Migraine

[J.Tatt]

I have been getting headaches for about two years now. More recently have they been getting more frequent and worse. I sometimes wake up with a pounding migrane and it doesnt go away all day! Other times I just develope a headache out of nowhere, it's like BAM the pain just hits me. So I just went to the neuologist and they told me I had CDH, chronic daily headache. I don't really understand what it is and I dont think the treatment will work, can anyone help me?

[myodoc]

As Neurologists, we try to classify headaches based upon the patient's symptoms and associated features. Once this has been accomplished, we then offer various treatment protocols based upon the frequency of the headaches. It sounds like you have chronic tension headaches (not necessarily psychologic) that are either daily or episodic. Sometimes migraine can transform to a daily pattern. Other circumstances include taking analgesic medications (ibuprofen, etc) on a daily or near daily basis which becomes toxic and leads to chronic headaches, excessive caffeine use, sleep deprivation, smoking and heavy alcohol consumption. Changes in periods or birth control pills can also worsen headaches. If the exam is normal, we don't usually send for imaging of the brain unless there has been a change in pattern. For treatment, we usually use a short course of steroids, narcotics or DHE, which is an old drug, to break the cycle. At the same time, we start prophylactic medications such as antidepressants or anti-seizure meds to prevent. If you are taking a lot of analgesics, then these are weaned off. Based upon your response over the next few months, the prophylactic medications can then be weaned off also. It's important to work with your Neurologist and keep a diary or calendar of your headaches as this will give both of you a better idea of the effect of treatment.

Hope that's helpful.