Posted by: GS | 2009-03-11

Need effective help and info.

Hi Doc,

My daughter is 25 and has suffered from Migraines for years. She has been on all knds of Meds Topomax, Tripeline and many more. Nothing seems to help her. She is off from work at least once a week due of a migraine and it takes her at least 2 days to get over the after effects. She sees a neurologist every 6 months. She has tried physio and needleling shoulder and back etc.

She is taking off work again tomorrow as she can feel it coming on....
What more can she do? She is now so dispondant that she does not even bother with doctors anymore, she just takes more and more pain killers...... I don' t know how to help her, I worry all the time as she lives alone. She also suffers from panic attacks. I just want to cry as I feel so helpless.

Any suggestions please and thank you.

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Our expert says:
Expert ImageHeadache expert

Dear GS,

None of the medications that are used by Neurologists to prevent migraine were actually designed for that purpose. What they found was that some people taking trepiline for depression also reported that their migraines improved. The same for topamax, which is an anti-epileptic. The panic attacks are what they call a co-morbidity with migraine – in other words the attacks occur more frequently in migraineurs. They usually subside when the migraine has been successfully treated.

To get to the root of the problem, your daughter needs what is called a “multidisciplinary assessment”. There are so many different structures in the head and neck, all of which can be involved in the headache process, that no single specialist can have all the knowledge necessary to make a comprehensive assessment and diagnosis. For instance, a neurologist will examine the brain and nervous system, a physiotherapist will look at the muscles, a dentist will examine the teeth etc. For this reason, the “multidisciplinary assessment” combines and integrates the expertise of different specialists who would normally treat headache patients in isolation, into a single more comprehensive body of knowledge. This enables the different members of the team to provide a co-ordinated treatment plan, so that all the contributing factors are addressed.

This assessment must include a thorough examination of the head and neck muscles to determine the presence of abnormal tension, and of the external carotid vasculature to determine whether there is an arterial element to the pain.

If the correct diagnostic procedures are done, then the treatment can be directed at the actual cause of the problem, and the results are excellent in most migraine sufferers.

Headache sufferers often have a poor Quality of Life due to the constant pain and associated symptoms. For a free assessment of how your headaches are affecting your Quality of Life, click on

This information has been supplied and checked by the multidisciplinary team of specialists at The Headache Clinic, in association with The International Headache Society and the South African Institute of Headache and Migraine Science. For consultation with these specialists, call The Headache Clinic (Cape Town, Durban, Johannesburg) on 0861 678 911.

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

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