MedHelp has a helpful and detailed FAQ Health Page on Headaches and Migraines, the link is below:
Go to your nearest hospital immediately or call EMERGENCY services immediately if you experience any of the following NEW and UNDIAGNOSED symptoms:
- Sudden pain that you would describe as the "worst pain you have ever had."
- Sudden vision change or loss of vision.
- Paralysis on one side of your body or paralysis of part of one side of your body.
- Sudden difficulty speaking or understanding others
- A headache accompanied by confusion or a dramatic change in behaviour
- Loss of consciousness or noticeable change in level of consciousness (example: friends tell you that you appeared awake but did not respond to them or your surroundings for 10 minutes)
Although these can all be rare symptoms of migraine, if you have never experienced these symptoms before then they could be a sign of something much more serious. You may often hear fellow migraineurs others talk about changes in their own behaviour or temporary paralysis during a migraine, but if you have never experienced these symptoms yourself before, do not assume that it is a migraine symptom in your case as well. Always seek emergency services if you experience NEW symptoms that may indicate an emergency situation (stroke, heart attack, etc.).
If you experience any change in your migraine pattern it is still advisable to make a regular appointment with your family doctor or your migraine specialist in order to update them about your condition.
The following is a list of questions that I frequently get asked. I am not a doctor, I am just a migraineur like you, so please only take medical advice from your doctor. The following is provided for information purposes only, and is based on what I have read and heard about migraines, and it is not supposed to replace the advice of a doctor:
Q: What types of acute migraine medication are available?
A: Many types of medication can help migraines. If you suffer from multiple migraine headaches a month or if you suffer from chronic migraine headaches, it is usually advisable to avoid OTC pain killers as they can actually cause rebound headaches if taken too often. That is why it is always advisable to see a doctor in order to get a prescription for a medication more suitable for migraines. The following are examples of medications that are sometimes prescribed for migraines:
- Triptans: Sumatriptan/Imitrex, Rizatriptan/Maxalt, Zolmitriptan/Zomig, Almotriptan/Axert... etc.
- NSAIDS: Naproxen
- Ergot alkaloids
- Other pain medications: opiates... etc.
Q: What types of preventative/prophylactic medications are there for migraines?
A. There are three main categories of daily preventative/prophylactic medications for migraines:
- Antidepressants: amitriptyline ... etc.
- Anticonvulsant: valproic acid, topiramate/topamax ... etc.
- Betablockers: nadolol ... etc.
Botox can also be used as a preventative/prophylactic treatment for migraines. Injections are given every 3 months.
Q: What do I do if I am in severe pain, 10/10 or worse, and I just can't stand it at all and it won't stop? Can I go to the hospital? What will they give me if I go to the hospital?
A: Yes! You can go to the hospital if you are in severe pain and it will not stop and you can't manage the pain. It is especially important to go to the hospital if you feel like you are going to be at risk to yourself or others because of the pain. Hospitals in different countries and different areas of different countries all have different protocols for treating severe migraines, so I can't answer what types of treatment you will get for sure. Although, for the most part, emergency departments will treat severe migraines with at least one of the following medications or a combination of the following:
- If you have not already used two doses of triptans in the last 24 hours, they may give you an injection of sumatriptan.
- They may give you an antiemetic medication by IV that is called metoclopramide.
- They may give you IV fluids, such as normal saline
- They may give you an ergot alkaloid.
- They may give you oral pain killers or pain killers by IV. The pain killers could be tylenol/acetaminophen, morphine or dilaudid/hydromorphone.
- They may leave you to rest in a dark room.
- They may run tests such as a CT scan, an MRI, an EEG, and/or blood tests.
Q: What type of supplements could I take that have been proven effective in scientific trials? I am already taking all sorts of prescription medication... so all I can really add in right now are supplements. -OR- I don't want to take prescription medications, what types of supplements can I take?
A: There are 3 types of supplements that have been proven effective in scientific trials: B2, Magnesium citrate and CoQ10. It is important to check with your doctor or pharmacist before taking any of these supplements even though you can buy them OTC at the drug or health food store. Magnesium and CoQ10 can both mix very badly with some medical conditions and with some medications. The following are the doses that have been proven effective in scientific trials:
- B2 @ 400mg per day
- Magnesium citrate @ 400mg per day
- CoQ10 @ 300mg per day.