No specific test can diagnose migraines. So your doctor needs to ask a lot of questions and rule out other problems to know if you have them.
She may ask you to keep track of your headaches for a few weeks -- when you get them, your symptoms before and during them, and anything that seems to trigger them. These patterns can help her decide if your headaches are migraines.
You’ve tried everything for your cluster headaches, and you've gotten no relief. Is it time to look into an experimental treatment called neurostimulation?
The basic idea is to use electricity to activate nerve cells, which alters your body’s pain signals, says Joel R. Saper, MD, founder and director of the Michigan Headache & Neurological Institute in Ann Arbor.
Some of the devices that do that are hand-held. For others, you have to get surgery to implant them, usually in your head.
She’ll also want to know whether headaches run in your family. Plus, she’ll do a careful physical exam to make sure you don't have any other symptoms that point to another health problem as the source of your headaches.
What Are the Treatments for Migraines?
There are two main ways to treat them. The first is to stop a migraine, if possible, or at least to control your symptoms, like pain and nausea. The second way is to prevent future attacks.
Stopping Migraine Pain
To stop the pain, it's important to take medication at the first sign a migraine is coming. So, if you have an aura or other symptoms before the headache starts, take the medicine then.
Many drugs can help, but the leading ones are called triptans. They come in different forms including dissolvable pills, regular pills, skin patches, and nasal spray. They include rizatriptan (Maxalt), sumatriptan (Imitrex), zolmitriptan (Zomig), and others. Some of these drugs may work better for you than others. It may take some time before you and your doctor can find the right one.
Ergot alkaloids are another type of drug that can stop a migraine. The most popular one is dihydroergotamine (DHE). You can take it as a nasal spray or a shot. NSAIDs (nonsteroidal anti-inflammatory drugs), such as ketoprofen or ibuprofen, may also stop a migraine attack. Often, doctors recommend taking anti-nausea drugs, too.
Your doctor may suggest the Cerena Transcranial Magnetic Stimulator (TMS), a prescription device you place on the back of the head at the start of a migraine with aura. It releases a pulse of magnetic energy to part of the brain, which may stop or lessen pain.
Aside from taking medicine, you’ll want to be as comfortable as possible until your migraine stops. Try lying down in a dark, quiet room and trying to sleep. Put a cold pack on your head. If nausea or vomiting keeps you from taking medicine or your symptoms don't improve, you may need to go to a hospital for treatment.