An old advertisement for a<unk>  medicine Primary<unk>  syndromes<unk> ve many different possible treatments. In those with chronic<unk> s the long term use of opioids appears to result in greater<unk> rm than benefit. Migraines Migraine can be somewhat improved by lifestyle changes, but most people require medicines to control their symptoms. Medications are either to prevent getting migraines, or to reduce symptoms once a migraine starts. Preventive medications are generally recommended when people<unk> ve more than four attacks of migraine per month,<unk> s last longer than 12 hours or the<unk> s are very disabling. Possible therapies include beta blockers, antidepressants, anticonvulsants and NSAIDs. The type of preventive medicine is usually chosen based on the other symptoms the person<unk> s. For example, if the person also<unk> s depression, an antidepressant is a good choice. Abortive therapies for migraines may be oral, if the migraine is mild to moderate, or may require stronger medicine given intravenously or intramuscularly. Mild to moderate<unk> s should first be treated with acetaminophen (paracetamol) or NSAIDs, like ibuprofen. If accompanied by nausea or vomiting, an antiemetic such as metoclopramide (Reglan) can be given orally or rectally. Moderate to severe attacks should be treated first with an oral triptan, a medication that mimics serotonin (an agonist) and causes mild vasoconstriction. If accompanied by nausea and vomiting, parenteral (through a needle in the skin) triptans and antiemetics can be given. Sphenopalatine ganglion block (SPG block, also known nasal ganglion block or pterygopalatine ganglion blocks) can abort and prevent migraines, tension<unk> s and cluster<unk> s. It was originally described by American ENT surgeon Greenfield Sluder in 1908. Both blocks and neurostimulation<unk> ve been studied as treatment for<unk> s. Several complementary and alternative strategies can help with migraines. The American Academy of Neurology guidelines for migraine treatment in 2000 stated relaxation training, electromyographic feedback and cognitive behavioral therapy may be considered for migraine treatment, along with medications. Tension-type<unk> s Tension-type<unk> s can usually be managed with NSAIDs (ibuprofen, naproxen, aspirin), or acetaminophen. Triptans are not helpful in tension-type<unk> s unless the person also<unk> s migraines. For chronic tension type<unk> s, amitriptyline is the only medication proven to help. Amitriptyline is a medication which treats depression and also independently treats pain. It works by blocking the reuptake of serotonin and norepinephrine, and also reduces muscle tenderness by a separate mechanism. Studies evaluating acupuncture for tension-type<unk> s<unk> ve been mixed. Overall, they show that acupuncture is probably not helpful for tension-type<unk> s. Cluster<unk> s Abortive therapy for cluster<unk> s includes subcutaneous sumatriptan (injected under the skin) and triptan nasal sprays. High flow oxygen therapy also helps with relief. For people with extended periods of cluster<unk> s, preventive therapy can be necessary. Verapamil is recommended as first line treatment. Lithium can also be useful. For people with shorter bouts, a short course of prednisone (10 days) can be helpful. Ergotamine is useful if given 1–2 hours before an attack. Secondary<unk> s Treatment of secondary<unk> s involves treating the underlying cause. For example, a person with meningitis will require antibiotics. A person with a brain tumor may require surgery, chemotherapy or brain radiation. Neuromodulation Peripheral neuromodulation<unk> s tentative benefits in primary<unk> s including cluster<unk> s and chronic migraine. How it may work is still being looked into.
Headache
Toothache
Nausea
Tinnitus
Osmophobia
Vomiting
Dizziness
Nasal congestion