What Are the Treatments for Complicated Migraines?

Migraines are specific headaches caused by blood vessels dilating in the head and brain and decreased blood flow in the cerebral area. Complicated migraines, or complex migraines, cause migraine headaches and neurological problems such as paralysis, weakness and sensory difficulties. Treatments for complicated migraines include trigger avoidance and medications.

Trigger Avoidance

• If you experience complicated migraines, keep a headache journal to document where, when and for how long your migraines last. Try to recall your feelings, what you ate, what environment you were in, the weather and sensory triggers around you at the time of the migraine attack. Talk with your doctor about potential triggers and ways to avoid them to lower your risk of having a complicated migraine episode.

  Migraines are more common in women than in men, and many women experience them when hormonal levels change. When you are menstruating or going through menopause your estrogen levels change, in some cases inducing migraines. Some women find oral contraceptives and hormone-replacement medications worsen their migraines, while others find them helpful.

  Some foods can trigger migraines in certain individuals. Common triggers include alcohol, cheese, chocolate and monosodium glutamate, which is found in many Asian foods. Eat regular meals to reduce your risk of migraines; they can be brought on by skipping meals or by sudden drops in blood-sugar levels.

  Use relaxation techniques such as deep breathing or meditation to manage your stress levels and avoid migraine triggers. Talk with your doctor or psychiatrist if you are feeling unusually depressed or anxious. She can help you cope with your feelings through therapy or medication.

  Environmental changes in weather and barometric pressure can induce migraines as well. Although there is little you can do to change the environment, being aware of potential triggers can help you prepare for a migraine attack before it starts.

Pain-Relieving Medication

• Pain relievers can help shorten the duration of a complicated migraine if you take it as soon as you feel the headache coming on. Try over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin, to relieve pain. If over-the-counter pain relievers fail to control your pain adequately or if you find yourself taking them frequently, talk with your doctor about a prescription pain reliever for your migraines.

  Triptans, such as Imitrex, Amerge and Axert, can help relieve migraine pain as well as nausea and light sensitivity. Ergotamine medications, such as Migergot and Cafergot, are less expensive than triptans but they are also less effective. Most doctors prefer to use triptans, but ergotamine is a useful alternative for patients who may not have insurance coverage. Your doctor may prescribe an anti-nausea medication if your migraines cause severe nausea or vomiting. Narcotic painkillers are a last resort for migraine pain. They are usually only prescribed to patients who cannot take triptans or ergotamine.

Preventive Medication

• Preventive medications can help reduce the frequency and severity of your migraine attacks. If you have two or more debilitating complicated migraines a month, your doctor may recommend you go on a preventive medication daily or when triggers approach, such as the onset of your menstrual period.

  Cardiovascular drugs called beta blockers can help reduce the severity and frequency of complicated migraines. Other cardiovascular drugs such as calcium channel blockers and antihypertensive medications can also help. Tricyclic antidepressants can help prevent migraines and other types of headaches by affecting serotonin levels in the brain. Botox injections given in the forehead and neck can help prevent migraines in some individuals, according to the Mayo Clinic, but the procedure needs to be repeated about every three months to remain effective.