Postherpetic Neuralgia Case Studies

Migraine headaches are the third most prevalent illness in the world, and ranked as the sixth most disabling illness. Statistics show that only about fifty percent of people who suffer from chronic headaches know that they’re suffering from a migraine. 76% of people who suffer from migraines worry that they will suffer for the rest of their lives, and 37% of sufferers worried about their migraines between attacks. Studies found that approximately 12% of Americans suffer from migraines, and 40% of Americans could benefit from preventative therapies. Even though studies show that at least 40% of sufferers could benefit from preventative therapies, only one in five sufferers are currently using preventative therapies. Studies also show that over 25% of people who suffer from migraine attacks miss at least one working day over the past three months, and nine out of ten sufferers say that they cannot “function normally” during those days. At least 98 percent of migraine attack sufferers take medications for temporary headache relief, whether it be over the counter or prescription. Only 12% of sufferers take preventative medications as opposed to the 98% of sufferers taking medications for relief. Severe migraines are ranked in the highest of seven disability classes, along with psychosis, dementia, and quadriplegia, published by the World Health Organization. People who participated in a survey who admitted to a

IW is currently taking Naproxen. IW is taking gabapentin but states that it has not helped as he has some grogginess. Patient has 50% relief with current medications.

Migraines contrary to old beliefs are not just bad headaches! Migraines are actually a neurological disease that affects 38 million people worldwide, according to the Migraine Research Foundation, 1 in 4 U.S households have at least one person who suffers from debilitating migraines living there. Although there is no cure for migraines, the vast majority of these victims use Excedrin Migraine or Advil Migraine to try to dull the sharp, throbbing pains they experience. These over the counter pain relievers may be very similar but they also have many differences.

Patient is a 19-year-old right-handed white female who is a fair historian. She states that she started having headaches as a child. Her father told her that he also had headaches and that they would eventually go away. She describes having a severe headache, which she calls her first migraine, after softball practice at age 12. Menarche was at age 13 with no change in her headaches. Her headaches have not been menstrually related. There was no clear change in her headaches during pregnancy or in the postpartum period. She states that she gets a dull headache two to three days out of a week. This is in variable locations on her head, but can also be a nuchal. The pain is of variable quality, but it does worsen with exertion. She also gets more

Although she finds it mildly beneficial, she complained of intense gastric pain while taking ibuprofen. Heather is wary of supplementing with any form of acetaminophen as she felt “loopy,” at one instance which she did not attribute to any other underlying cause (i.e. fever, medication). Heather also has an aversion to opiates, as she does not tolerate the euphoria and confusion while being on them. The option of bupivicaine +/- corticosteroid was presented to treat her SI join pain and to produce a NSAID sparing effect. However, she is afraid of needles therefore this option was not pursued. Rather a trial of Tramadol immediate release, at a dose of 25-50 mg PO at bedtime was provided to Heather. Her SI joint pain was reduced by 30% (9/10 to 6/10) within 30 minutes of starting Tramadol, without any noticeable side effects. There was no effect on her chronic daily headache pain. She started taking tramadol immediate release around the clock, and wore off after 4 hours. Therefore a prescription for Zytram XL (Tramadol CR) was provided to decrease her baseline pain and address end of dose pain. In addition to she was provided an additional repeat of immediate release tramadol for breakthrough pain. Lastly she discontinued use of ibuprofen as her pain relief from Tramadol was

suffer from Migraines usually experience pain on one side of their head. There are several

He was prescribed with the following: Neurontin 600mg 3 tablets daily #90 as it decreases numbness, improves walking and activity tolerance and has no side effects; Zanaflex 4mg, 1 tablet daily as needed #5; Zohydro 10mg, 1 tablet daily #30 with 1 refill as it decreases pain from 9/10 to 6/10, improves walking and activity tolerance, no side effects, no abuse or aberrant behavior, consistent urine drug screen, signed medication agreement and receives pain medication from a single provider; Norflex 100mg, 1 tablet daily as needed #25 with 1 refill as it relieves muscle spasm episodes which allows for increase in walking, exercise, and activities of daily living; Vistaril 25 mg decreased to 1 tablet at bedtime #25 as it improves sleep and increases daytime activity tolerance (2 months supply). Patient will follow-up in 2

