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Chronic headaches caused by many factors - Ogden Clinic provided source, Standard-Examiner 06/12/2013

(Standard-Examiner) OGDEN — Approximately 45 million Americans suffer from chronic headaches. Twenty-nine million of those are migraines. The majority of these headaches last a few hours, but some can last for weeks.

The causes are complex and can range from strong odors, such as perfume and smoke, to stress, food additives, hormonal and weather changes, skipping meals and sleep changes.

Treatment can be as inexpensive as drinking a cup of coffee or as costly as Botox injections.

“There are ongoing studies for headaches and the newest for migraines is using Boxtox injections to treat patients who have chronic migraines, which means headaches at least 15 days a month,” said Dr. A Nadim Al-Sadat, an Ogden neurologist.

Botox is made from a type of bacteria called Clostridium botulinum type A. The toxin causes muscle fiber paralysis by disrupting the transmission of nerve cells to the muscles. The treatment isn’t a magic bullet for everyone, but studies have shown the headaches to be greatly reduced in some individuals.

Migraine comes from the Greek word hemikrania, meaning pain on one side of the head. Migraines can begin with an aura, which are visual disturbances such as flashing lights or blind spots. Some people have a short wave of dizziness or sweating. The aura is usually, but not always, followed by the migraine headache, which can include a throbbing-type pain, nausea, sensitivity to light and sound and sometimes numbness in the face or limbs.

“Some people can get the aura but do not develop the migraine that follows, and this condition is called migraine variant or migraine without aura,” Al-Sadat said.

According to two studies presented at this year’s American Academy of Neurology’s 65th annual meeting, women who have migraines with aura may be more likely to have problems with their heart and blood vessels, and those on newer contraceptives may be at higher risk for blood clots.

Another study, published in the April issue of The Lancet Neurology, also revealed that migraine pain is not caused by an expansion of the arteries on the outside of the skull, as previously thought. MRI scans of 19 women who had migraine attacks showed no blood vessel expansion.

Instead, researchers now theorize they may be caused by extra-sensitive nerve fibers around the blood vessels.

Migraine is one of three main types of headaches. Tension headaches can feel like a tightening on both sides of the head and can also last for days. They are most often caused by stress or bad posture and can worsen with noise.

Cluster headaches are felt on one side of the head behind an eye. They are more common in men, can last up to 45 minutes and can strike up to four times a day. Al-Sadat also said cluster headaches are associated with eye redness, watery eyes and drooping of the eyelid.

Most headaches are primary in nature, meaning there is no other disease going on inside the body. However, Al-Sadat said, secondary headaches include other conditions, such as brain tumor, stroke, meningitis and increased pressure on the brain.

“The headache that starts and continues is more concerning than the headache that is episodic,” he said. “Other concerning signs are headaches that come all of a sudden and become the worst headache of your life.”

Al-Sadat said headaches accompanied by fever, neck stiffness, profuse vomiting, confusion or weakness on one side need prompt medical attention. Pregnant or post partum women, patients with cancer, those who are immuno-compromised and those on blood-thinning medications, as well as people with a recent trauma to the head, should also seek medical attention for any headache.

It’s also important not to take too much over-the-counter medication, as this can lead to rebound headaches, Al-Sadat said.

p>“The brain of migraine patients does not like to be exposed to medications like ibuprofen, Tylenol, Excedrin or even frequent caffeine, so if a patient’s headache becomes more frequent, they need to go on a preventive medication, which means taking medication daily to prevent their headache,” he said.

Some of these medications can include antidepressants, triptans, ergots, anti-nausea medications, beta blockers and anti-seizure drugs.