Headache Treatments
Why should I see a Headache Specialist?
Migraine is a condition which is still largely under diagnosed and poorly treated. Most patients with headaches are dissatisfied with current treatment options and suffer needlessly. Trupti Gokani MD, is Board Certified in Neurology and is the founder and director of the North Shore Headache Clinic. She has spent the last few years working in headache clinics and understanding the complexities of treating the headache prone individual. This background allows a broad understanding of the role medications and non-medication approaches play in headache relief. The success of treating a headache patient is based on the understanding that headache is potentially a manifestation of multiple systems gone awry. Thus healing the system with “cocktails” of medications, supplements, herbs and injections allows patients achieve an optimal state of health. The key is understanding the root cause of pain and identify all underlying causes of pain, rather than just treating the pain alone. Hidden sources of pain such as sub clinical thyroid issues, vitamin deficiencies, gut issues often corrected may help decrease or eliminate the headaches all together. Combining this with Yoga, Chiropractic treatments, Massage, Acupuncture, PT, and /or Cognitive therapy often leads to success.
Dr. Gokani’s specialties include treatment of: Migraine, Tension-type headache, Cluster headaches, Neck pain/spasm, ADHD, Bipolar Disorder, Fibromyalgia, Insomnia, Anxiety Disorders, Depression and symptoms associated with the Menopausal transition.
What options are available alone or in combination for Headache, Mood and Pain treatment?
- Traditional medications (seizure medications, antidepressants, blood pressure medications for prevention and triptans for abortive measures)
- Non-traditional medications- supplements, herbs, amino acids, homeopathic, and ayurvedic options
- Botox injections for headaches, neck pain, hyperhidrosis, TMD
- Trigger point injections utilizing traditional agents (bupivicaine/depomedrol) and/or non-traditional agents (herbal preparations/homeopathic) for relief of headache and neck pain
- IV Nutrient therapy to control and treat chronic illnesses such as severe headaches, fibromyalgia, chronic fatigue, depression, allergies, etc
How does Botox work for headaches?
Botulinum Toxin Type A has been studied in over 1000 patients with Chronic Headaches. This agent likely works by preventing the release of inflammatory peptides by the trigeminal nerve endings. The injections are given in the frown area, forehead, temples and occasionally neck regions. In our experience, about 60-70% of patients respond favorably, and patients experience few, if any, side effects. The injections last about 3 months.
Dr. Gokani has given over 100 lectures to internists, family physicians, obstetricians, otolaryngologists, anesthesiologists, physiatrists, neurologists, psychiatrists, nurses, physician assistants, students and the community on topics related to headache and mood disorders. She is a consultant and speaker for Allergan (manufacturers of Botox), Endo, Merck, Ortho McNeil, and Pfizer pharmaceuticals.