Q. I'm starting to notice a couple of changes with my migraines and wonder if these are common. One is that I am getting mini-cluster headaches once or twice a day, 2 or 3 days before a big migraine attack, and the other is nausea with no migraine pain. I typically get the nausea after the migraine pain has begun, but is it possible it can switch?

Nausea frequently accompanies migraine, but until recently little has been known how it may affect the progression of the disorder. Now, researchers say, a large study has shown that compared to migraineurs who experience little or no nausea, migraineurs with frequent, persistent nausea were twice as likely to progress from experiencing episodic migraine (migraine less than 15 days per month) to having chronic migraine (migraine 15 or more days per month).

Relief for people who suffer from chronic migraine may be derived from the hormone oxytocin, according to information presented at the International Headache Congress during June in Boston. In the study of 40 participants, those who received an intranasal dose of oxytocin reported significant pain relief from 2 to 4 hours later. Sixty-four percent who were treated with the hormone reported a substantial decrease in pain compared to 27% of those who received a placebo. 

In a recent study, acupressure wrist bands were effective in relieving migraine-related nausea, one of the most disabling symptoms associated with this headache disorder. Researchers in Germany evaluated Sea-Band acupressure bands in 41 migraineurs who had experienced migraine attacks for an average of 26 years. The average intensity of pain was 7.1 on a 0 to 10 scale, and the average level of nausea was 6.2.

Q. I’ve had chronic daily headaches for more than four years. I just cannot get relief. I have tension headaches that typically start at the same time each day. Recently, I’ve been having more and more nausea and visual problems. I fear I may have rebound headache from using ibuprofen nearly daily for so long. I would like to know if there is an invasive but guaranteed method for eliminating head pain so I can have my life back. I’m doing a trial with an implant in my forehead, but I haven’t gotten the results I was hoping for. I am now hoping my doctor will allow me to try again with an occipital area implant.

Q. My adult daughter has had a headache for six months. It never goes away, no matter what she takes. Her primary doctor gave her a prescription for a limited number of Vicodin®, which dulls the pain a little, and she takes a muscle relaxant. She had her first migraine with aura at age 20 and until this year only got a migraine about twice a year. I thought she got off easy compared to her oldest sister, who suffered from severe migraine all through high school, and her other sister who outgrew cyclic vomiting syndrome. My daughter has had all the tests you can imagine and is seeing a neurologist who diagnosed her with chronic daily migraine. He says the next step is to start Topamax® and increase by increments, up to 200 mg. I’m concerned because she previously tried Topamax, up to 50 mg, but experienced tingling in her hands and nausea. My daughter’s quality of life is suffering and we are desperate to obtain relief for her. Do you have any advice?

Many pharmaceutical companies are researching completely new compounds to attack headaches from different angles. Merck & Co., Inc., announced that a Phase III clinical trial showed that a new compound called telcagepant (formerly known as MK-0974) significantly improved relief of migraine pain and associated symptoms comparable to the triptan zolmitriptan, but with fewer side effects.

Q. For the past year, off and on, and for the past three months continuously, I have had headache/dizziness related to the sensation of clogged ears. Per the advice of an ear, nose and throat specialist, I  do a saline sinus rinse, take a dose of Flonase, and I breathe steam with eucalyptus oil on a daily basis. I put a humidifier on my CPAP. I have also tried Sudafed, Claritin and Coricidin with no relief.  I am miserable, and the condition disturbs my sleep. Is there any hope for me? 

In the first half of this year, the pharmaceutical company NuPathe Inc. plans to resubmit its new drug application to the U.S. Food and Drug Administration (FDA) for Zelrix, a transdermal sumatriptan patch intended to treat migraine. The company had hoped to launch the new product in that time frame, but the FDA raised concerns in mid-2011 about the chemistry, manufacturing and safety of Zelrix, slowing the product's release.