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MOH or Chronic Migraine/Botox


I am wondering how to differentiate chronic migraine from MOH?

For years I had episodic migraines. On December 2,2015 I ended up in the ER with the worst migraine of my life. The severity has decreased since then, but I have had daily headaches ever since that worsen as the day goes on. Typically they are 2 in morning, and increase to 5 by night (laying down relieves pain somewhat-they are worse upright at end of day).
They are very different from my episodic migraines. More dull, constant and less light and food sensitivities.

When the headaches became daily, I was on clonzapam, lyrica, baclofen and diclofenac for cfs, fibromyalgia,Ehlers Danlos and autoimmune disease. I was also getting Botox cosmetically between my brows to hide my pain from my kids. I had significant muscle and back pain. But only a few migraines a year. I stopped the diclofenac a year ago (in event of MOH) with no real improvement. I also stopped cosmetic Botox. I am weaning off baclofen slowly. But still daily headache. My quality of life is poor.

I have not taken a single pain reliever in 8 months.
While my doctors have dismissed MOH, I still wonder whether any of my meds may be causing the daily headaches?
Can one get chronic migraine abruptly, as I did?

I have not had nerve blocks, but get complete headache relief from novacaine for dental procedures as well as when lidocaine was placed on my sphenoganglion for an endoscope of my sinus. However, the headache returns when block wears off.

I am considering Botox but a bit nervous it could make me worse?.

Any feedback would be greatly appreciated!

  1. Hi Pajk
    I am new to the forum and recognize time has past since your post. Just in case you are still watch I thought I would share.
    My everyday head pain started rather suddenly and I regularly try to think of why. There must be an explanation.
    I think everyone with migraines try to find some meaning to explain why they are happening to me.
    My daily pain varies each day and often it is better in the morning and worse at night. Lately, I have been waking with overwhelming pain in the night. I get up and try to settle myself. That usually gives me a few minutes to rebuild my pain defences and assess what I am dealing with.
    I admire that you can manage your pain without pain medication. Personally, if I was off pain medication for eight months, I would not be concerned obout moh unless there are other drugs like triptans causing rebound headaches.
    I think there is too much emphasis placed on moh when dealing with daily headaches. I get daily headaches and moh is just one of the many contributors to be managed like all the others.
    I tried the lidocaine route and admire you have kept it up. It is certainly affective for certain headaches. Botox also works for many people. It does not sound like you received the full head treatment that most migraine patients receive. In my experience, Botox would not make headaches any worse. However, when I was on two vials, I found the poison was more that my system could easily clear and did feel sick for a few days.
    Hope I have shared useful information from my experience.

    1. I was told I had to treat baclofen as a pain med and keep it under the 10-15 days a month as well. I'm the same as pain is worse standing up. I think my neck and jaw are triggering my daily headache. I have had severe TMJ issues since a kid and then I had jaw surgery that was done wrong and messed up my bite alignment which causes my neck to be misaligned.

      I go to a chiropactor/massage that works on helping me structurally from pelvis up (I have a twist and wrong tilt angle). I also got severe whiplash and moderate concussion a couple years ago which have definitely not helped.

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