Posted by: Anonymous | 2009-06-05

Puzzling migraines

My friend is struggling with migraines. He' s been for tests, but they can not figure out why he gets them or how to avoid getting them. The only triggers we have so far identified as possible causes is sweet things - buiscuits almost always causes it, too much chocolate or sweets and sweetened fruit juices. Stress and not getting enough sleep also seem to trigger them but not always. Funny enough since he started smoking he is getting them a bit less even though he still eats the same things and has the same stress. HIs eyes go blood red when he gets one of his migraines and the pain is so bad that it makes him nauseous. Nothing seems to work, drinking pain pills just seem to stretch out the time it takes to blow over, yet once he' s thrown up from the pain it seems to break after.
He' s not on a medical aid and we don' t have money for more tests at the moment.
Any ideas what might be causing this and what he can do to be rid of these nasty headaches for good?

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Our expert says:
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Dear Anonymous,

If the tests your friend has had showed up nothing, then he has had the wrong tests. Unfortunately there is only one way to treat migraines properly, and that is to first diagnose where the pain is coming from, and then to treat the structure that is responsible for the pain. To get to the root of the problem, he needs what is called a “multidisciplinary assessment”, which should include a neurological examination to rule out any serious underlying condition. 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.

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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