• migraine

    Photo from livesuperfoods.com

    This article first appeared in the September 2005 issue of Smart Parenting magazine

    Throughout medical history, headaches have been one of mankind’s most common complaints. But did you know that women are more likely than men to have headaches? According to some medical researches, boys and girls are equally likely to have headaches until they reach puberty, when female sufferers surpass males.
    Joel I. Orosa Paraiso, M.D., a neurologist with the New York University Medical Center for 13 years and now holding clinic at the Community General Hospital in San Pablo City, Laguna, explains the nature of different types of headaches plaguing women and gives tips on how to get relief.

    Vascular/migraine headache  
    Mild or slow throbbing that starts usually on one side of the head then spreads to the other side and becomes severe; sometimes associated with nausea and vomiting at the peak of attack; may last for about a few days, after which the patient is headache-free until the next episode. A visual aura (seeing lights/colors or image distortion) may sometimes precede the pain.

    Causes: Changes in hormone levels affecting puberty, menstrual cycles, pregnancy, childbirth, breastfeeding and menopause; alcohol; caffeine; MSG; weather changes; and medications

    Treatment: Depending on the type of headache, a doctor may give prescription drugs that are:
    a. preventive – Medicines that prevent attacks which include anti-depressants, beta-blockers, muscle relaxants and other medication specific for migraines
    b. abortive – Medicines that shorten duration and intensity of attacks

    Muscle tension headache
    Experienced initially on both sides of the head usually in the frontotemporal area; pain manifests as tightness around the head and is usually experienced towards the afternoon and almost on a daily basis.

    Causes: Tight, contracted muscles in the neck, jaw, shoulders and scalp; insufficient sleep; overworking and missed meals; anxiety, frustration and depression

    Treatment: Home remedies such as resting in a quiet darkened room, doing relaxation exercises or having a massage, using hot water bottles/heating pads, having a hot bath, applying an ice pack to the temples or a cool compress on the forehead, and taking over-the-counter analgesics

    Facial pain headache  
    Includes trigeneral neuralgia where there is shooting pain in the upper third, middle third or lower third of the face; and temporal arteritis (inflammation of the walls of the artery) which is usually common among the elderly and females; pain is usually localized and symptoms include impaired vision and pain aggravated by chewing.

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    Causes: Inflammation of the temporal artery (any of the three arteries on either side of the brain)

    Treatment: Anti-epileptic drugs are usually effective in controlling this type of pain.

    Headache secondary to facial/cranial structures
    Causes: Inflammation and pressure of the sinuses triggered by allergies, colds and sinus infec-tions; toothaches and eye problems like glaucoma; dental problems like teeth grinding or dental procedures such as a root canal

    Treatment: Sinus headaches are usually re-solved by taking a decongestant with an analgesic, but if there is infection of the sinuses, your doctor may prescribe an antibiotic; treatment for dental problems is best consulted with a dentist and eye problems with an ophthalmologist.

    Rebound headache
    Causes: Brought about by frequent use of pain relievers for short-term relief that in turn causes the headache to return again and again for increasingly longer periods of time.

    Treatment: Discuss with your doctor what alternatives are available if you find yourself taking more medication with less relief; usually, switching to other medications to prevent further discomfort solves the problem.

    Malignant headache
    This type of headache may be a sign of a serious illness specially when associated with symptoms like vomiting, dizziness, numbness, focal weakness, visual changes, seizures, excessive drowsiness or even personality or behavioral changes.

    Causes: Conditions such as head injuries, brain tumors, infections in the brain, strokes and vascular abnormalities such as aneurysms or AV (arteriovenous) malformations can cause these kinds of headaches.

    Treatment: Since this type is due to an injury or underlying illness, a doctor should be consulted immediately.

    Although headaches such as migraines and tension-type headaches are not dangerous, they have a huge effect on women’s lives. Since most headaches begin after puberty or the early twenties and peak during middle age, debilitating attacks can hamper activities such as starting a family, managing a business or establishing a career. Therefore, headaches that occur frequently should be seen by a health professional so that appropriate treatment can be prescribed. “It is very important to identify the etiology or cause of a headache whether it is coming from within the brain or outside the brain for it to be properly treated,” stresses Paraiso.

    Keep a journal of pain
    Making lifestyle changes and learning relaxation techniques can reduce headache attacks. Moreover, identifying stressors and managing them properly may also limit headache episodes.

    Paraiso suggests that you keep a headache diary to help identify what causes your symptoms. Include details such as date and time the headache began, location of the pain, how it spread to other parts from the initial site, whether it started suddenly or worsened gradually, if there were any experiences prior to the headache, other symptoms, duration, frequency and what you did to make it stop. It will also help to describe what you were doing just before the headache started, what you ate for the past 24 hours, how long you slept the previous night, if there was any stress in your life at the moment, etc. After several entries, you might begin to see a pattern.

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    This diary will also help when discussing your condition with your doctor. Note down all details in tabulated form for easier interpretation. “In any situation, it is always important that we get an objective data from the patient because that is how we can modify and alter treatment,” Paraiso explains. Following treatment plans designed by your doctor should get you on your way to being headache-free.


    Emergency signs
    When do you need to head for the E.R.? Paraiso lists down signs:
    • When the character of the headache changes, e.g., becomes more frequent, intensity worsens, duration of attacks becomes longer

    • When neurological signs occur such as sudden vision changes like double vision, dimness, blurring or loss of vision in one or both eyes; blurred speech; confusion or change in behavior; sudden loss of movement or muscle weakness in a part or all of one side of the body; and seizures

    • Suddenly experiencing the worst headache of your life associated with symptoms such as vomiting, double vision, change in one’s level of consciousness or any other focal-neurological symptoms


    When kids get the ouchies
    Q  Do kids also get headaches?
    A  Migraine headaches are common in children too, especially if there is a family history, says neurologist Joel I. Orosa Paraiso, M.D. He says that if a child’s headache is associated with vomiting or occurs daily, it is best to consult your pediatrician who may refer you to a neurologist if needed.

    Q  Is it okay to give paracetamol to babies and children when they complain of a headache?
    A  “Ideally no, but if the child does not respond to an over-the-counter medication, then a formal consultation may have to be done for proper evaluation,” advises Paraiso.

    Q  So any type of headache in a child should be consulted with a doctor?
    A  “I think mothers have this instinct whether or not her child’s headache is something to be concerned about,” muses Paraiso. He observes that mothers usually start worrying if:
    •  the headaches seem to have a pattern.
    •  the child is not a headache sufferer before and suddenly complains of one.

    Tip: Discuss medication your child has been taking with your doctor so he can formulate a treatment strategy that may include non-medicinal methods to relieve pain such as stress management and relaxation techniques.


    And lastly, when self-medicating:
    ...read carefully and follow all medicine package directions.

    ...do not exceed the maximum recommended dosage.

    ...do not give aspirin to children unless directed by your doctor. (There is the
    risk of contracting Reye’s syndrome, a potentially fatal disease.)

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