Q: I was diagnosed with migraines three years ago and started taking propranolol to stop the attacks. Since I have been on the medicine, I haven’t had a migraine—until a week ago. I was on my way to pick my children up from school when my eyes started to go funny—seeing zigzag lines—and I knew a migraine was about to start. By the time I got home, my right arm and the right side of my face were numb, and then the pounding headache started. I went straight to bed, and the migraine headache lasted until the next day. This is typical of my headaches except for one thing—my head is still tender and sore to touch, and it feels like my hair hurts. I just want some reassurance that this is normal. Should I be feeling like this a week after having a migraine?
A: That’s great that propranolol worked so well to reduce the frequency of your migraine attacks. Since migraine is a potentially lifelong medical condition, it’s not unusual to still have breakthrough attacks even when taking preventive medication. It is reassuring that this recent attack started the same way as your other attacks. You didn’t mention taking any medication to treat the attack, so it likely ran the entire course of neuron excitation in the brain; vascular changes and inflammation. Symptoms such as your hair hurting and tender or sore scalp/muscles on your head are common complaints of cutaneous allodynia (meaning that normal touch is unpleasant or painful). These sensations are due to abnormal brainstem processing of pain signals during the migraine attack. Some migraine sufferers experience postdrome—vague symptoms that can last days after the migraine attack. If you are still not feeling back to normal, see your healthcare professional.
Lisa Mannix, MD, Headache Associates, West Chester, OH
