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Migraine Misdiagnosis
Are You
Being Treated for the Wrong Type of Headache?
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There are currently over 28 million
people in the U.S. who are being treated for migraines.
Studies done in recent years, however, show that this number
could potentially be much higher due to the large number of
patients diagnosed with tension or sinus headaches who
actually have migraines. More serious types of headaches are
also hidden in this large group of headache patients.
Diagnosing Your Headache
Before any sort of treatment can begin, it is imperative
that a proper diagnosis is made by a physician. “Headache
sufferers need a thorough evaluation by a physician,” says
Everett Heinze, M.D., a neurologist with The Austin
Diagnostic Clinic (ADC). “A physician should go beyond the
known symptoms and look at medication and physical history
as well as perform diagnostic tests to rule out any
underlying causes.” These tests may include blood tests,
x-rays, CT scans or MRI scans.
Primary Headaches
The vast majority of headaches are considered primary
headaches – headaches that are not a symptom of another
illness or condition. Migraines, tension and cluster
headaches make up this group and have similar symptoms.
Typical symptoms include:
Migraines: An intense, throbbing pain on one side of the
head near the eye. Often accompanied by nausea and
sensitivity to light and sound, they are severe enough to
interfere with daily life.
Tension Headaches: The most common type of primary headache.
Often begin at the neck or back of the head and cause a
feeling of tightness, fullness or pressure.
Cluster Headaches: Occur in "clusters" once to several times
a day over a period of a few weeks to several months. Often
involve severe pain around or behind one eye.
Secondary Headaches
Secondary headaches are the result of a physical
disorder or disease such as a sinus infection, tumor or
bleeding in the head.
“It often requires a physician to distinguish between
primary and secondary headaches,” cautions Dr. Heinze,
“because the outward symptoms may be similar. For instance,
with sinusitis—as with migraines—the pain occurs over, above
and around the eye. Real sinus infections, however, are
frequently accompanied by additional symptoms such as fever,
swollen lymph nodes and nasal discharge. In fact, the
majority of headaches thought to be sinus headaches are
really migraines.”
Prevention and Treatment
Once migraines have been properly diagnosed, they can be
successfully treated and often prevented. Patients need to
work with their physicians to determine the treatment plan
that is right for them and how to stop the pain once it
starts.
“Pain medication varies depending on the severity of the
pain,” explains Dr. Heinze. “Over-the-counter drugs such as
ibuprofen, aspirin, Tylenol or Excedrin can help with mild
pain, or stronger prescription drugs and medicines developed
specifically for migraines can also be used. Some of the
migraine medications are particularly effective if taken at
the first sign of a headache.”
“There are also several options when it comes to
prevention,” adds Dr. Heinze. Drugs which are more commonly
used to treat high blood pressure can be used for migraines.
Anti-depressants are another option. “We’ve also learned
that muscle relaxants used alone or in combination with
other medication can also reduce the frequency and severity
of migraines.”
Migraine Management
“There are other medications that can be prescribed,” says
Dr. Heinze, “but managing migraines can also be done by
identifying triggers and making lifestyle changes.”
He recommends the following:
• Avoid trigger foods including
cheeses and red wine.
• Exercise regularly.
• Learn to manage stress. Biofeedback may help.
• Quit smoking.
• Develop healthy sleep patterns – go to bed and wake up
at the same time everyday.
• Keep a headache log for one to two months to help you
and your physician learn if there is a pattern to your
headaches.
“If frequent headaches do occur,
consult with a physician and share all of your symptoms.
Avoid self-diagnosis and have a thorough examination by a
physician,” Heinze cautions. “Once it is determined that a
migraine is the headache culprit, it is important to
continue working with a doctor to determine how to
effectively prevent and treat this condition.”
Additional Primary Headache Symptoms:
• Migraines - Most migraine
sufferers get at least one attack a month, which can
happen at any time and, if left untreated, can last from
four hours to three days.
- Some sufferers can experience
an ‘aura’ about 10-30 minutes before the pain begins.
This is characterized as bright shimmering lights around
objects or at the edges of the field of vision, wavy
images or hallucinations. Others experience temporary
vision loss
- Nonvisual symptoms include motor weakness, speech or
language abnormalities, dizziness, vertigo and tingling
or numbness of the face, tongue or extremities
- Women are three times more likely than men to suffer
from migraines
• Tension Headaches – May occur
several times per month and can last from several
minutes to several days.
- They affect men and women equally
• Cluster Headaches – Can last from a few minutes to
over two hours and occur up to eight times a day.
- Other symptoms may include tears, a stuffy or runny
nose, flushing and swelling of the eyelid on the same
side as the pain
- Far more common in men
- Often begin in the middle of the night and tend to
occur around the change of the seasons
Secondary Headaches
• Sinus Headaches/Sinusitis – Many patients go to their
doctor complaining of a sinus infection and without
performing the proper tests are given a prescription for
antibiotics for a condition that doesn’t exist. Taking
the wrong medication can make the migraines worse and
the body will build up a resistance to the antibiotic
over time.
The Austin Diagnostic
Clinic (ADC) is a multi-specialty clinic with physicians
representing 24 medical specialties at more than 10 locations.
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