SWITCHING OFF HEADACHES
REPORT: MB #2997
BACKGROUND: Hemicrania continua is a rare, treatable headache, that is not caused by any outside conditions. To be diagnosed, one must suffer from a headache for more than three months and experience headaches marked by continuous pain on one side of the face which varies in severity. More women than men suffer from hemicrania continua, and the cause is unknown. Symptoms include runny nose, tearing, eye redness, eye discomfort, sweating, and swollen and drooping eyelids. Migraine-like symptoms include nausea, vomiting and sensitivity to light and sound. There are two types of hemicrania continua -- continuous and remitting. Continuous is marked by daily headaches. Remitting takes place when the headaches last for months at a time and are followed by a short pain-free period of either weeks or months until the headache reoccurs.
TREATMENTS: For hemicrania continua and other types of chronic headaches, the most commonly recommended treatment is medication. Antidepressants are the most common medication prescribed for all chronic headaches except hemicrania continua. These drugs also help alleviate the daily stressors that often come with the chronic headaches. Tricyclic antidepressents such as nortriptyline (Pamelor) and protriptyline (Vivactil) are the most effective against headaches, according to the Mayo Clinic. Beta blockers are drugs commonly used to treat high blood pressure, but they also serve as medication to treat chronic migraines. Doctors often prescribe beta blockers to be used with antidepressants for better results. These medications include atenolol (Tenormin), metoprolol (Lopressor, Toprol), nadolol (Corgard) and propranolol (Inderal). Chronic daily headaches may also be treated with anti-seizure medications such as divalproex (Depakote), gabapentin (Neurontin) or topiramate (Topamax). When the migraine is very severe, or if one is going through withdrawal from other pain relievers, prescription nonsteroidal anti-inflammatory drugs may be used. These include naproxen (Aleve, Anaprox), ketoprofen and mefenamic acid (Ponstel).
The most common drug used to treat hemicrania continua is an anti-inflammatory called indometacin. This provides quick relief from most symptoms, but may cause stomach problems for some patients. Doctors also may recommend less-effective drugs such as ibuprofen, celecoxib or naproxen for temporary symptom relief.
OCCIPITAL NERVE STIMULATION: An alternative to drugs, occipital nerve stimulation is a new treatment for hemicrania continua. The method involves implanting a suboccipital bion device into the head which emits nerve stimulation. The use of a miniature nerve stimulator decreases pain for patients by 80 to 95 percent, according to a study conducted University of California, San Francisco. Previous trials have reported the nerve stimulation method is a safe and an effective long-term pain treatment.
OTHER METHODS: The transcranial magnetic stimulator (TMS) is another recently developed, non-drug treatment for chronic headaches. The device stimulates function in the targeted brain areas with a highly focused, pulsed magnetic field. It is currently being used to treat patients with migraine and depression. Researchers at Ohio State University report that this device may actually treat headaches rather than simply temporarily reduce the symptoms.
FOR MORE INFORMATION, PLEASE CONTACT:
Lauren Hammit
UCSF Public Affairs
(415) 476-0557
