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Daily persistent headache. All treatments failed.

Hello! My girlfriend suffers from a severe headache (8-10 points) every day. Suffering for a long time, from the age of 10, but for the last 2 years the pain has intensified. She has several serious diseases: Epilepsy (seizures 2-3 times a month), Multiple sclerosis (in remission), Depressive-anxiety disorder.

We sought treatment and tried all possible methods: Ibuprofen 800 mg, Paracetamol + Caffeine in high doses, Analgin, Spasmalgon, Triptans of all kinds (including Relpax), long-term use of antidepressants (Velaxin did not fit, switched to Brintellix), monoclonal antibodies course 6 months (two types), Botox (6 months - 3 times). She also regularly takes Gabapentin for epilepsy.
And alas, none of the above helped. Ibuprofen helped a few years ago.

MRI with contrast shows that the foci of multiple sclerosis are stable, there have been no changes in them in recent years. They found a suspicion of "Angioma of the brain", but the neurosurgeon assured that it was too small and in its infancy, so it could not affect the headache.

Tell me, please, are there any other ways to help cope with a headache ... The girl is young, 25 years old, and the headache greatly interferes with life. We are ready to go to another country for treatment, but we do not know where to turn for help with our problem.

  1. I am sorry your girlfriend has suffered for such a long time with no lasting relief. You have found a community where we understand how migraine impacts a person's life. Welcome to our community. It certainly sounds like you have been through a lot with your girlfriend. I'm glad she has you there to support her. Hundreds of drugs are used to manage migraine alone or in combination. For my husband, combination therapy is helpful. He combines drugs, and with the help of his migraine specialist, they have found a few non-drug therapies to add on that make his treatment plan more effective for him. His non-drug therapies currently are mindfulness/meditation, a neuromodulation device(Nerivio), biofeedback, and chiropractic care. Combined with supplements like magnesium, D3, and CoQ10, he has found a place where his chronic migraine is managed to the point that he can function normally most days. These may be options you may want to discuss with the doctor. Here are a couple of articles based on some of those therapies.
    https://migraine.com/living-migraine/mindful-meditation-insomnia
    https://migraine.com/living-migraine/mindful-meditation-insomnia
    https://migraine.com/blog/cefaly-migraineurs-review
    https://migraine.com/chronic-migraine-pharmacologic-management
    I hope these give you some insights into possible add-on treatment options.
    We are here to support you, so don't hesitate to keep reaching out in the different areas of the community. There is a lot of experience here! Let us know how things go moving forward. Warmly, Cheryl migraine.com team

    1. - So thankful you took the time to write us. What a journey for you both and how kind of you to be seeking answers and routes for relief on her behalf. It sounds like she has tried so many treatment strategies.
      I wanted to echo what shared regarding the importance of combining strategies to create an overall treatment protocol. I've lived with chronic daily migraine for decades now and for me - the best relief I've found comes when I put together multiple preventative and rescue approaches- natural and western therapies combined.
      So, an example would be the Botox- to perhaps try that hand in hand with another therapy.
      The only treatment that stood out to me that you did NOT mention (in your long list that showed how much effort and time she has put into this process) is anything in the CGRP family. Forgive my ignorance if there is a reason for this (like one of her other medical conditions means she cannot take that class of drugs). but if they are available to her, I would definitely recommend that she talk to her specialist about this. They are a newer class of migraine drugs (unique in that they are specifically designed to treat migraine as most other migraine drugs were created for other things and then found to help with migraine). There are now a number of types of these drugs- they can be taken monthly, daily - orally, by injection - some are preventative, some are rescue- others are both: https://migraine.com/cgrp-new-direction-migraine-treatment. Definitely worth exploring if she hasn't already.
      This leads me to my last question - is she seeing a migraine specialist? I realize she is juggling multiple conditions however, we strongly recommend those who are navigating chronic migraine to be evaluated and treated by a migraine specialist. These are neurologists who have specialized training in the complex neurological disease that is migraine. If we can help to send you resources on a referral to a migraine specialist, just let us know.
      One final thought on medication- has she ever tried Topamax? This is a drug that was created to help with seizures/epilepsy that was found to be effective at preventing migraine. So in your girlfriend's case, it could assist her with two of the conditions she is facing. It does have some side effects (aphasia, primarily - that can come on strong as the medication is being onboarded). Again, this would need to be discussed with her doctor - but just thought I'd mention it.
      I hope this proves somewhat helpful. Please know we are here for you anytime to provide support and information for you and your girlfriend as you continue along your journey.
      Warmly- Holly -migraine.com team.

      1. Hello! Thank you very much for such a long answer! Sorry for not answering for a long time, I was in surgery, but already at home 😀

        Alas, we have been using CGRP for 6 months. And it did not help, although we really hoped for this medicine.

        We tried drinking Topomax, but it didn't help either. And caused a lot of side effects due to epilepsy.

        Yes, we are treated by a doctor who only deals with migraines. But our doctor doesn't know how to help us.

        In any case, thanks a lot for your help!

      2. Thank you so much for circling back to help us understand more about your journey and the comprehensive list of all you've tried. We are here for you and with you as you continue along in your search for relief. You are not alone in this. Warmly- Holly -migraine.com team.

    2. Where are you both located (country)? There are migraine specialists in the United States but I am also curious to know about her previous interactions with her medical team. She has many different conditions, and management of all of them together in a delicate process, I'm sure. Particularly, MS and migraine are common comorbidities -- not for everyone, but for some. Don't lose hope. There are hundreds of possible migraine regimens, and it can take a lot of trial and error. Botox and other medications can take several months to see results. And often it takes several medications or regimens working together, plus diet and other lifestyle changes, to start to manage attacks.

      Please feel free to share more with us and we will do what we can to suggest new ideas, but remember that only her doctors can give medical advice. She is also welcome to join us here -- if you are interested, we also have websites for MS (MultipleSclerosis.net) and epilepsy (EpilepsyDisease.com) that you can visit if you're interested in exploring those angles as well, even if she is stable at this time (good news!).

      You are a good partner for showing such concern. We wish you both all the best, please keep us informed when you can. -Melissa, migraine.com team

      1. , Odd how that happens sometimes! Here is the link to those resources.
        https://mediglobus.com/clinics/country-korea/diseases-migraine/
        Warmly, Cheryl migraine.com team

      2. I am unfortunately only familiar with the healthcare system in the US and (much less so) the UK. I would look into the resources Cheryl suggested below, and even see if your doctors have any colleagues they are aware of elsewhere. Both of you take good care of yourselves in these unsettled times! -Melissa, migraine.com team

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