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Neurology (Expert Forum)
Chronic Migraine; Is there in-patient treatment?
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Chronic Migraine; Is there in-patient treatment?
by thurnauer, Dec 04, 2006 12:00AM
I have had a migraine for the past 11. The onset was the birth of my second child on 12/5/05. The delivery was uneventful, with exception to having postpartum elevated blood pressure and unilateral success of the epidural (left side numb, right side no affect). The conclusion from the professionals I have seen is that I have a history of migraine headaches and the delivery was just a trigger.
I tried BP meds and narcotics the first two months and then moved on to migraine and anti-seizure medications. I have had a MRI, CT scan, spinal tap, a sleep study(all within normal limits). Cleveland Clinic on 5/10/06 and saw Dr. Kriegler and had a 5 hour infusion; by that time I had gotten myself addicted to ibuprofen to assist with pain management. After I left the Clinic I had a DHE pain pack for 9 days; at the end of which I had about 6 hours pain free. That was the first and last time I have been pain free in the last 11 months. I am currently on 200 mg of Topamax and 120 mg of Cymbalta. I recently weaned off Lyrica which helped manage my pain due to the adverse event of weight gain. On 11/20/06 I had Botox for the first time which appears to have decreased the pain somewhat but did not eliminate it totally.
My question: Is there an in-patient treatment for migraine? A sort of in-patient protocol to utilize steroids and/or pain meds to shut down the brain and then restart it again? This has been going on for so long and the pain has been so constant; at times I feel I am going crazy and there doesn’t seem to be and end in sight. I just want me life back.
I tried BP meds and narcotics the first two months and then moved on to migraine and anti-seizure medications. I have had a MRI, CT scan, spinal tap, a sleep study(all within normal limits). Cleveland Clinic on 5/10/06 and saw Dr. Kriegler and had a 5 hour infusion; by that time I had gotten myself addicted to ibuprofen to assist with pain management. After I left the Clinic I had a DHE pain pack for 9 days; at the end of which I had about 6 hours pain free. That was the first and last time I have been pain free in the last 11 months. I am currently on 200 mg of Topamax and 120 mg of Cymbalta. I recently weaned off Lyrica which helped manage my pain due to the adverse event of weight gain. On 11/20/06 I had Botox for the first time which appears to have decreased the pain somewhat but did not eliminate it totally.
My question: Is there an in-patient treatment for migraine? A sort of in-patient protocol to utilize steroids and/or pain meds to shut down the brain and then restart it again? This has been going on for so long and the pain has been so constant; at times I feel I am going crazy and there doesn’t seem to be and end in sight. I just want me life back.
Doctor's Answer
by CCF-Neuro-M.D.-SH, Dec 24, 2006 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
There is a "In-patient" protocol for IV infusion in severe migraine (also called 'status migranosus'). This in-patient protocol these days is more often administered in outpatient IV infusion suites (same medications given for the same amount of time, usually 3-5 days of IV infusions). The protocol can vary based on your headache type, but generally consists of DHE, magnesium, depakote, kytril, benadryl given daily. Sometimes medications such as solumedrol and zyprexa or seroquel are also added. Unfortunately if your are taking the ibprofen or other pain medication twice per week they can cause rebound headaches, that cannot be cured by cocktails-only by stopping the medications. Some patients need 3-5 days of infusions allow them to get off their pain medication. Dr. Kriegler is an excellent doctor, and will be able to arrange the best IV infusions for you (there is an IV infusion suite in the CCF headache center).
I hope this has been helpful.
There is a "In-patient" protocol for IV infusion in severe migraine (also called 'status migranosus'). This in-patient protocol these days is more often administered in outpatient IV infusion suites (same medications given for the same amount of time, usually 3-5 days of IV infusions). The protocol can vary based on your headache type, but generally consists of DHE, magnesium, depakote, kytril, benadryl given daily. Sometimes medications such as solumedrol and zyprexa or seroquel are also added. Unfortunately if your are taking the ibprofen or other pain medication twice per week they can cause rebound headaches, that cannot be cured by cocktails-only by stopping the medications. Some patients need 3-5 days of infusions allow them to get off their pain medication. Dr. Kriegler is an excellent doctor, and will be able to arrange the best IV infusions for you (there is an IV infusion suite in the CCF headache center).
I hope this has been helpful.
I am just saying they do inpatient in St James Hospital in Chicago also.
I noticed you were talking about Botox
They do Botox for Headaches also.
They inject botox in your neck muscles and in your forehead.
They have all different kinds of migraine medications though that they specialize in... and they have trials too that you can sign up for.
I was in a trial.
I also had Botox 3X.
Good Luck!
Nancee
I had a brain and spinal MRI and have a choroid plexus cyst within my right temporal horn. It is small. I was wondering if this might be causing my headaches, naseau, vomiting etc. I also have a syrinx in my central canal that is small, but I understand that should be inopperable as it is in the central canal, and would probably cause more damage to repair. Both of these should be monitored?
I wanted to ask about these two things?
Thanks! Nancee
To post a question, you have to keep clicking on "post a question" they only allow one or two questions a day and the time you can post changes every day. It took me a couple weeks of attempting pretty frequently at various times to get my question posted. Good luck.
Thanks,
my sister, me and my brother all have migrain and lately, my sis was hit badly and was send to the hospital due to blur visions and half body numbless. She stayed there for 8 days and nothing much the doctor can do as the pain still there thru out her stayed.
I am so afraid that she will have mild stroke. And the doc diagnosed that she have chronic migrain. And she have been taking pain killer cafergot for many years and this time is the rebound migrain or overused of the