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1. 

   Elaine on August 28, 2017 at 8:12 am

   I have suffered from chronic migraine my whole adult life. Recently my headaches have gone from the classic one-sided pain to pain all over my head. I recently made 2 trips to Mayo Clinic. They did MRIs, blood tests, lumbar puncture, psyc testing. They thought I might have a leak in my cerebral spinal fluid and suggested a blood patch. This didn’t help at all. No pain medication helps, including opiods. In fact, as everyone probably knows, nothing helps (at least nothing I know of). Any ideas?

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     Sue Robbins on August 28, 2017 at 5:51 pm

     You are in a big big boat; I guesstimate that there are at least 3 to 4 million people with frequent, or daily, headaches, where nothing really works; I have published extensively on “Difficult to Treat, Refractory” headaches(I started the section of the AHS, The Refractory Headache Patient, back in 2001)….last year aI wrote a long article on Refractory Chronic Migraine for Scientific American Neurology……some options, for when nothing works, that I write about include: Botox(not really for just refractory, we use it earlier as well), Stimulants, MAOIs(such as Ensam patch), daily or frequent triptans, and occasionally long acting opioids; there are others as well; of course, these are end of the line therapies, under your doctors directions, with informed consent only….sometimes SPG(frontal up the nose) lidocaine blocks(done once per week or so for 3 weeks or longer), sometimes ONB(occipital nerve blocks) help; I tend to shy away from neurostimulators……..or surgery(with rare exceptions, sometimes for posterior occipital pain, there is one doctor in Houston who is good with that..Pam Blake,M.D. and Dr. Perry.)……Good luck, you are in a common situation……

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