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Suggest Remedies For Recurring Migraine Attacks
Question: i have had a migraine for the last 6 days. it goes away for an hour or so then returns. I'm having no luck with my sumatriptan or a chiropractor . i cant sleep and am missing work. what can i do?
Brief Answer:
Read below
Detailed Answer:
I read your question carefully and I understand your concern.
That persistence of the symptoms goes beyond a simple migraine attack. Migraine attacks by definition last from 4 to 72 hours. Sumatriptan is a good first choice drug, however there are cases where it doesn't work and some second line therapies may become necessary, even in the ER for protracted attacks lasting over 72 hours..
However since as I said that duration is beyond classical attack before taking other treatments a reevaluation of the diagnosis is necessary. Having been diagnosed with migraine doesn't render you immune to other causes of headache such as tumor, stroke, infection etc. So it is recommended to be checked for possible neurological signs indicating another cause or also causes such as high blood pressure.
Also if you have been taking sumatriptan regularly for a long time another cause to be considered is medication overuse headache, an intractable headache which may develop in patients who have been using painkillers frequently for a long time (at least for 3 months for 10 days a month)
If nothing suspicious is found (if yes brain imaging would be the next step) and medication overuse is not an issue, then intravenous treatment may be necessary even in the ER, with options which include intravenous valproate, dihydroergotamine, dexamethasone or a neuroleptic like Prochlorperazine.
I remain at your disposal for other questions.
Read below
Detailed Answer:
I read your question carefully and I understand your concern.
That persistence of the symptoms goes beyond a simple migraine attack. Migraine attacks by definition last from 4 to 72 hours. Sumatriptan is a good first choice drug, however there are cases where it doesn't work and some second line therapies may become necessary, even in the ER for protracted attacks lasting over 72 hours..
However since as I said that duration is beyond classical attack before taking other treatments a reevaluation of the diagnosis is necessary. Having been diagnosed with migraine doesn't render you immune to other causes of headache such as tumor, stroke, infection etc. So it is recommended to be checked for possible neurological signs indicating another cause or also causes such as high blood pressure.
Also if you have been taking sumatriptan regularly for a long time another cause to be considered is medication overuse headache, an intractable headache which may develop in patients who have been using painkillers frequently for a long time (at least for 3 months for 10 days a month)
If nothing suspicious is found (if yes brain imaging would be the next step) and medication overuse is not an issue, then intravenous treatment may be necessary even in the ER, with options which include intravenous valproate, dihydroergotamine, dexamethasone or a neuroleptic like Prochlorperazine.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank you. i will take your answer under advisement.
Brief Answer:
Thank you and all the best.
Detailed Answer:
I hope you will feel better soon.
Thank you and all the best.
Detailed Answer:
I hope you will feel better soon.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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