Category: Headaches

Are There Different Types of Migraine?

Posted on July 16, 2020 Headaches

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Migraine is more than just a bad headache. It is a neurological disease that has subtypes that may present with a variety of symptoms beyond head pain. There are several types of migraine that have different characteristics.

8 Types of Migraine

1. Migraine without Aura (Common Migraine)

Migraine without aura is also called common migraine. Symptoms include pulsing or throbbing pain on one side of the head. Sensitivity to light (photophobia), sensitivity to sound (phonophobia), nausea, and vomiting are also symptoms of this type of migraine. Pain may worsen during physical activity. Symptoms typically last between 4 and 72 hours. If the attack lasts beyond 72 hours, it is referred to as status migrainosus.

2. Migraine with Aura (Classic Migraine)

Migraine with aura is a type of migraine that includes symptoms like sensory and visual changes. These visual changes are referred to as an “aura” and can include seeing spots, zigzags, or flashes of light. Other symptoms may include difficulty speaking clearly or tingling and numbness on one side of the body. These symptoms can last anywhere from 10 to 60 minutes. Often these symptoms are a signal that a severe headache is about to occur.

3. Silent Migraine

A silent migraine may also be called an Acephalgic Migraine. This type of migraine does not include head pain as a symptom. Instead, people experience an aura, visual disturbances, dizziness, nausea, or other migraine symptoms. Silent migraine often affects people who get other types of migraine as well and it can be brought on by the same triggers.

4. Hemiplegic Migraine

This type of migraine has symptoms similar to a stroke. People who have hemiplegic migraine experience weakness on one side of the body, loss of sensation, and/or a sensation described as “pins and needles” on one side of the body. Someone having a hemiplegic migraine may also experience visual aura symptoms but no head pain. These episodes can for just a few hours or for several days.

5. Retinal Migraine

A retinal migraine is a type of migraine that causes visual disturbances in one eye before the headache phase of the migraine attack. Visual symptoms may include temporary blindness, seeing twinkling lights (scintillations), or having areas of decreased or lost vision (scotoma). The headache phase of the migraine begins within 60 minutes of the visual symptoms. According to the American Migraine Foundation, retinal migraine is most common in women during their childbearing years.

6. Menstrual Migraine

If an individual has severe headaches accompanied by other symptoms of migraine that occur between 2 days before their period and in the first 3 days of flow, they may be menstrual migraines. Menstrual migraine is triggered by the drop in estrogen levels that occur just before a menstrual period. True menstrual migraine headaches only occur before the menstrual flow, but many women who are migraine suffers may experience headaches both around their menses at at other times. Your neurologist may be able to adjust your therapy based on your pattern.

7. Abdominal Migraine

Abdominal migraine is typically seen in children between the ages of 5 and 9 but can occur in adults as well. Children who experience abdominal migraine may experience other types of migraine as adults. Abdominal migraine typically consists of abdominal pain, nausea, and vomiting as primary symptoms. The pain can be moderate to severe and is usually located in the middle of the abdomen and is often described as a dull or “sore” type of pain. Attacks can last between 2 and 72 hours.

8. Chronic Migraine

According to the International Headache Society, chronic migraine is defined as a headache occurring on 15 or more days per month for more than three months. And on at least 8 days per month, the headache must have the features of migraine headache. This tends to be the most debilitating form of migraine and one of the most disabling afflicting humanity. Many people who have this type of headache, forget about the daily headaches that they experience, and only “count” the severe migrainous headaches, and don’t realize that they have chronic migraine. Fortunately, although this condition is quite debilitating, it is also quite treatable, and there are even specific therapies that are developed just for chronic migraine. If you think that you have chronic migraine, it is important to see your neurologist.

Regional Neurological Associates is happy to report we are reopening to see patients in-office for conditions like migraine. Patients can now make same-day appointments and expect to be treated with the best care and attention. Our current office hours are: Monday – Friday from 9 am – 4 pm. If you have questions or concerns about your neurological health, call us at (718) 515-4347 to make an appointment.

While we are pleased to be seeing patients in the office again, we ask that anyone experiencing symptoms like fever, cough, or shortness of breath reschedule your appointment or schedule a telemedicine appointment. Please contact our office to change your in-person visit to a Telehealth visit (718) 515-4347.

Botox for Pain Relief: How it Works

Posted on April 29, 2020 Chronic Pain, Headaches

Most people are familiar with Botox injections as cosmetic procedures, but many people don’t know about the benefits of botox for pain relief. Botox is effective for treating chronic pain as well as for cosmetic purposes. For people who have a chronic migraine or another headache disorder, these injections can provide much-needed relief and greatly improve their quality of life.

