Migraine: Diagnosis and Treatment

In this video, Dr. Bill McCarberg and his panel discuss migraine headaches; the indicators for the history, physical examination of the patient, and some treatment options.

Discussion highlights include:

• 96% of chronic sinus headaches are actually migraine
• Common migraine triggers include stress, weather, and hormones.
• Cervicogenic headaches with neck pain that radiates and myofascial trigger points may mimic migraine.
• The comorbidities of the patient are essential to consider before prescribing an abortive, prophylactic, analgesic, or other medication to relieve migraine symptoms. Comorbidities often include fibromyalgia, anxiety, depression, and/or irritable bowel syndrome.

Lawrence Robbins, MD, one of the nation’s top headache medication management experts discusses important aspects about many drugs and how they are used.

• 60% to 70% of patients will respond well to tryptamine-based drugs.
• Beta blockers, calcium channel blockers, anti-depressants, and anti-convulsants are among the choices for migraine prevention.
• The patient’s caffeine consumption, nicotine use, and napping influence sleep quality, and are important considerations in total migraine management.
• Dr. Robbins discusses migraine symptoms and their impact on the medication management of the individual patient.

Chronic Daily Headaches: Diagnosis and Treatment