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When is a Headache Not Just a Headache?


June is Migraine Awareness Month, a good time for parents to know how common it is for kids to suffer.

As many as one in 10 children end up with a migraine headache at some point before age 17. But that pain is often misdiagnosed in kids.

Dr. KJ Oommen, a neurologist at Covenant Medical Group, explains that sometimes the symptoms of a migraine can even mimic a stroke.

“Some symptoms, such as dizziness, tiredness, losing balance, speaking gibberish and things of that nature can fool you particularly when they precede the headache at times without progressing to a headache, in a condition called migraine sans migraine or non-cephalalgic migraine. Even facial weakness, paralysis and fainting may occur as part of the syndrome of migraine, especially in what we call complicated migraine.”

Dr. Oommen says parents may come to see him because they are concerned about all those issues particularly because the fainting spells may be misdiagnosed as seizures, not even considering that a migraine could be the reason for these problems.

He said that typically a migraine affects one side of the head, but the symptoms of complicated migraine can affect both sides, particularly in the temples or forehead. When the full-fledged syndrome is developed, there is no doubt; until then, there can be doubt about what you’re actually dealing with.

You can always refer the patient to a headache specialist, they are very adept at making this diagnosis, and that would be the best approach if there’s any doubt at all.

Dr. Oommen says the classic theory has been that migraines are the result of the constriction of blood vessels, which is often followed by dilation of the blood vessels. It is in the phase of dilation or as dilation occurs is when the actual headache becomes apparent.

“That theory worked for some time, so, for years, many of the medications introduced were based on that theory,” Dr. Oommen said. “As time has passed, that theory has been challenged. The new theory postulated inflammations and the substances that cause pain released by nerve endings are the reason for the headache.”

Then came Botox. Botox injections were approved in October 2010. Along with it came a new theory that it acts primarily by blocking CGRP, which increases in the blood during a migraine. Now, companies are developing new drugs (monoclonal antibodies) to block CGRP before it increases, to prevent the migraine before it even starts.

Dr. Oommen says the best thing to do first is to talk to your physician, and get a referral to a neurologist, and finally, if necessary, go to a headache specialist.

To book an appointment with Dr. Oommen, call: (806) 725-4115.

This post is not intended to diagnose or treat any medical condition. Please seek medical advice from your physician for any related medical condition. If you are in need of a primary care doctor, click here to find one in the Covenant Health network.

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