When is Botox for Pain Relief Used?

Botox injections are used for pain relief for several conditions. In neurology, Botox is used primarily for the treatment of chronic migraine. However, it can be used for pain relief in other instances. The most common uses of Botox for pain relief are:

Chronic migraines
Tension headaches and other headache disorders
Nerve pain
Chronic neck and back pain
Arthritis

How It Works

Botox for pain relief uses a diluted form of botulinum toxin type A. Small amounts of the diluted toxin is safe to inject into the muscles to relieve the pain associated with migraine, headache disorders, nerve pain, and other types of chronic pain. Botox helps treat headache disorders like migraine when injected into the pain fibers associated with headaches. For treatment of other types of pain, the injections function the same way but are given in different areas. Botox works by blocking the release of chemicals that activate a pain response in the brain.

What to Expect

During the procedure, the doctor will ask the patient to contract their muscles to help identify the treatment sites. After determining the locations for the Botox injection, the physician will give the injection. These injections typically contain a mixture of botulinum toxin and saline solution or local anesthetic. Between five and 10 injections in multiple areas may be needed to successfully relax tense muscles. The procedure usually takes about 5 minutes.

Shortly after administering the Botox injection, patients may experience mild side effects such as swelling, bruising, and some pain. Rarely, patients will experience nausea, a temporary headache, and other flu-like symptoms. However, most complications are short-term and resolve without medication. Patients can apply ice to the treatment site and take over-the-counter pain killers to reduce any discomfort.

Other Injections for Headache and Migraine Relief

The Botox injection should begin working within 10 to 14 days, with long term pain relief lasting anywhere from three to four months. Therefore patients may need additional medications to ensure sustained pain relief. These medications may include peripheral nerve blocks or sphenopalatine ganglion blocks. Both of those medications can quickly treat migraines and severe headaches. Patients see results in minutes rather than days. Peripheral nerve blocks also help with other symptoms related to migraines including light and noise sensitivity, and nausea.

Benefits of Botox for Pain Relief

Botox is particularly helpful in treating chronic migraine because it has long-lasting results. Patients experience considerable pain relief for months at a time. At Regional Neurological Associates, we recommend a series of injections to the scalp, neck, and shoulders about 4 times a year. If you are experiencing symptoms of chronic migraine and want to learn more about how Botox may help, call (718) 515-4347 to make an appointment.

7 Reasons to See a Neurologist

Posted on December 30, 2019 Alzheimer's, Back Pain, Dementia, Headaches, Multiple Sclerosis, Neck pain, Parkinson's Disease, Stroke

Human brain digital illustration. Electrical activity, flashes and lightning on a blue background.; blog: reasons to see a neurologist

Neurologists are doctors that have specialized training in the diagnosis and treatment of disorders affecting the nervous system. Your nervous system is made up of your brain, spinal cord, and nerves throughout your entire body. If you are experiencing symptoms that indicate a problem with your nervous system, your primary doctor will probably refer you to a neurologist. The following are all good reasons to see a neurologist.

1. Existing Neurological Disorders

The presence of a previously diagnosed neurological disorder is probably one of the most obvious reasons to see a neurologist. Even if your symptoms are well controlled, frequent monitoring may be needed. Conditions you might see a neurologist regularly for include

Parkinson’s Disease
Multiple sclerosis
Dementia, including Alzheimer’s Disease
History of stroke

2. Persistent Headaches

Most people experience headaches every now and then, but if you have frequent and persistent headaches, then that’s a good reason to see a neurologist. Headaches are a couple and different types of headaches have a multitude of causes. To make sure there is not a serious condition at the root of your headaches, a doctor should evaluate you.

3. Migraine

One coming type of headache that affects many people is a migraine. If you have frequent and persistent headaches accompanied by other symptoms, you may be suffering from migraines. Symptoms of migraine include:

Headache on one or both sides of the head
Headache that worsens with physical activity
Pain that is throbbing or pulsing
Nausea and vomiting
Light sensitivity
Sensitivity to sounds
Sensitivity to smells

According to the American Migraine Foundation, migraine impacts over 37 million people in the United States and 144 million worldwide. If you have symptoms of migraine that your primary care provider is unable to treat, you should see a neurologist.

4. Blackouts

You can think of a blackout as a momentary glitch in the nervous system. During a blackout, the individual is unaware of what is happening and goes into a trance-like state. Sometimes a person will thrash around as if having a seizure during a blackout. Other times they will be motionless and unresponsive. If you experience blackouts frequently, then you should seek attention from a neurologist.

