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Ask the Clinician: Answers to Readers' Questions
October 12, 2004

From John Claude Krusz, MD, PhD, and Teri Robert, for About.com

Created: October 12, 2004

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Dr. Krusz is a recognized expert in the fields of headache and Migraine treatment and pain treatment. To read more about Dr. Krusz, click HERE.

If you have a question for this section of our site, please click HERE. Questions will be answered by publishing the answers here. Please note: We cannot handle emergencies or diagnose via the Internet. For those questions, please see your physician.

1) ...I had a severe migraine that lasted for several days, when the migraine lifted, I got a needles and pins numbness over the entire left side of my body from my ear to my toes, this didn't go away for 3 days and then it came back for a few days...  woke up with severe double vision, diagnosed as 6 nerve palsy... I am concerned about the risk of stroke after my opthalmoplegic and hemiplegic migraine attack. My neurologist said I may have had a mini-stroke after this migraine but MRI showed nothing. Are my stroke risks much higher now that I have had these unusually severe and rare migraines? Amy.
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2) I have suffered with headaches for 10-12 years. I am 38 now, with a very regular cycle. My headaches are always on the same side... Never any where else. I do not get auras or any symptoms before I actually get the headache. I am light sensitive and movement of my head or bending over is pretty rough and causes a lot more pain for me. ... perimenstrual headaches ...I take Tylenol #3 about two days before my cycle starts and pretty much for about 4-5 days after trying to prevent the headache from coming. I will also take it a day or so when I ovulate. These are my two bad times of the month... suggestions?... Chrissy.
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3) MY 11-year-old has been experiencing headaches when I get my menstruation. The first one was a severe Migraine. Today's was a minor headache. Could my menstrual cycle affect her?
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4) I am a 36-year-old woman, who has a prescription for Zomig. Sometimes it works with one pill, sometimes it works when I take one then another an hour later. But how long should I wait to go get an injection if the Zomig doesn't work? Also, why do people treat me like a burden and a drug addict at the ER?
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5) I am a 22-year-old male who suffers from migraines and tension headaches. I use a combination preventative/rescue med combo for my migraines (common migraines)... I suffer a migraine on average once or twice a month. My real nuisance are tension headaches. I suffer at minimum 4-6 tension HA's a month. I use a standard dose of Excedrin for only 1 out of the 4-6 headaches a month, because I'm concerned of rebound headaches.// would it be reasonable to discuss with my neurologist the possibility of trying a "classic" tension head med, such as Midrin or Fiorinal?... Brad.
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6) I have been diagnosed with chronic depression and have been taking Effexor XR 150 mg for a year now. I have had migraines most of my life. I am 55 years old. Since starting the medication it seems my headaches are more often and it takes more to dull the pain. I have to take about 8 codeine tablets just to make it tolerable. My questions are:

Will taking these pills together with Effexor XR cause any long term damage? Are some of the side effects of Effexor XR migraine headaches? Is there an food group that is acting as a trigger that I should avoid?

I have had many side effects from the Effexor XR ... Doctor told me they were normal and they would go away... but the written material about the Effexor XR says to discontinue use immediately if these side effects occur. I need the medication for my depression so what is my alternative for dealing with the migraines... Bryan.
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7) I had my first migraine with aura preceding it at 18. Since then, I have experienced migraines about once a year. I had a CAT SCAN done, but nothing showed up. Now that I am 37, I have experienced a migraine 4-5 times in the past 6 months. I also have sinus pressure. My doctor told me that migraines cause the sinus pressure but I thought it was the other way around. Can Sinus headaches cause the same debilitating reaction as migraines?
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8) I have been suffering from cluster headaches for over thirty years. I am male, now in my mid forties. I have been happily in remission for three years and am petrified at the prospect of the certain return of a cluster phase. In my case, the usual frequency is one or two a day for one to two hours of absolute debilitating pain. The clusters generally last for three to five weeks. During my last phase I found Imitrex nasal spray to be effective, but I am nonetheless afraid. Are there any breakthroughs in this area. Thank You, LK.
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