Posted by: Shelley | 2008/08/21

Cluster headaches

I am having problems for the last week and a half with migraines. I last had a bout of these headaches 3 years ago. It seemed to occur when I wa on leave which was quite strange as I would have thought if brought on by stress it would of happened whilst working. Needles to say I treated it with ant-inflammatories and Migril. My headaches generate on the right side affect my right eye which waters consistently. I became photophobic, nauseaous and had an aura of flicking lights or loss of peripheral vision. I have not been diagnosed by anyone just really from literature. The headaches then stopped and life returned to normal. Now they are back with a vengence no aura I wake up with them and Myprodol is useless. My GP gave me Maxalat whch works wonders my only concern is how long can one continue taking this medication as it is a schedule 4 drug and constantly needs a script. Please help I am trying to avoid things such as alcohol, cheese and choc. I have been on oral contraceptives for 15 years as well as a smoker....

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Our expert says:
Expert ImageHeadache expert

Dear Shelley,

You are correct to be concerned about Maxalt – using this drug on an ongoing basis will lead to Medication Overuse Headache (MOH). MOH is a problem that occurs in headache sufferers who have to take rescue medication on a regular basis - the headaches become more frequent and more severe! Because of this, the patient increases the dosage and takes the drugs more often, and a vicious circle is set up, making the headaches worse and worse.

The answer therefore is not to rely on medication or painkillers! The correct way to deal with the problem is to have a proper diagnosis of the causes of the headache. If the causes are treated, the headaches no longer occur, and it is no longer necessary to rely on potentially harmful “rescue” medication.

To get to the root of the problem, you need 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 assessment must include a thorough examination of the head and neck muscles to determine the presence of abnormal tension. This enables the different members of the team to provide a co-ordinated treatment plan, so that all the contributing factors are addressed.

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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