5. Seizures

If you have a seizure but have not been diagnosed with a seizure disorder like epilepsy, you need to see a neurologist. While many types of epilepsy are present during infancy and childhood, there is such a thing as adult-onset epilepsy. A seizure can also be a symptom of another condition such as meningitis or a brain tumor.

6. Dizziness

Dizziness, or vertigo, is the sensation that the world is spinning around you. Or it may seem like you are spinning around while the world is standing still. Vertigo can be life-altering because it prevents you from carrying out daily tasks like going to work and caring for your family. While vertigo may resolve itself after a while, you should still see a neurologist to have the underlying condition diagnosed. Many of the causes are not life-threatening, but they share symptoms with more serious conditions like stroke. Some conditions that are linked to vertigo and dizziness include

Benign paroxysmal positional vertigo (BPPV)
Meniere’s disease
Vestibular neuritis/labyrinthitis
Vestibular migraine

7. Neuropathy

Peripheral neuropathy, usually just called neuropathy, is the name given to a group of conditions that affect the body’s peripheral nerves. The peripheral nervous system connects the central nervous system, made up of the brain and spinal cord, to the rest of the body. Neuropathy can take many forms, including:

Chronic pain
Difficulty balancing
Poor coordination
Burning sensations
Numbness, weakness, or tingling in the affected body part
Paralysis

There is a long list of conditions that can cause neuropathy, ranging from autoimmune disease to vitamin deficiencies. One type of neuropathy many people have heard of is diabetic neuropathy, due to how common diabetes is in the US.

Make an Appointment to See a Neurologist

If you have a diagnosed neurological disorder or one of the above symptoms, it’s time to make an appointment to see a neurologist. The dedicated team of professionals at Regional Neurological Associates has advanced training in diagnosing and treating neurological disorders so you can feel confident you are getting expert care. To make an appointment, call (718) 515-4347.

9 Neurological Disorders You Need to Know

Posted on November 15, 2019 Back Pain, Conditions, Dementia, Headaches, Multiple Sclerosis, Neck pain, Parkinson's Disease, Stroke

Human brain digital illustration. Electrical activity, flashes and lightning on a blue background; blog: 9 Neurological Disorders You Need to Know

Due to the complexity of the brain and central nervous system, neurological disorders can seem like a mystery. There are numerous types of diseases and disorders related to neurological health, and a variety of factors that can lead to each condition. If you’re curious about conditions that can affect the brain and central nervous system, here are nine neurological disorders you need to know about.

1. Stroke

A stroke is an interruption or reduction of blood flow to the brain. When the blood supply is limited or stopped, then the brain tissue does not get enough oxygen and other nutrients carried in the blood. Within minutes of a stroke beginning, brain cells will begin to die, causing damage and potentially permanent complications. It is crucial for a stroke patient to get immediate medical attention to minimize those complications.

A person having a stroke may experience trouble with speaking and comprehension, headache, difficulty walking, paralysis (in the face, arm, or leg), or vision problems. Catching these symptoms early is important so treatment can be given as soon as possible.

2. Epilepsy

Epilepsy is a disorder of the central nervous system in which abnormal brain activity causes seizures or other periods of unusual behaviors and sensations. Sometimes people with epilepsy experience a loss of awareness of their surroundings during a seizure or episode. The condition may be controlled or managed with medications and surgery.

3. Multiple Sclerosis

Multiple Sclerosis (MS) is a condition of the central nervous system (CNS) in which the body’s immune system attacks the CNS. The protective myelin sheaths covering the nerve fibers are damaged, causing communication issues between the brain and the body. There is no cure for MS but some patients respond well to treatments to preserve their quality of life. People with MS experience a wide variety of symptoms including loss of balance, difficulty walking and difficulty with muscle coordination. They may also go through periods where symptoms are in remission.

4. Parkinson’s Disease

Parkinson’s disease (PD) is a neurodegenerative disorder that affects movement. The disease affects a part of the brain called the substantia nigra, where there is a loss of dopaminergic neurons. Symptoms usually develop gradually as the disease progresses. Tremors are a common symptom that may present as shaking in the hands, arms, legs, jaw, or head. Patients may also experience limb stiffness, difficulty with balance or walking, slowed movement, and decreased coordination. Parkinson’s disease cannot be cured or reversed, but there are many treatments that are tailored to each patient’s symptoms. Medications and surgical therapy are common treatments, and sometimes lifestyle changes can improve symptoms.

