Posted by: Theresa | 2019/04/20


Suffered from migraines for 42 years

Over the years have tried everything various triptans to beta blocks. The only med that lifts the migraine with awful side effects is migril, immigran is great but the migraine comes back after four hours.Have been to two neurologists , who have tried a protocol for epilepsy, which also didn’t work. Have recently moved to Pretoria and heard about a drug which I have just started, Toplep , I have been taking 25 mg daily ,have had two migraines after administering for days. Help .

Expert's Reply


Headache expert
- 2019/04/23

Dear Theresa,

Toplep is another anti-epileptic drug. Taking drugs for migraine is not the best way to treat it. Most people who are given drugs to prevent migraine stop taking them either because they don't work, or because the side effects are worse than the migraine. One has to have a proper examination by experts to find out where the pain is coming from - and in migraine it never comes from the brain - even if it sometimes feels that way.

To get to the root of the problem, it is necessary to undergo an in-depth diagnosis to determine exactly where the pain is coming from. 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. To learn more about the multidisciplinary assessment, please click here


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. For more information on how the muscles can affect headaches, please click here. For more information on the involvement of the arteries in the pain please click here and here.


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 here


To contact The Headache Clinic (Johannesburg, Cape Town), call 011 484 0933, or e-mail to

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.

Want to comment?

Thanks for commenting! Your comment will appear on the site shortly.
Thanks for commenting! Your comment will appear on the site shortly.