The Efficacy And Cost Effectiveness Of Prescription Therapy For Chronic Migraine ( Cm )

but these painful, long lasting headaches can leave nasty, long term effects. My reasoning behind

Migraine are also a financial burden, it costs the United State 20 billion each year attributed to medical expenses, and indirect expenses such as missing work. Suffers like myself spent a lot of money on medications, hospital emergency visits and our primary specialists.

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.

On admission, Ms. Pilkey subjectively described her pain as being rather excruciating. There were times when she had to curl up into a ball due to pain during the week prior to admission. Her headaches felt like a “stabbing pick which penetrates her head” that is not localized to a particular region. The initiation of topiramate on July 31st 2015 has helped. The frequency, duration and degree of pain from chronic daily headaches had reduced considerably, allowing Heather to have a better quality of life. However, the degree of cognitive impairment, manifested in difficulty understanding commands and word finding have been more pronounced. In addition, she often forgot to take her morning dose of topiramate due to the cognitive deficits

Trigeminal neuralgia is a severe facial pain that is treated conservatively if possible, and frequently when this fails progresses to glycerol rhizotomy, percutaneous trigeminal nerve compression via balloon radiofrequency rhizotomy of the trigeminal nerve , or posterior fossa microvascular decompression. Atypical facial pain is an extremely difficult problem to treat. Initially it may be treated with medications. Failures are not infrequent. Central post-stroke pain(CPSP syndrome) is also a relatively rare facial pain syndrome. As pointed out by Dr. Konrad, articles suggest that it may affect 1.5 to 8% of all stroke patients[1]. As with the other forms of facial pain, there are few alternatives available. Opiate medications remain available but are usually less than satisfying and frequently meet with only modest success. With the growing epidemic of narcotic usage in this country, the CDC(Center for Disease Control) has produced guidelines for opiate prescribing pattern. It is generally recommended as being contraindicated in chronic pain

Placebos are used as a form of treatment for patients; placebos offer no medication but seem to relieve patents of the pain and symptoms they have (Seymour, 2011). Medication has down sides, such as creating drug dependencies and increased tolerance for the drug resulting in a decrease in the amount of success that drug has to treat the pain. Placebos offer a medicine-free treatment to help patients deal with pain. Many studies have been done to examine the difference between medicine and placebos pills to treat migraine headaches. Placebos have been found to have similar pain-relieving effects to medicine, without the harmful risks the medication has (Seymour, 2011).

The first theory is cortical spreading depression (6). A wave of decreased electrical activity of the nerves in a patient’s brain leads to a change in neural and vascular function (6). In response, an aura is present prior to a migraine. Furthermore, hyper excitability of trigeminal nerves activates the discharge of substance P, neurokinin, and Calcitonin Gene-Related Peptide, all of which are neuropeptides associated with inflammatory processes (8). These substances cause the release of pro-inflammatory mediators in the brain and for vasoconstriction then vasodilation to occur, leading to a migraine (4).

Many genetic factors are also clearly an indicative of the susceptibility to migraine headaches. While the exact mechanism remains uncertain, it is thought that migraines are caused by genetic abnormalities that cause hyper-excitability of the nervous system. The nerve terminals release neurotransmitters such as substance P, neurokinin A (NKA), and calcitonin gene-related peptide (CGRP), which then binds to the receptors on intracranial blood vessels, causing vasodilation, mast cell degranulation, increased vascular permeability and blood vessel edema, plasma protein extravasation, and sterile inflammation. The cranial nerves are then reactivated causing the pain experienced during a migraine.

Migraine is a form of neurovascular pain syndrome with alters central neuronal processing by activating the brain stem nuclei, cortical hyper excitability, and spreading cortical depression ("Migraine: Headache: Merck Manual Professional", n.d.). Migraine also affects the trigeminovascular system, which triggers neuropeptide release and causes painful inflammation in cranial vessels and the dura mater ("Migraine: Headache: Merck Manual Professional", n.d.). Migraine attacks are not caused by a primary vasvular event, but episodic and varies among different patients (Goadsby, Lipton, & Ferrari, 2002).

And although one of the side affects may be a headache, Botox has helped many people who have experienced these chronic

Migraines aren’t recent, in fact that have been around since as early as 7,000 BC, but unfortunately valid treatment was not around back then. ‘Trepenation’ is the earliest form of treatment available for migraines, in which one purposefully drilled multiple holes into the head of the sufferer in order to ‘remove the evil spirits from one’s head’ and was believed to be effective whether that point of view was developed from being consistently closed minded or the surviving patients had experienced the absolute pinnacle of the ‘Placebo effect’. The first effective form of treatment for migraines was only developed multiple thousand years later in 1868, in which a substance created from a fungus known as ergot was used. It continued to be used and developed until eventually during the late 20th century when more effective methods were created and confirmed.

This is where I begin to think that this is what will define what my forever will become. A constant pain in the back of my head that begins to debilitate me. Something that medications aren’t fixing. Something that doctors aren’t finding answers to. A migraine. A constant longing migraine. Today is day 123. I have had this since September. It won’t leave. It keeps getting worse. Don’t try to give me suggestions because I’ve most likely tried them and no, nothing at all works on me by any means.

A migraine is a headache disorder and it affects half of the head. A migraine causes an extremely painful headache. This headache can last hours or even days. Doctors aren’t sure what causes migraine headaches, but they think imbalances in the brain may play a role. There are different types of migraines, but the most common types are; migrane without aura and with aura. The first one, also of which is most common, (Is the with or without Aura?) is considered a common migraine. This type of headache results in an intense headache, usually on one side of the head. This type of headache is usually worsened by movement and can last anywhere from 4-72 hours. Other symptoms may include; nausea, sensitivity to light, noise and smells, and blurred

Migraines and a variety of other types of headaches, such as sinus headache and tension headache, are quite painful. Migraine is a word typically used to describe a wide range of related disorders. They are the most common cause of daily head pain, afflicting more than eighty-seven percent of people who complain of head pain daily. There are many types of migraines: Abdominal migraine, hemiplegic migraine, and ocular migraines. Migraines have many symptoms that can occur in various blends. The typical migraine headache contains throbbing or pulsating, and often is associated with nausea and changes in vision. Migraines can last your whole lifetime. However, in some cases people have lost the pain of migraines due to older age.

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