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Searching for the right treatment path

My daughter (20) dealt with migraines when she was young 10-12 years old. After testing and various medications, it seemed to subside in high school for the most part....with the exception of the occasional headache that just required her to go to sleep.

She is now a junior in college and is battling them again. This time they are different. She has had a near constant headache for close to two months. She rates the daily headache at a 2-3 (on a 1-10 scale) with the occasional 10 causing her to vomit and even put her in the ER.

We made her quit her job and move home for the summer to try to get control of this.

We got in with a Neurologist and he examined her and ordered an MRI which came back normal.
He has started her on Topomax and another medication that she is to take if they get severe. She takes one when it gets bad and then a second when the first doesn't provide relief. These meds have brought the severity down to where they don't get bad enough to make her vomit, but she still deals with the constant daily nagging headache.

Now, she is also very tired from the Topomax.

She is a high anxiety gal that deals with OCD as well. Starting back a while before the headaches came back she began taking Zoloft for some sever OCD issues. She says that the Zoloft is a life saver and is scared to death not to take it.

The first thing I thought was the meds.......but she was on them a fair amount of time before the relapse.

Since she is a high stress type of over achiever, I thought that school may be the issue, but she says that this past semester has been the easiest so far and that her stress level is lower than it has been in years.

When the headaches come on, the only sort of relief she seems to get is from me rubbing the muscles around her shoulder blade.

Her posture has never been very good and she wears pretty tight sports bras all of the time. So, now I am wondering if she is dealing with headaches due to posture or tension.

I have ordered her a posture brace, have an appointment scheduled for a medical massage and am wondering if the issue is not neurological but rather, some sort of physical issue.

The headaches are usually on one side of the head.

She also has some jaw soreness and is close to needing her top wisdom teeth removed (something else we are looking at possibly doing this summer).

Does any of this sound familiar to anyone?

My next steps for now are:
-Another visit to neurologist, to let him know the Topomax doesn't seem to help, but the escape meds do.
-Massages to relieve tension
-Posture correcting brace to relieve tension
-Visit to dentist to look at removal of wisdom teeth
-Considering physical therapy

  1. I'm sorry to hear she is going through this, especially while dealing with school. I have been dealing with migraines for 22 years so I have a few things I can tell you.
    1. Topomax is preventive not abortive, so it won't help once she gets a migraine.
    2. The one sided eye pain sounds like cluster headaches, the most painful of all types. So she does need an abortive med.
    2. The jaw pain, back tension, shoulder blade pain sounds like TMJ, it was just suggested to me by a headache specialist (not a neurologist) they aren't always your best bet for migraines. Read up on it and continue seeing your doctor, but make an appointment with her dentist too, a night guard and/or injections may help.
    I hope she gets some relief!

    1. Hi Hizzoner,

      I'm so sorry to hear your daughter is having such a hard time. It's awful to see our children, no matter how old they are, in pain.

      Getting an accurate diagnosis (instead of speculating online, however easy that is) will allow your daughter to get the correct treatment plan and learn all she can about her type of headache disorder. There are over 300 different types of headache disorders of which migraine is just one, and our migraine patterns can change over time.

      It may be time to seek out the expertise of a "true" migraine/headache expert. These doctors are board certified in headache medicine which is different than being certified in neurology. It's not that neurologists aren't good doctors, rather they have a hard time being experts in one area because they treat so many different conditions such as multiple sclerosis, stroke, epilepsy, Parkinson's and others. Migraine/headache experts typically treat one condition all day, every day, migraine and headache. When you get a moment take a look at these articles for more information; and

      I hope this is helpful, please let me know.

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