Headache & Migraine

Majority of headaches are not serious and patients can get treatment from nearest general practitioner. You should see Neurophysician for following headaches:

1. Headache that is frequent or severe. Especially, when it is accompanied with vomiting/ nausea. Also, when you dislike bright lights or noise during headache.

2. Headache that is very severe.

3. Headache that lasts from days to weeks and needs frequent treatment with painkillers or injections.

4. Headache that leads to unconsciousness.

5. Headache that is brought about by physical activity or sexual activity.

6. Headache that is accompanied by blurring of vision or seeing patterns of light.

7. Headache accompanied with weakness of any part of body.

8. Headache that occurs daily and patient needs frequent pain killers.

9. Headache with fever and pain in neck.

10. Headache with seizures.

11. Headaches that require frequent visit to hospital emergency.

Causes:

Majority of headaches do not have any specific underlying cause. They are usually due to changes in chemical activity in brain. Few are associated with spasm of muscles of skull and neck. Only few headaches are associated with infection in brain, brain tumors or any structural defect. Anxiety can contribute to headache. Some headaches like migraine run in families.

Symptoms:

Headache is experienced on one or both sides of head. Sometimes headache is experienced behind and around eyes. It can be mild or very severe. Nausea and vomiting can also occur. Some patients experience fear of bright lights and noise with headache. Some patients can get blurring of vision or they can see stars or light patterns with headache. Frequency of headache varies from occurring after months or occurring daily. It can be mild or very severe. Some headaches tend to get worse in the evening hours. Some headaches occur with physical activity. Sometimes patient are awakened from sleep with severe headache. Some patients can have current like pains in face (trigeminal neuralgia).

Treatment:

Patients who have long-standing headaches can get drug treatment for headaches. These drugs may need to be taken for couple of months on and off. Sometimes for severe headache intravenous injections are prescribed by doctors on need basis. Some patients need Botox or nerve blocks for frequent headaches after consultation with treating doctor.

Diet:

In patients with migraine- chocolates, cheese and cola drinks are known to increase headache. All such foods should be avoided. Excessive use of tea and coffee should be discouraged. Prolonged fasting can trigger headache in some patients

General measures for headache patients:

1. Headache is usually not dangerous and should not panic the patient.

2. Patients should adopt a healthy lifestyle. Daily walk and exercise can help reducing the frequency and intensity of headaches.

3. Stress can cause and aggravate the headache. Patients should try to keep themselves happy and may seek help of psychiatrist if needed.

4. Excessive use of painkillers should be discouraged. It can not only give rise to rebounding headaches but can also damage stomach and kidneys of the patient. If you require painkillers more than twice a week then you should see your doctor.

5. Good sleep and hygiene are extremely important for patients with headaches. Patients should sleep early.

6. Sometimes very thick pillow can cause head and neck pain.

7. Patients should take balanced diet. They should avoid chocolate itself and chocolate flavoured other items like drinks, cakes, biscuits etc. Patients should decrease consumption of soda drinks and cheese. They should decrease caffeine intake as well.

8. Patients should avoid looking at TV, computer and mobile screens for long periods of time. This can aggravate headache.

9. Female patients tend to have headache during certain phases of their menstrual cycle. They need to discuss it with their doctor.

10. Patients who are suffering from migraine should avoid strong sunlight and should preferably use sunglasses while going out in the day.

12. Patients are recommended to not to google their symptoms. As they may end up diagnosing themselves with brain tumor!

Frequently Asked Questions:

Will patient of migraine need treatment for lifetime?

Patient suffering from migraine need drug treatments for months on and off. This should not discourage the patient s taking one or two pills in a day usually keeps the headache off.

Is headache caused by decrease in eyesight?

Patients experience headache while reading can have problems with eyesight they should sew the ophthalmologist.

Is headache hereditary?

Only few headaches like migraine can be hereditary.

What are the new treatments available for headache?

There are many new treatments available for headache like some intravenous injections that may need to be given every 3 or 4 months. Botox can also be used in treatment resistant cases. Some form of nasal sprays are also available for severe headaches. Some implantable devices are available for certain type of headaches. You need to discuss this with the treating doctor whether or not you are suitable for such treatments.

Is there any risk of brain tumor with headache?

Majority of headache are not related to structural brain defect like brain tumor etc. It is very unlikely that your headache is related to brain tumor unless you have strong family history of brain tumor. Stay positive.

Do i need to get CT or MRI scan of head for headache?

Most of headaches are not dangerous and brain scan in unnecessary. There is absolutely no use of exposing yourself to radiation. Headache that is associated with certain other symptoms may be further investigated with brain scan and your doctor will definitely tell you when it is needed.

Disclaimer:
The information given here is intended for use of general public . It should not be taken as standard medical reference.

About the Author:

One of the most well known neurologists in Lahore, he is serving as Assistant Professor of Neurology at Lahore General Hospital. He is a graduate of King Edward Medical College and did residency in general medicine & neurology at Mayo Hospital Lahore. He did FCPS in neurology and moved to Lahore General Hospital, and has been working there since.

2 Comments

  1. Areesha Khan August 19, 2020 at 5:49 pm - Reply

    Doctor I have head pounding and my bp is low what to do in this case shall I come for a followup or what remedies should I take?

    • Shahid Mukhtar August 20, 2020 at 6:45 pm - Reply

      This could be due to a number of reasons. Please book an appointment from the button at the top and visit for a check up.

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