Migraine Management

Marsha Alexander, RN, MSN, FNP-BC Specializing in Treatment of Migraine

We offer extensive therapeutic treatment options including:

• Education
• Lifestyle management
• Botulinum toxin injections
• Occipital Injections
• Trigger point injections

There are many ways to manage Chronic Migraine.  Acute Medications are taken when a migraine or headache is starting or has started.  It helps to stop or reduce pain but doesn’t necessarily prevent headache or migraine.  Preventive Medications are taken to help prevent headaches and migraines from occurring.  Botox is a preventive treatment and FDA approved for Chronic Migraine (15 or more headache days per month, each lasting 4 hours or more).  If you have Chronic Migraine, a preventive medication like Botox may be an option for you.

What is Migraine?

Migraine is a chronic and

episodic disorder, characterized

by headache attacks.1

 Recurrent headaches lasting 4-72 hours

 One-sided, pulsating, moderate-to-severe pain

 Decreased ability to function in everyday situations

Associated Symptoms

Often 2 of these 3 key associated symptoms are also

present during an attack: 1

 Nausea and/or vomiting

 Sensitivity to light (called photophobia)

 Sensitivity to sound (called phonophobia)

Other symptoms may include sweating or cold hands,

diarrhea, pale skin color, and scalp tenderness or pain

from touch or pressure (such as a necklace touching

skin, hair brushing, or shaving). is kind of pain is

called allodynia.

Migraine Is Very Common –

Your Are Not Alone

Migraine a-ects nearly 30 million people in the US. 2

 12% of people 12 years and older

 More common in women (17% vs 6% in men)

 Nearly 25% of migraine su-erers frequently

lose time at work, home, or in social settings due

to migraine

 More than 50% of su-erers have difficulty

functioning or require bed rest during a

headache attack.

What Can You Do to Help Yourself?

Track your symptoms with a headache diary

Keep a headache diary — and share the results with

your healthcare professional. A free downloadable

diary is available on the NHF Web site at

www.headaches.org/pdf/Headache_Diary.pdf.

 Record frequency, severity, and duration of attacks

 Keep track of treatment(s), outcomes, and

side eects

 Identify and avoid possible triggers

 Diet and eating schedule

 Sleep schedule

 Exercise schedule

 Stress level

 Exposure to lights, sounds, or smells

 Weather

 Menstrual cycle — for women

Discuss your symptoms with your healthcare

professional

Diagnosing migraine depends on clear communication

with your healthcare professional. -ere is no test to

show that you have migraine — diagnosis is made

by discussing the history of your symptoms. Often,

tests that are conducted are done to rule out other

potential conditions.

Schedule a visit with your healthcare professional,

and be prepared for your visit. Keep a headache diary,

and consider completing a MIDAS questionnaire, a

short list of questions designed to help measure the

impact of migraine on your life (available online at

www.headaches.org/pdf/MIDAS.pdf) before your

visit. Be ready to:

 Describe the severity and type of pain, its specific

location, and duration of attack

 Describe how you feel before, during, and after

an attack

 Discuss other symptoms, including nausea and

vomiting and sensitivity to light and/or sound

Treat early for best outcome.

 Treat at the first sign of an attack — don’t wait!

 Keep medications with you when you go out or travel.

 Consider preventive therapy if you have frequent

or severe attacks.

What are the available options for

Treatment?

RE FOR Figure excerpted Wanted medication Had because Had ADMINISTR Sumatriptan injection, Nasal Injectable Transdermal (investigational)

Oral Orally tablet

How Do You Take Your Medicine?

How you take your medication — orally, by injection,

or by nasal spray — may be important, especially if

you experience nausea or vomiting with an attack.

People with migraine often delay treatment for migraine

— from minutes to hours. Nearly 40% of the

time, treatment was delayed for more than a full hour.8

Nausea is the second leading cause for patients to delay

taking medication greater than 1 hour.

TRE ATMENT OPT IONS IN MIGR AINE

Acute medications

Preventive medications

Identify and avoid triggers; maintain

healthy sleep, diet, and exercise habits;

reduce stress

Relaxation training, hypnotherapy,

biofeedback, cognitive/behavioral

management, acupuncture, nutritional

supplements, physical therapy, massage

Triptans, ergotamine derivatives,

over-the-counter and prescription*

pain relievers

Antiepileptic drugs; beta blockers,

calcium channel blockers, tricyclic

antidepressants

Lifestyle modification

Nonpharmacologic and

complementary therapies

Acute therapies are taken to stop an attack once it has begun. Preventive therapies are taken daily,

whether or not a headache is present, to reduce the frequency or severity of attacks.

*Prescription pain relievers are not commonly used.

For lists of potential triggers and more information

about managing your migraine, you can visit

www.headaches.org. Speak to your healthcare

professional about all your treatment options.