Top 75 Migraine and Headache Questions, #72

Ask the Clinician Health Pro
  • Full Question:

    I am a 43 year old female with a history of migraine since age 21. For the last two years, the frequency of the migraines have dramatically increased to 3-4 times per week. I limit the use of Relpax to two times a week to prevent rebound. I have been tried on Topamax up to 200 mg/day with no improvement. I am now on Inderal 60 mg bid with some improvement. Head MRI was negative. Do you recommend any vascular studies to be done in addition to the MRI? My headaches are almost always left sided with pain over the eye, temple and down the neck, especially under the left ear. The migraines are significantly worse 7 days premenstrually but also occur at other times. Do you think additional studies or lab are needed? Lab done previously has been negative (TSH, magnesium, CBC). Susan.


    Dear Susan;

    It's not really possible to recommend that more testing be done or not be done for a patient never seen in our office. That being said, you have had the tests most commonly ordered for headache or migraine. So unless there are unusual symptoms, in most cases, no further testing would be ordered. Keep working with your doctor on your preventive regimen. You're making progress but, obviously, there's room for more. It's often a combination of agents that provides the best reduction in frequency and severity rather than a single medication.

    Good luck,
    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 Patient Teri Robert, team up to answer your questions about headaches and migraines. You can read more about Dr. Krusz or more about Teri Robert. If you have a question for this section of our site, please click HERE. Accepted questions will be answered by publishing the answers here. No questions will be answered privately.

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Published On: February 20, 2007