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Reader’s Mail: Seek Professional Help for Change in Headache Patterns

Q. I have had migraines for more than 30 years and am successfully managing with them with abortives. Until recently they were mainly without aura, but lately I have been getting several auras a week, but without a headache. Can you explain what is happening and provide any suggestions for treatment?  I also get scalp pain that sometimes progresses to a headache and sometimes not. I usually treat that with a non-steroidal anti-inflammatory medication.

I would appreciate any comments or suggestions you have on either of these issues.

A. Auras are electrical events in the brain called spreading cortical depression. About 25% of migraines are associated with an aura. Usually, auras precede the headache phase of a migraine. People can also get auras without  a headache or at times with a low-grade headache. However, in your case these auras represent a change in your headache pattern, and it is very important that you talk to your healthcare professional to determine if you need medical testing.

Roger Cady, M.D.
Director, Headache Care Center
Springfield, Missouri

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