(a) Signs/symptoms of migraine headaches. Included are the
1 Paroxysmal (sudden onset) of headache, often preceded by
psychologic or visual disturbances. The headache may be unilateral (on one side of the
head) or bilateral (on both sides of the head).
3 Commonly, sharp pains in the frontal region of the head,
especially at the temple.
4 Excessive sweating, nausea, and vomiting.
5 Hypersensitivity to light and sound.
(b) Treatment of migraine headaches. It is important to take
medication early on in a migraine headache attack. Ergotamine tartrate (Gynergen) is
the drug of choice for this condition. Ergotamine tartrate stimulates the smooth muscle
of the blood vessels to constrict. The dosage is 2 mg orally or 0.25 mg intramuscularly
or subcutaneously. CAUTION: This medication can build up in the patient's body
causing ergotism. (Ergotism is poisoning from excessive use of medicinal ergot.) Signs
and symptoms of ergotism include numbness/tingling of fingers or toes, muscle pain
and/or weakness, gangrene, and blindness. Another ergotamine preparation is
ergotamine and caffeine (Cafergot). Ergotamine, phenobarbitol, and belladone
(Cafergot P-B) are effective therapy for migraine headache complication by tension and
gastrointestinal upset. A general aid for a migraine headache is to have the patient sit
or lie down in a darkened, quiet room for one to two hours. The darkened room is used
because of the sensitivity to light experienced by a patient with a migraine headache.
(2) Cluster headache (Morton's syndrome). The cause of this disorder is
similar to that of a migraine headache. The exact cause of a cluster headache is
unknown. Sensitivity to histamines may be a cause of this type of headache.
Signs/symptoms of a cluster headache. Included are the following:
1 Severe and frequent attacks of short duration, usually in "cluster
or group." The headaches may occur daily or several times a day for several weeks.
The headache problem may resolve itself for a few months, then recur.
2 The headache may occur at the same time of day and on the
same side of the head behind one eye.
3 Pain is accompanied by a tugging, pulling, or pressing sensation
behind one eye.
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