I am not sure I actually have migraines and was wondering if you could help. I do not get the typical migraine symptoms such as nausea and the excruciating pain in the head. But I do have either a good headache or lightheadedness at least 50% of the time. Some doctors have called this a migraine and some have not. I was given Topamax, but am afraid to try it because of my sensitivity to medicines and the fact that it may not be a migraine after all. My brain MRI and blood work all come back normal. Thanks for your insight, Maria.
For a diagnosis of Migraine, there should be symptoms other than headache and lightheadedhess. You're right on that issue. For a Migraine diagnosis, the headache should have at least two of the following characteristics:
- unilateral (one-sided) location
- pulsating quality
- moderate or severe pain intensity
- aggravation by or causing avoidance of routine physical activity (e.g., walking or climbing stairs)
During the headache, you should have at least one of the following:
- nausea and/or vomiting
- photophobia and phonophobia
This article outlines the four potential phases of a Migraine attack and their symptoms - Anatomy of a Migraine. It should help give you an overview of a Migraine attack.
MRI and blood work usually come back "normal" in Migraineurs. Is there any history of Migraine, sick headaches, or sinus headaches in your family? Migraine is genetic, so a known family history is also one element of diagnosis.
As for medications, if this is Migraine, there are many, many options for you. If you're uncomfortable with Topamax, as your doctor about other options. There are now over 100 medications and supplements that can be used for Migraine and headache prevention. The frustration of trying to find what works for us can make it seem as if we’ve tried it all, but with so many possible preventives, it’s literally impossible to have tried them all. See Migraine preventive medications – too many options to give up! for more information.
Given the uncertainty of your diagnosis, it may well be time to consult a Migraine and headache specialist. 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.
John Claude Krusz and Teri Robert
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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Published On: December 28, 2008