5. Peripheral Neuropathy

Peripheral neuropathy, commonly referred to as just neuropathy, is a group of conditions related to damage to the peripheral nerves and the symptoms that damage produces. The peripheral nervous system is the network of nerves that connects the CNS to the rest of the body. Symptoms vary and range in severity from mild to disabling, but they are rarely life-threatening. A person with neuropathy may experience chronic pain, lack of coordination, or tingling, weakness, or numbness in the area of the damaged nerve, as well as other symptoms.

6. Dementia

Dementia is the term for a group of brain conditions that impair a person’s ability to think, reason, and remember things. In some cases, language skills, the ability to manage emotions, and perception are also impaired.

Dementia often develops gradually, but in certain cases it may appear suddenly. Sudden onset is usually associated with severe head trauma. Common types of dementia include Alzheimer’s Disease, vascular dementia (caused by strokes or cerebrovascular disease), and Lewy body disease.

There is no cure for most types of dementia, but the effects of dementia caused by infections or vitamin deficiencies may be reversed with treatment. It is estimated that up to half of people 85 and older experience some form of dementia.

7. Psychiatric and Neurobehavioral Disorders

These disorders are related to the connection between the brain and behavior. Neurobehavioral disorders are impairments associated with brain diseases like multiple sclerosis, stroke, and dementia or brain injury. Psychiatric disorders are associated with abnormal functions of the part of the brain responsible for social cognition. Historically, the study and treatment of these disorders were separate, but today doctors embrace a connection between the two in order to better treat and diagnose a wide range of conditions affecting the brain.

8. Vertigo

Vertigo is a sensation of dizziness. People who experience vertigo sometimes describe it as either feeling like you’re spinning while your surroundings stay still or the feeling that the world around you is spinning and you are standing still. Vertigo is a symptom of a number of conditions including Meniere’s disease, vestibular migraine, or benign paroxysmal positional vertigo (BPPV). Vertigo can either resolve on its own or be treated based on the underlying cause.

9. Headaches

Headaches and migraines are common neurological disorders that many people are affected by. A headache is defined as pain in any region of the head. There are several different types of headaches with a range of causes and symptoms. Common types of headache pain include sharp pain, throbbing, or aching.

Migraines area type of headache that can be quite severe and incapacitating. Along with head pain, people suffering from migraines may experience nausea, light and noise sensitivity. Symptoms may worsen when moving or bending over. Symptoms can last for several hours or even several days. When someone has more days with a migraine than without one, then they are considered to have chronic migraines.

Make an Appointment

At Regional Neurological Associates, we are committed to providing our patients with expert care for all types of neurological conditions. Our experienced doctors are highly trained in a variety of subspecialties including migraine headaches, stroke, and pain management. If you have questions or concerns about any of these neurological disorders, call us at (718) 515-4347 to make an appointment.

5 Types of Headaches Explained

Posted on August 14, 2019 Headaches

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Headaches are a strikingly common medical complaint that nearly all of us have experienced at one point or another. They are quite often described with vulgar language while individuals experience extreme discomfort during an episode.

Before going into some of the more common types of headaches that individuals face, it is important to state that one should always seek medical attention following any type of trauma affecting the head, neck or spine that causes severe pain or neurological deficiency. This may be indicative of a much more severe problem than a typical headache and could be life-threatening if not addressed quickly.

Despite how common they are, there are a number of complexities that differentiate each episode from one another based on the mechanism of onset, presentation of symptoms, location of pain and potential management for the condition. Below are five of the more common types of headaches that people commonly face:

1. Tension Headaches

Tension headaches affect approximately 3 out of 4 people at some point in their lives and can be brought on by a number of different reasons. Often, they result following emotional distress, stress or strong emotional distraught, or general tension in the neck and shoulders. The pain will usually be focalized in the back and sides of the neck as well as the base of the neck, especially when the muscles of the neck and shoulders start to spasm. Management is best done using over the counter anti-inflammatory medication or heat on the back of the neck. These headaches usually do not persist for long.

2. Migraines

Migraines are less common than tension headaches but are widely considered to be much more severe in both symptoms and duration, lasting up to multiple days at a time with little to no relief. While they are not as well understood as other types of headaches, there are a number of triggers that can lead to an episode, such as stress or missing meals. Often there may be visual disturbances along with intense pain on one side of the head. Management is often addressed with medication, either over the counter or prescribed, removal of triggers and escaping to a dark, quiet room.

3. Sinus Headaches

Sinus headaches occur when pressure in the sinuses of the head build-up in conjunction with severe congestion. Often, this will occur seasonally as allergies are in full swing. Often, they will present with pain in the front of the head as well as potential earaches. Utilizing allergy medication to reduce sinus symptoms may help reduce the frequency and severity of sinus headaches.

