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them in random spots of the head. Often they are seen in conjunction with other primary headache such as migraine, although the stabbing headaches and more typical migraine attacks do not typically occur simultaneously. They are too brief to treat as they occur, but if they become quite frequent a medication known as indomethacin may be helpful.
Robert Kaniecki, MD
The Headache Center University of Pittsburgh Pittsburgh, PA
neW dailY PersisTenT HeadacHe
My headache began January 21 of last year 2012 and I have had it every day since. From what I have read, my situation is like others who have this condition. Meds don’t seem to work so you continue to try new ones via a neurologist who specializes in headaches. All tests are clear – MRI, MRA, MRV, CT scans, blood work, spinal tap. I occasionally try alternative methods– Botox, occipital nerve block, chiropractic care, naturopath, Chinese herbalist, massage, yoga, Thai yoga therapy-none of which help with the headache either. I have read that this can last from months to decades. Is there any current information on the most successful approaches to make the headache go away? –Amy K.
visual field loss and HeadacHe
i feel as though there are times when i get a this cause the headache to not go away? –sherry P.
migraine that i take too much medicine. Would
Thank you for an important question. The fact is that most medicines used to treat attacks of migraine can make future attacks more frequent and challengi ng to treat. This condition is called medication overuse headache and is an important risk factor for migraine to go from being episodic to chronic (more than 15 days of headache per month). The acute medications most incriminated in this process include opioids, butalbital, triptans, ergotamines, and caffeine–containing analgesics. For this group of medications a person is at risk if they use the medication 10 or greater days per month. For nonsteroidal anti-inflammatories and simple analgesics, the limit is generally set at 15 or more days per month. When migraines are becoming more frequent and the use of acute medication is increasing, it is wise to see your healthcare professional and consider preventive medications and behavioral adjuncts that can reduce the frequency of migraine.
Roger K. Cady, MD
Headache Care Center Springfield, MO
New Daily Persistent Headache (NDPH) is unfortunately a poorly understood headache disorder. It is characterized by the onset of a headache that becomes chronic very rapidly. In many cases, as is your history, people identify the very day the headaches started and report that it has been present since that time. The headache typically waxes and wanes throughout the day and is of moderate intensity. Associated symptoms similar to migraine are often present though less intense. Sometimes this headache is preceded by a viral infection but no specific virus has been identified and this is certainly not the case for everyone.This headache pattern can persist for years and as such it can be a very disabling headache syndrome. There is no specific treatment for NDPH and generally migraine preventive medications are tried to see if they can be beneficial. Some specialists feel gabapentin may be effective in some cases, but there is little data to support this and most of the time it is a trial and
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Volume 3, Issue 2 • 2013