Migraines affect nearly 28 million people or 12% of the population in the United States. Migraines are typified by moderate to severe head pain. The head pain is often accompanied by one or more of the following; nausea, photophobia, phonophobia or vomiting. Migraines are considered a chronic neurological disorder. The incidence of migraine related nausea (MRN) is very high among migraneurs. Roughly 90% of patients experience MRN at one time or another. Roughly 50% of patients report experiencing MRN with high frequency (greater than half the time). MRN can hinder the efficacy of currently available migraine drugs in a number of ways. Many patients who experience MRN will delay or avoid taking oral or nasal migraine medication as it can further irritate their stomach. The GI upset associated with migraines can also affect absorption and thus limit systemic exposure to the drug. Researchers have been working diligently to find a solution to this problem.

Migraine headaches. At this point, I am going to have her try Imitrex with her next headache. She is going to start with 50 mg, one p.o. at the onset of her headache, may repeat in two hours, #15 with one refill. She is going to monitor for triggers and try to avoid those if possible. We did review the side effects of the Imitrex and she is aware of what to be watching for. She will let me know if that does not seem to be working. We did talk about increasing that to a full 100 mg dose, if she finds the 50 mg dose is not working.

Patient was unable to identify any triggers for onset or worsened pain (pain 6/10—10/10 being the worse pain imaginable). Pain is slightly decreased with the use of ibuprofen. No report of nausea, vomiting, photophobia, loss of vision, numbness/tingling, weakness, or gait abnormalities. The recent headaches differ from the migraines he has experienced since his first combat deployment in 2009. The migraines have occurred approximately once every 2 to 3 months. The headaches begin with shimmering floaters moving through vision. In addition to a “pounding” sensation, the migraines cause nausea, which lasts between 2 and 36 hours. He has not sought treatment for the migraines, which last occurred approximately 3 months

That morning, H.B. was scheduled to receive Propranolol for her hypertension. When assessing her vitals, her blood pressure was found to be 140/90 and her heart rate was 56 beats per minute (bpm). I double checked the pulse with the pulse oximeter

Excellent POST! Your detailed patient symptoms clearly outline a moderate migraine clinical presentation. Each patient presents differently is also a key to recognizing how to positively treat to meet individual factors (allergies, drug interactions, pregnancy concerns, age ect). For example, Woo and Robinson (2016) identify serotonin syndrome developments with interactions with triptans (p. 1043). Reviewing each patient’s medication list comprehensively is imperative and utilizing resources such as a pharmacist, can positively prevent potential detrimental events.

It lasts only several seconds at a time. Then it is resolved without any residual pain. This has slowly increased in frequency over the year, where it occurs now once or twice a week, but she states she can sometimes go one to two weeks without one and then seems to have two or three days in a row with one of these headaches. She has not noticed any increase in her other headaches frequency. She did have one postcoital headache, which was severe, viselike pain that lasted several hours. She is unable to tell me if there was photophobia, phonophobia, or worsening with exertion, as she stayed in bed. She has never had a coital or orgasmic headache in the past. She has not had any exertional headaches in the past. She did have an MRI, which revealed the two tiny foci of flair hyperintensity noted in the high

According to Key Facts and Figures about Migraine (2014), migraines are the most common neurological condition in the developed world, even more prevalent than diabetes, epilepsy and asthma combined. The statistics on migraines are very alarming because of the very little knowledge of the actual cause of the disease. The migraine trust compiled a list of different studies and concluded the following. “Severe migraine attacks are classified as among the most disabling illness, comparable to dementia, quadriplegia, and active psychosis. There are an estimated 190,000 migraine attacks every day. Depression is three times more likely in people with migraines, Migraines remains undiagnosed and undertreated in at least 50% of patients. Over half

Additionally, there is no specific cure for migraine headaches. In addition, the goal in treating migraines is to treat migraines symptoms. Also, migraines can be treated with amitriptyline or venlafaxine. Furthermore, a migraine can be treated with blood pressure medicines such as propanolol. Researchers have also proven that migraines can be treated with seizure medicines such as valproic acid. (http://www.sciencedaily.com/news). In addition, when I read that you can treat a migraine with seizure medications, I thought that research finding was interesting to be aware of. Also, researchers stated that you could treat a