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It’s time to learn from those in the know. In every issue of HeadWise ® , our experts
respond to reader-submitted questions about migraine and headache disorders.
HEMIFACIAL SPASMS
I have developed severe hemifacial spasms. They
create a constant headache and seem to be sparking
migraines as well. What is the connection? I have
tried gabapentin, Botox injections, massage and
acupuncture with no positive results. What other
possible treatments could possibly work? –Dorene
I have to assume that this is the correct diagnosis,
but hemifacial spasm is by itself painless. It is usually
treated with Botox, but that needs to be administered
by someone with great expertise in treating that
condition. Carbamazepine and baclofen are
medications that sometimes help. We always order a
MRI scan in this condition to make sure that there isn’t
something, like a blood vessel loop, compressing the
facial nerve in the brain (pons).
Mark W. Green, MD
Mount Sinai Hospital
New York, NY
FERMENTED FOODS AND HEADACHE
I was wondering if raw organic (unfiltered) apple
cider vinegar would be ok for a migraineur like me?
I was told apple cider vinegar is generally made from
crushed apples, but bacteria and yeast are added to fer-
ment the liquid. I know to avoid fermented food and
drinks, so I would like to make sure if it’s ok. –Janet H.
Fermented foods that contain tyramine (caused
by the breakdown of the amino acid tyrosine) are
usually problematic in migraine patients that are
on specific medications that interact with tyramine,
particularly MAOI inhibitors. Apple cider vinegar has
been mentioned as a possible home-based therapy for
migraine, although there is no clear scientific evidence
that it helps. It is unlikely that the unfiltered apple
cider vinegar will trigger a migraine and is o.k. to try in
a migraineur.
George R. Nissan, D.O.
Plano, TX
HEADACHE AND SCHOOL
Why do I always get headaches as soon as I go to
school? I’m a 17-year-old high school student and
most days I get some sort of headache. – Dylan H.
Headaches are a threshold phenomenon, meaning that
anybody can get a headache in the setting of enough
triggers. There are many reasons why the school day
can be the thing that pushes people over the edge in
terms of getting a headache, but it usually isn’t the only
trigger at play. For example, factors like quality of sleep
the night before, quantity and frequency of caffeine
use, hydration status, pattern of not eating breakfast
or skipping meals, hormonal fluctuations during your
menstrual cycle, regularity of exercise, overuse of pain
medication and stress of school are all examples of
triggers that may factor in to whether or not you get
a headache. That being said, anyone who is getting
headaches on a frequent basis should see her doctor for
a thorough evaluation to make sure there aren’t other
underlying medical reasons for headaches. The most
important thing to do is to begin keeping a diary of
your headaches so that you can track when they happen
www.headaches.org
|
National Headache Foundation
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