Danette C. Taylor, DO, MS, FACN
Dr. Taylor has a passion for treating patients as individuals. In practice since 1994, she has a wide range of experience in treating patients with many types of movement disorders and dementias. In addition to patient care, she is actively involved in the training of residents and medical students, and has been both primary and secondary investigator in numerous research studies through the years. She is a Clinical Assistant Professor at Michigan State University's College of Osteopathic Medicine (Department of Neurology and Ophthalmology). She graduated with a BS degree from Alma College, and an MS (biomechanics) from Michigan State University. She received her medical degree from Michigan State University College of Osteopathic Medicine. Her internship and residency were completed at Botsford General Hospital. Additionally, she completed a fellowship in movement disorders with Dr. Peter LeWitt. She has been named a fellow of the American College of Neuropsychiatrists. She is board-certified in neurology by the American Osteopathic Board of Neurology and Psychiatry. She has authored several articles and lectured extensively; she continues to write questions for two national medical boards. Dr. Taylor is a member of the Medical and Scientific Advisory Council (MSAC) of the Alzheimer's Association of Michigan, and is a reviewer for the journal Clinical Neuropharmacology.
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
In this Article
- What is a migraine?
- What are the risk factors for migraine?
- What causes migraines?
- What triggers migraines?
- What are the signs and symptoms of migraines?
- How are migraines diagnosed?
- What is the treatment for migraines?
- What self-care treatment measures work for migraines?
- How are migraines managed during pregnancy?
- How are migraines managed in children?
- What is the prognosis for migraines?
- Can migraines be prevented?
- Take the Headaches Quiz
- A Visual Guide to Migraine Headaches - Slideshow
- Headache & Migraine Triggers - Slideshow
- Find a local Neurologist in your town
How are migraines diagnosed?
According to the International Classification of Headache Disorders II (ICHD-II) criteria for migraine without aura, a patient must have had at least five headache attacks fulfilling the following criteria:
- Headache attacks lasting 4 to 72 hours (untreated or unsuccessfully treated)
- The headache has at least two of the following characteristics:
- Unilateral location
- Pulsating quality
- Moderate or severe pain intensity
- Aggravation by or causing avoidance of routine physical activity (for example, walking or climbing stairs)
- During the headache, at least one of the following characteristics:
- Nausea and/or vomiting
- Photophobia and/or phonophobia
- The headache cannot be attributed to another disorder
What is the treatment for migraines?
The treatment for migraines depends upon on how frequently the headaches occur and how long the headaches last.
The treatment of an acute migraine headache may vary from over-the-counter medicines, like acetaminophen or ibuprofen, to prescription medications. Triptans (sumatriptan, rizatriptan, eletriptan, zolmitriptan, naratriptan, almotriptan, and frovatriptan), may be extremely effective in treating migraines and may be prescribed to help the patient treat their migraine at home. Not every patient can take these medications and there are specific limitations regarding how often these medications can be used. Other medication regimens may also be used to control headache. Some medications are appropriate for home use and others require a visit to the health care professional's office or emergency department.
Narcotic pain medications are not necessarily appropriate for the treatment of migraine headaches and are associated with the phenomenon of rebound headache, where the headache returns -- sometimes more intensely -- when the narcotics wear off. In all cases of migraine, the use of acute pain therapies must be watched closely so that a patient does not develop medication overuse headache.
If an individual experiences frequent headaches, or if the headaches routinely last for several days, then preventive medications may be indicated. These may be prescribed on a daily basis in an effort to decrease the frequency, severity, and duration of migraine headaches. There are many different medications which have been shown to be effective in this role, including blood pressure medications (propranolol, nadolol, verapamil, and flunarizine), anti-seizure medications (divalproex sodium, topiramate and gabapentin), antidepressant medications (amitriptyline and venlafaxine) and other supplements (magnesium, butterbur, and riboflavin). The specific medication which is selected for a patient is dependent on many other factors, including age, sex, blood pressure, and other pre-existing medical conditions. Some patients who experience more than 15 headache days every month might benefit from Botox injections.
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