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My daughter 18 years old has had a migraine/headache for…

My daughter 18 years...

My daughter 18 years old has had a migraine/headache for almost 3 weeks. We have been to ERtwice for morphine/reglan/antihistimine cocktail. They prescribed narcotics,imitrex, raglan and nothing seems to dull the pain completely or make it go away. she had a history of them right when she was beginning her menstrual cycle and they last a few years. They have tapered off in the last 2 years and now this one is back with a vengeance. Dr. also put her on a low dose birth control a week ago to see if that helped the hormonal aspects of it if that is whats causing this one. It's very frustrating as she is a competitive tennis player and going to college in the fall to play tennis. She has not been able to train much at all for the last 3 weeks. I'm desperate and can't see a neurologist for another 10 days... earliest appointment. Any suggestions would be greatly appreciated

Doctor's Assistant: Is the headache episodic or daily? And what about nausea?

Daily and nausea light headedness

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

Nothing except the migraine history I explained

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Answered in 8 minutes by:
3/20/2018
Dr. Muneeb Ali
Dr. Muneeb Ali, Intensivist
Category: Neurology
Satisfied Customers: 9,228
Experience: Experience of Neurology of over 4 years, well versed in EEG, NCS and EMG alongwith MRIs and CT scans
Verified

Hi,
Welcome to JA and thanks for this question. I'm sorry to hear about your daughter. Actually, if she has been experiencing a migraine consistently for the past three weeks then the first thing to do is to get an MRI of the brain. This would be important to rule out other causes of a headache. Secondly, in order to control the recurrent attacks, she needs to be started on prophylactic medications which can include acetazolamide which has been found to be very successful in patients in whom the headaches are associated with the periods. This type of a migraine is known as catamenial migraines and acetazolamide is very helpful in that situation. Other medications which can be helpful in this situation would include,

Amitriptyline

Calcium channel blockers like verapamil

Valproic acid

topiramate

Propranolol

If none of the above work then botox injections can be very useful in this situation. In severe resistant cases, the following therapies can be tried,

Transcutaneous nerve stimulation

BP medications like lisinopril or candesartan which have been used in some cases with good success

Acupuncture

Venlafaxine

Gabapentin

Do you have any more questions?

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Customer reply replied 1 month ago
She also had a CAT Scan and it was fine no abnormalities

A CT scan would show major issues but a MRI scans the brain in more detail and small lesions which may be missed on a CAT scan would be easily picked up by a MRI. Which is why i would still recommend getting a MRI done.

Do you have any more questions?

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Customer reply replied 1 month ago
Is topirimate a prophylactic? Can you prescribe medication?

Topiramate is a prophylactic medication used to prevent migraines. Unfortunately we cannot prescribe online, this is an information only site.

Dr. Muneeb Ali
Dr. Muneeb Ali, Intensivist
Category: Neurology
Satisfied Customers: 9,228
Experience: Experience of Neurology of over 4 years, well versed in EEG, NCS and EMG alongwith MRIs and CT scans
Verified
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Dr. Muneeb Ali, Intensivist
Category: Neurology
Satisfied Customers: 9,228
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