Migraine Management Overview
Migraines are more than just headaches. They are recurring attacks of moderate to severe throbbing or pulsing pain that are generally located on one side of the head. Additional symptoms of migraine attacks can include nausea, vomiting, and sensitivity to light and sound. The causes of migraines aren’t completely understood, but genetics and environmental factors appear to contribute.
While lifestyle changes and over-the-counter medications such as aspirin or ibuprofen can provide relief for some migraine sufferers, other patients may find these methods ineffective. These patients may believe they need to live with painful, debilitating migraines for their entire lives. But advanced migraine treatments are available that may provide relief when other treatments fall short. At MedStar Health, our specially trained headache specialists can work with you to find treatments that can stop and prevent your migraines.
Our Approach to Care
At MedStar Health, our surgeons are experts in diagnosing and surgically treating various headache disorders. When approaching migraine care, there are two categories of treatment: abortive and preventive. Abortive treatments are designed to stop migraine symptoms after they start, while preventive treatments aim to reduce the frequency or severity of migraines.
Typically, we try to treat migraines first with abortive treatments. Any abortive treatments we provide should be taken as soon as you notice migraine symptoms. If severe, frequent, and long-lasting migraines persist, we’ll look at preventive treatments.
Abortive and preventive treatments for migraines at MedStar Health include:
- Botox® therapy: Botulinum toxin injections can prevent the muscle contractions that lead to migraines. It’s generally reserved for patients with at least 14 headaches a month.
- External nerve stimulation (Cefaly): An egg-sized device placed on the forehead stimulates the trigeminal nerve using precise micro-impulses, producing a sedative effect that can help relieve pain or reduce the frequency of migraines.
- Medications: A variety of prescriptions, such as antidepressants, anti-seizure medications, and painkillers, can improve migraine symptoms.
- Nerve blocks: Anesthetic agents are injected near the occipital nerve in the back of the head to reduce migraine pain.
- Nerve decompression surgery: People with migraines who also have chronic daily headaches may benefit from surgery to reduce pressure on certain nerves. The area of the head where the surgery is performed depends on where your migraines are typically located.
- Transcranial magnetic stimulation (TMS): A special device held against the back of the head delivers a magnetic pulse to reduce or stop migraine pain. It induces mild electrical currents in the brain that are thought to interrupt abnormal electrical activity caused by migraines.
Choosing MedStar Health
When you choose MedStar Health, you benefit by seeing a multidisciplinary team of providers who specialize in the diagnosis and treatment of patients with various headache disorders. We partner with our patients to create a safe and effective management plan. You can conveniently find our Headache Center at MedStar Georgetown University Hospital where you’ll have access to other medical specialties and advanced levels of care should you need it. We also offer migraine services at MedStar Montgomery Medical Center in Olney, Maryland.
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Frequently Asked Questions
To most patients, TMS feels like tapping on the skull and experience essentially no pain. You may feel uncomfortable with the tapping sensation and you may have mild head soreness during the first week of treatment.
More insurance providers are recognizing the benefits of migraine surgery. Your migraine surgery may be covered by insurance if it is deemed medically necessary. Please contact your insurance company to determine your coverage.
Before surgery, you may be asked to get blood tests and take or adjust medications. If you smoke, quitting will help you heal faster and avoid possible complications. You’ll also need to arrange for transportation to and from the hospital and for someone to stay with you the night you return home.