most common types of headache. This condition sends many patients to the emergency room each day, and is a commonly seen ailment in health clinics.

What causes migraine headaches?

Doctors do not fully understand what causes migraine headaches. Many researchers believe that migraine headaches result from abnormal changes in substances produced by the brain, and as certain chemicals increase, brain inflammation occurs. This inflammation results in blood vessel swelling, which compresses brain nerves and causes pain.

What triggers a migraine headache?

Triggers are events, substances, and situations that bring on a migraine headache. Common triggers include:

  • Strong odors
  • Bright lights
  • Loud noises
  • Alcohol and caffeine
  • Hormonal changes
  • Stress and anxiety
  • Weather changes
  • Foods with nitrates (lunch meats and hot dogs)

What are the symptoms of a migraine headache?

Migraines are throbbing, intense pain that occur with certain medical conditions. These include nausea, vomiting, and sensitivity to light and sound. In addition, aura occurs, which is visual disturbances that occur 10-20 minutes before the onset of severe head pain. The symptoms of aura are disturbed sense of touch, smell, and/or taste, seeing zigzag lines, having blind spots, and perceiving flashing lights.

What are the treatment options for migraine headaches?

The pain management specialist uses a combination of treatments to treat migraines. These are:

  • Medications – First-line drug therapy for migraine headaches are abortive agents, such as Imitrex and Maxalt. For prevention of these headaches, the doctor may prescribe antidepressants, like amitriptyline and nortriptyline. Drugs that affect levels of serotonin and other brain chemicals are serotonin norepinephrine reuptake inhibitors, such as Effexor and Vibryd. In addition, anticonvulsants can provide some preventive efforts and include topiramate.

 

  • Sphenopalatine ganglion block (SGB) – With this procedure, the doctor inserts a small catheter through the nostril and positions it near the sphenopalatine ganglion nerves. These nerves are located at the back of the throat beneath the brain. Once the catheter is in place, a long-acting anesthetic is instilled onto the nerves for a blocking effect. In a recent clinical study, the majority of participants reported significant pain relief that lasted form more than 30 days.

 

  • Botulinum toxin A (Botox) – This is used for prevention of migraine headaches, which works by paralyzing and blocking acetylcholine release from brain nerve cells. The doctor will inject this substance into the forehead, upper neck, and temples. A recent research report found that Botox injections reduce the intensity and severity of migraine headaches.

 

  • Occipital nerve block (ONB) – When pain occurs at the posterior region of the head, a long-acting anesthetic can be injected into the scalp and near the occipital nerves. Several clinical studies show that ONB reduces pain by 50%.

 

  • Radiofrequency denervation – To destroy a portion of the nerve roots along the cervical (neck) spine, the doctor can use radiofrequency energy. Fluoroscopy (x-ray guidance) is used to insert the probe/needle to the site of the nerves. According to a recent clinical study, ONB has a 75% efficacy rate.

Resources

Lee, JB, Park, JY, Park, J, Lim DJ, et al. (2007). Clinical efficacy of radiofrequency cervical zygapophyseal neurotomy in patients with chronic cervicogenic headache. Journal of Korean Medical Science, 22(2), 326-239. doi:  10.3346/jkms.2007.22.2.326

Palmisani, S, Al-Kaisy, A, Arcioni, R et al. (2013). A six-year retrospective review of occipital nerve stimulation practice – controversies and challenges of an emerging technique for treating refractory headache syndromes. The Journal of Headache and Pain, 14 (67). doi:10.1186/1129-2377-14-67.

Siberstein, S, Mathew, N, Saper, J, & Jenkins, S (2000). Botulinum toxin type A as a migraine preventive treatment. BOTOX Migraine Clinical Research Group. Headache, 40(6), 445-450.

Varghese BT & Koshy RC (2001). Endoscopic transnasal neurolytic sphenopalatine ganglion block for head and neck cancer pain. J Laryngol Otology, 115(5):385-7.