Can a person experience a migraine without pain?

Yes, they are not uncommon.  Typical symptoms include visual symptoms (flashing lights, zig-zag lines, or the absence of vision in all or part of the visual field).  Other symptoms can include tingling on one side of the body and/or slurred speech, or vertigo.  These types of migraines are often referred to as aura without headache (acephalgic migraine).  Symptoms may last from minutes to days.   Treatment varies but may include migraine specific medication.  These symptoms should always be evaluated by a healthcare provider for a correct diagnosis.

To make an appointment, please call 949-861-8717.

What type of doctor is best at treating headache?

In the past, neurologists were the most common type of doctor that patients would see for severe headaches.  Now, headache has become a specialty open to non-neurologists as well as neurologists.  Currently, there are only a little over 500 headache specialists in the United States.  Dr. Susan Hutchinson is a Board Certified Family Medicine Physician with a sub-specialty in headache.  I am a neurologist who completed a full 1 year headache fellowship. Dr. Hutchinson’s 21 years of practicing general family medicine including women’s health can help in recognizing the important role of hormones to headache and she is especially well-suited to treat menstrual migraine.  My background as a neurologist is well-suited to recognizing neurological conditions that may be associated with migraine.  Together, our practice provides an excellent comprehensive approach to the headache patient.

To make an appointment, please call 949-861-8717.

Why does a particular medication work really well for my friend with migraine but not for me?

Medications don’t work the same for everyone.  Your genes can influence the way your body responds to certain medications.  The good news is that gene testing is now available and can be as simple as a cheek swab that’s used to collect cells that contain your DNA.  We have begun using this technology to assist in optimal medication prescribing to better suit the individual patient.

To make an appointment, please call 949-861-8717.

What is the difference between a migraine and a cluster headache?

molly_croppedMigraines are characterized by disabling attacks often including throbbing/pulsating pain, nausea, sensitivity to light, and the desire to be in a dark quiet room.  In contrast, cluster headaches are characterized by incredibly severe pain in and around one eye with drooping of the eyelid on the affected side, tearing, nasal congestion, and the sufferer is agitated, pacing, and may even be hitting their head against the wall.  In fact, cluster has often been referred to as the “suicide headache” due to its severity.  Migraine is much more common than cluster and it tends to be recurrent throughout the year.  In contrast, cluster, as the name implies, often clusters together during certain times of the year and may go away for months at a time.  Unlike migraine, cluster is much more common in men.  Treatment is different for migraine and cluster, so proper diagnosis and evaluation is important.  We treat both in our practice.

If you think you are suffering from one of these, call for an appointment 949-861-8717.

What is the difference between a headache and a migraine?

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What is the difference between a headache and a migraine?

Migraines are headaches, but not all headaches are migraines.  So, a migraine is a type of headache.  There are many other types of headaches including:  tension headache, cluster headache, cervicogenic headache, trigeminal neuralgia, occipital neuralgia to name a few.

– Dr. Molly Rossknecht

For more information, call and schedule an appointment at 949-861-8717

How long does it normally take to determine if a treatment isn’t working?

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How long does it normally take to determine if a treatment isn’t working?  How patient should I be?

For most headache prevention treatments, it can take up to 4 weeks to see significant benefit (however some patients may see benefit at 1-2 weeks).  If at 4+ weeks there is no real headache benefit and if you are tolerating the medication/treatment well (as far as adverse effects) we would likely discuss adjusting your dosage.  Every patient is different and it’s just a matter of finding out what dosage of medication you respond to.  If you have reached a therapeutic dose for a few weeks and you do not feel it is helping, at that point we would make a change, discuss other options.

– Dr. Molly Rossknecht

For more information, call and schedule an appointment at 949-861-8717

Can Migraines Be Prevented?

molly_croppedNow that I know my headaches are migraines, can they be prevented?

Yes, there are many different treatment options for migraine prevention, it’s just a matter of finding the right one for you.  There are 2 ways we look at treating migraine- prevention (daily treatment to cut down the amount of headache days per month) and abortive therapy (what to do/take when you have the migraine).  If you are only having a few migraines per month and you are headache-free the other days, there isn’t a real need to take something every day to prevent them (you just need an abortive).

However, if you are having many headache days per month, prevention is definitely key to cutting down the number of days (zero would be ideal!).  When you get to a place where you are feeling better and having less headaches, then we can discuss coming off the prevention to see how you do…. preventatives do not have to be a “forever” thing.  In other words, if you are doing really well on a preventative medication I would not want you to think you will have to take it for the rest of your life.  Headaches can change/improve over time. – Dr. Molly Rossknecht

For more information, call and schedule an appointment at 949-861-8717