4. Exertional Headaches

Intense physical activity such as running, jumping, heavy weight lifting n may cause exertional headaches. Often, these types of headaches result from a build-up in pressure that occurs while performing activity, causing a strain on the body as a whole but especially the head. They usually subside quickly and may be aided by over the counter medication.

5. Cluster Headaches

Cluster headaches are named such because they tend to recur over a period of several weeks. They usually present with pain limited to one side of the head, typically around one eye. In most cases, medication will need to be prescribed to manage the condition and make symptoms more bearable. Often, the individual episodes will last less than 3 hours.

When to Seek Treatment

If you are experiencing chronic headaches or head pain that does not line up with any of the types of headaches listed above, it is advised to seek medical attention to identify the source of your pain.

One of the oldest neurology practices in the Bronx and Westchester, the physicians at Regional Neurological Associates specialize in the diagnosis and treatment of a variety of neurological conditions including chronic headaches such as migraines. To schedule an appointment, call (718) 515-4347.

Treatment Options for Migraines

Posted on June 17, 2019 Conditions, Headaches

Anyone who has ever dealt with migraines needs no introduction to how painful and debilitating they can be. For those suffering from chronic migraines, quality of life is often impacted.

Migraines are considered chronic when a person has headaches on more days than not. There various traditional and alternative treatment options for migraines that may be available to offer relief and restore your quality of life.

1. Medications

Medications are a very common treatment option for those who suffer from migraines. This method is normally are broken up into two categories: pain relief and prevention.

Pain relief medications fall along a spectrum of options depending on the severity of the migraines. Over the counter medications such as ibuprofen and acetaminophen can be used alone or in combination with drugs such as caffeine to help alleviate the symptoms of more mild migraine attacks. However, most individuals who suffer from chronic and severe migraines may receive little to no benefit from these options as they are less potent and do not have long-lasting effects. Medications, such as those for anti-nausea, may be prescribed to help patient’s manage the adverse symptoms commonly associated with migraines.
Preventative medications are commonly prescribed for issues aside from migraines but may help with the symptoms associated. Some of these include medications for hypertension, depression, seizures, and so on. As they all have a number of side effects and intended actions, it should be discussed carefully with one’s physician.

2. Botox

While most known for use in cosmetic procedures, Botox is FDA-approved for the treatment of chronic migraines in adults who are age 18 and older. A form of botulinum toxin, Botox works to prevent migraines before they start by entering the nerve endings around where it is injected and blocking the release of chemicals that are involved in pain transmission.

3. Nutrition

Adequate hydration and nutrition is often the most overlooked aid in relieving symptoms associated with migraines. When the body is dehydrated, migraines will often be more severe, especially in those who have a prior history. By ensuring proper hydration, the blood stream’s concentration is at a more ideal level, allowing for adequate flow to the brain and the body as a whole. If water intake is greatly increased, be sure to add in electrolytes so as to maintain the body’s natural balance.

In addition to water, there are a number of foods that have been shown to help relieve the painful symptoms of migraines. Foods that are rich in Omega-3 fatty acids, such as salmon, have anti-inflammatory properties and help with metabolism at the brain. This can help to reduce the pain levels associated with more severe migraines.

Your physician may recommend that you work with a registered dietician as part of your treatment plan for chronic migraines.

4. Acupuncture

Based on eastern medicine and the concept of meridians, this method utilizes different trigger points to alleviate migraine pain. Case studies have shown some degree of success depending on the patient and their pain. According to the American Migraine Foundation, the frequency of headache is dropped by 50% or more in up to 59% of individuals receiving acupuncture and this effect can persist for more than 6 months.

5. Psychotherapy

Some individuals have found that working with a therapist has helped them learn how to interpret and understand their pain better, which has allowed them to gain an understanding of their condition and better control their perception of pain. A form of cognitive behavioral therapy, psychotherapy can also aid in the treatment of anxiety and depression, which are extremely common in patients suffering from chronic pain conditions.

6. Meditation

Meditation can be effective for individuals whose migraines are triggered by stress, anxiety and tension. The idea is that by alleviating the underlying cause of stress, mind-body techniques like meditation can help relieve headaches and potentially prevent them from occurring in the first place. Some brain wave and imaging studies suggest that the practice of mindful meditation can actually modify brain structure and activity.

When to Seek Help

Whether you suffer from minor or severe pain caused by migraine headaches, the physicians at Regional Neurosurgical Associates can help you live a normal, pain-free life. Our goal is to determine what is triggering your migraine and provide long-term solutions to help prevent future cases. Call Regional Neurological Associates at (718) 515-4347 to schedule an appointment today.