William Prado, migraine patient

News, Your Health | one month ago

What to Do When Migraine Pain Doesn't Go Away

When this patient sought help for severe, daily migraines, our headache specialists found the cause – and the treatment.

When William Prado first came to Atrium Health for headache relief, his migraines were so severe that they disrupted much of his life. He had a migraine every day, which caused double vision and a drooping right eye. With a job in the restaurant industry, William’s work schedule had to be put on hold with each headache.

“It felt like someone was inflating a soccer ball inside my skull. There was such bad pressure on my brain,” Williams says. “I’d have to stop whatever I was doing.”

When over-the-counter medicines didn’t help, William sought care at his primary care provider and then at the emergency department. Initially, he was told a sinus infection was the culprit. Still, no treatments helped. Doctors referred him to Dr. Nauman Tariq, a headache specialist with Atrium Health Neurosciences Institute. Tariq discovered that William’s headaches were caused by Tolosa Hunt Syndrome, a rare disorder that affects only one in a million people.

“I’m just happy to know what this is, that it’s something that’s not going to kill me,” William says. “It’s good to see an expert like Tariq. It’s impressive how he specializes in just migraines, and works with other doctors who do, too.” 

At least 39 million Americans experience migraines, according to the American Migraine Foundation. Some people can manage migraines with behavioral changes, over-the-counter medications and care from a primary care physician. But for people like William, whose migraines persisted and affected his ability to live and work as usual, seeing a neurologist who specializes in headaches can be the best next step.

Headache specialists have an extra year of fellowship in headache and facial pain, in addition to their four-year neurology residency. This expertise offers an advantage to people with chronic migraines who need next-level care and the help of the latest research. Tariq, who previously served as the director of the Headache Center at Johns Hopkins Hospital, specializes in migraines, cluster headaches, trigeminal neuralgia, chronic post-traumatic headaches, cervicogenic headaches and orofacial pain.

“The FDA has approved 15 new migraine treatments in just the last 12 years, so it’s hard to catch up on all of those treatments for primary care providers and even general neurologists,” Tariq says. “Exciting research is in the pipeline right now.”

At Atrium Health, headache specialists work as part of a multi-disciplinary team. This team meets regularly to discuss complicated cases and share new research. Also on the team are behavioral therapists, physical therapists, interventional pain physicians and a neuro-ophthalmologist. This team works closely with radiation oncologists as well. Whether the patient’s pain is caused by swelling behind the eyes, temporomandibular disorders (TMD) or trigeminal neuralgia, members of the team can offer expertise and a collaborative approach.

The Atrium Health team of migraine specialists creates an individualized treatment plan for each patient. It may include cognitive behavioral therapy (CBT) to manage pain without medication. It may involve infusions, in which medications are delivered by intravenous injection (IV) so that the drugs get absorbed very quickly and achieve a faster response. Or it may involve medications, such as CGRP (calcitonin gene-related peptide) blocking drugs, which prevent migraines from causing pain.

“We recommend that patients come see us if their headaches are not being controlled by over-the-counter medicines or behavioral changes. Here, they can get treatments customized to their headache frequency and severity,” Tariq says.

Returning to Life with Controlled Headaches

William now has his migraines controlled, which enables him to return to work and to his usual activities.

“I’m still learning about Tolosa Hunt Syndrome, and I still see Tariq about every six months for follow-up appointments,” Williams says. “I feel like he’s my friend now.”

This is the goal of the headache experts at Atrium Health Neurosciences Institute: to manage the pain of migraines so that patients can return to enjoying their lives and their work.

“I feel a sense of pride and accomplishment when our patients are able to return to their usual routine and life after their treatments,” Tariq says. “I feel very happy for William. He’s a young, smart man who was really struggling, wanting to get his life back and return to his job. It’s a great feeling to know that we all made a difference in his life.”

Learn more about the headache specialists at Atrium Health Neurosciences Institute or make an appointment by calling 704-468-8888.