12/17/07 #6 - 15 year old daughter with 3-month Migraine?

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  • Full Question:
    My 15 year old daughter has been out of school with severe migraine for three months. Triptans do not work for her. She's seen three pediatric neurologists. She's been hospitalized twice for DHE infusion (20 doses) with magnesium sulfate, Toradol and Depakote. She has sinus surgery to clear out her infected sphenoid sinus. She's been on Topamax, Indocin, Zanaflex, Elavil, Corgard, and high dose prednisone. She had Botox injections. She just had a spinal tap today, which shows normal pressure. She's had acupuncture, biofeedback, psychotherapy and yoga sessions. Nothing works.

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    She suffers from central and cutaneous allodynia, so the slightest touch of her head, face and neck are torture. The neurologist is suggesting Sansert, but the side effects are really scary, and I read that it does not work for acute migraine, which my daughter has had for months. Doc also suggests going to Mayo Clinic for a second opinion, and notes that her headache may never go away. I'm worried that my 15 year old daughter will be spending the rest of her life in a dark, cold and quiet room! Do I have reason to offer her any hope? What have we not tried that we can try?  Please help! Abby.






    Dear Abby;


    For several reasons, including some potential cardiac effects with long-term use, Sansert is seldom used these days. When used, it is definitely a preventive, not for acute Migraine.


    I don't know where you live, but there may be good Migraine specialists closer to you than the Mayo. There's a link below to our directory of recommended specialists. At 15, your daughter really doesn't need to see a pediatric Migraine specialist; a "regular" specialist would probably be better.


    From what you said, there are still many choices for IV therapies to break her current Migraine. See IV Treatment of Refractory Migraines for more information about other medications that can be tried. Once this Migraine is resolved, it may well be time to find an effective preventive for her. Once again, there are many options. There are now over 100 medications in use for Migraine prevention. You can find a comprehensive listing of them in Migraine preventive medications: too many options to give up!.


    Since her current neurologist commented to you that "her headache may never go away," it's time to move on. Remember that neurologists aren't necessarily Migraine specialists, and it sounds like time for an actual Migraine specialist. Please don't give up and don't let her give up. As much as she's already tried, there are still many, many options open to her.


    Good luck,
    John Claude Krusz and Teri Robert


    If you need to find a headache and Migraine specialist, please see our listing of patient recommended specialists.


    Another good source of information and support is our forum. To post to the forum, you'll need to register, even if you're already registered on the main section of our site. You can use the same email address and password for both registrations.


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    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.


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    © Teri Robert and J.C. Krusz, 2007.

    Last updated December 17, 2007.

Published On: December 17, 2007