Full Question:
Last year I developed a severe migraine that lasted for 3 months and left me unable to work. On January 8 of this year I developed the same type of headache only it has lasted 4 months so far and left me unable to get out of bed most days. With both occurrences I have been hospitalized and put on DHE but to no avail. The first time I was also given one round of Botox which didn't help. I have had migraines for over 20 years but these are new. What type of migraine could it be as it doesn't respond to any treatment.
I am frustrated and want to find help but my new specialist doesn't seem to be doing anything to help me. I saw him last week and all he did was prescribe Toradol shots for the really bad days. He has me on Depakote and I think it is causing severe depression but isn't helping with the headache. He hasn't ordered any testing and I can't keep living like this. Kathy.
Full Answer:
Dear Kathy;
Any type of Migraine can become intractable, which means that it doesn't respond to treatment. IV infusion is often excellent for stopping intractable Migraine. DHE is only one of several medications that are used for this type of treatment. You can read more about IV infusion for intractable Migraine in IV Treatment of Refractory Migraines.
Depression is listed as a potential side effect of Depakote. Do not, however, stop taking it "cold turkey." It needs to be tapered down to discontinue it because abruptly discontinuing it can cause potentially serious problems, including seizures.
If you feel your doctor isn't listening, or if you feel you're not making progress with him, remember that there's nothing wrong with getting a second opinion from another specialist. No doctor is the right one for every patient. It’s important to note that neurologists aren’t necessarily Migraine and headache specialists. Take a look at the article Migraine and Headache Specialists - What's So Special? If you need help finding a Migraine specialist, check our listing of Patient Recommended Migraine and Headache Specialists.
As for testing, it's impossible for us to say if any testing would have been appropriate for you. When a diagnosis of Migraine is clear, it's not unusual for no testing to be ordered. There are no diagnostic tests to confirm Migraine. Testing is usually performed to rule out other causes of the symptoms.
Good luck,
John Claude Krusz and Teri Robert
To review other questions from our Ask the Clinician Column,
browse the Ask the Clinician archives.
If you need help finding a Migraine and headache specialist,
visit our listing of Patient Recommended Specialists.
About Ask the Clinician:
Dr. Krusz is a recognized expert in the fields of headache and Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about Dr. Krusz or more about Teri Robert.
