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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Migraine

I have had migraine headaches for several years now. They started in my early 20s and I am 35 now. Recently, within the last few months, I have noticed my face itches just before and then during the migraine. Only on the side of the migraine. After the migraine is over, the itching stops. Also, since the itching, the migraine pain has changed somewhat. The pain moves around my eye. It usually starts in the temple, like normal, but then moves to my cheek or the back of my eye or above my eye or the bridge of my nose or the scalp on the same side and then back to the temple again. All the while itching above where the pain is currently, or is about to jump to. The skin on my face and scalp is slightly more sensitive than on the other side. No rash. No swelling. No eye irritation. Once, I had blurry vision on the side of the migraine. It has been getting more frequent. Excedrine migrain/other migrain treatments still seem to work for the headache itself to some degree, as before, but nothing seems to calm the itching. What could this be? Should I be concerned?
Fri, 18 Oct 2019
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General Surgeon 's  Response
Hello,

In the absence of other info, speaking of the treatment of a migraine attack, I would say that the best initial choice is over the counter anti-inflammatory pain killers (NSAIDs) like Ibuprofen.

If not effective and typical migraine with severe pain a class of medication called triptans is the chosen drug, most common representants are sumatriptan, zolmitriptan.

If nausea and vomiting is an issue they are available also as a nasal spray, or for sumatriptan also as patch or subcutaneous injections.

Another alternative to triptans would be DHE (dihydroergotamine) also available as a nasal spray.

In some cases antiemetics (antivomiting) medication is also effective, like metoclopramide, chlorperazine. There are preparations on the market containing acetaminophen or a NSAID with an antiemetic.

In rebel severe cases where nothing works might need iv medication in the emergency room.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Iven Romic Rommstein, General Surgeon
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Suggest Treatment For Migraine

Hello, In the absence of other info, speaking of the treatment of a migraine attack, I would say that the best initial choice is over the counter anti-inflammatory pain killers (NSAIDs) like Ibuprofen. If not effective and typical migraine with severe pain a class of medication called triptans is the chosen drug, most common representants are sumatriptan, zolmitriptan. If nausea and vomiting is an issue they are available also as a nasal spray, or for sumatriptan also as patch or subcutaneous injections. Another alternative to triptans would be DHE (dihydroergotamine) also available as a nasal spray. In some cases antiemetics (antivomiting) medication is also effective, like metoclopramide, chlorperazine. There are preparations on the market containing acetaminophen or a NSAID with an antiemetic. In rebel severe cases where nothing works might need iv medication in the emergency room. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Iven Romic Rommstein, General Surgeon