Migraine Management Essential 1: Diagnosis and Doctors
What type or types of Migraines do you have? If the only diagnosis you’ve been given is Migraine, the diagnosis is incomplete
There are several types of Migraines, and it’s important to know which types you have. Migraine without aura is the most common, followed by Migraine with aura. Most people who have Migraine with aura also have Migraine without aura. There also subtypes of Migraine with aura — basilar-type Migraine, sporadic hemiplegic Migraine, and familial hemiplegic Migraine. There are also other types of Migraine, retinal Migraine and abdominal Migraine.
Why we need to know what type(s) of Migraine we have:
One reason we need to know what type or types of Migraine we have is related to which medications we can use when a Migraine strikes. Triptans (Imitrex or generic sumatriptan, Maxalt, Zomig, Amerge or generic naratriptan, Relpax, Axert, Frova, and Treximet) and ergotamines (DHE-45 and Migranal Nasal Spray) are usually not prescribed for basilar-type Migraine. They’re usually not prescribed for hemiplegic Migraine either, but one small study in which participants with Hemiplegic Migraine were given triptans did not show any problems. Especially if we have different types of Migraines, it’s important to know what they are and be able to identify them when they occur. We can’t call our doctors every time we have a Migraine, so we have to determine which medication to take and when to take it.
We also need to know what type of Migraine we have because they’re less frightening when we understand more. If you’ve never been told what type of Migraines you have, ask your doctor. If your doctor can’t answer the question, it may be time to consider a new doctor.
The right doctor:
Whether we’re dealing with Migraine disease or another disease, the right doctor is integral to good disease management, feeling better, and a better quality of life. We need to be proactive about managing our Migraines, so the right doctor is one who wants to work with us as treatment partners. We need doctors who will lay out all of our options, then make decisions with us, not for us.
In some cases, family doctors can help with Migraine management. In other cases, neurologists can help. In some cases, however, we need a specialist who regularly participates in continuing medical education about Migraine and has gained valuable experience by limiting his or her practice to Migraine and other headache disorders — a Migraine and headache specialist.
If you think you need a new doctor, or if you’re curious or unsure, you can find more information in my post Is It Time for a New Migraine Doctor?