Migraine treatment by a migraine specialist
Migraine treatment is not just a matter of taking a painkiller. It often requires an in-depth assessment by a migraine specialist. My qualifications as a neurologist help me to assess and diagnose patients who suffer from migraines and other headache disorders. In my neurological practice in Mount Lawley Perth, I frequently receive referrals from general practitioners to assist them with diagnosing and managing their patients with chronic migraines.
If you suffer from chronic migraines, you would know that they can be the most debilitating ones. In that case, you can often experience headaches on 15 or more days per month. And a typical situation would be that your headache, in case of a chronic migraine, would not respond to the usual headache tablets or migraine medications.
That’s why it is often best to find the most specialised help you can find. A neurologist looks at the underlying mechanics of your brain, and always aims to provide the most suitable treatment for your specific situation.
Migraine Specialist Perth
New migraine treatment options in Perth
The innovation in migraine treatment is ongoing, and as a neurologist, I stay in tune with the latest national and international research in this area. So if you are diagnosed with migraine, it’s important to verify that you are offered the latest, globally approved treatment options that are available.
Treating migraine is not a one-size-fits-all program. Every choice you and I make in regards to your treatment plan, at my practice in Mt Lawley, depends on your personal situation and on your diagnosis.
Migraine specialists have been treating chronic migraine sufferers with botulinum toxin A (Botox) for some time, but it is only since 1 March 2014 that the treatment is subsidised on the Pharmaceutical Benefits Scheme (PBS).
To qualify for PBS subsidised Botox, you must have experienced an average of 15 or more headache days per month, with at least 8 days of migraine, over a period of at least 6 months. You must also have failed to respond to other treatments.
How does Botox work? Botox works by blocking the nerves that convey pain sensation.
So how is Botox administered as a migraine treatment? Botox is injected by a qualified neurologist or a migraine specialist into the muscles, at approximately 31 different points of the face, head and neck, and this is repeated every 3 months.
The Botox treatment results with my patients here in Mt Lawley Perth, are positive for the majority of patients. They can expect at least 50% reduction in the frequency of their headaches.
If you have chronic migraines, you cannot lead a normal life when half the month is affected by headaches. Often you can’t go to work and simply can’t function. My patients often report an improvement in their quality of life and an increased ability to function once they start their Botox treatment.
Although Botox injections for chronic migraine prevention are relatively safe, minor side-effects are possible. They include pain at injection sites, muscle weakness near where the medicine was injected, droopy eyelids, uneven eyebrows, dry eyes and excessive tearing. Side effects are usually short lasting.
New future treatments:
CGRP (calcitonin gene-related peptide) inhibitors
- Examples are erenumab (Aimovig), fremanezumab (Ajovy) and galcanezumab (Emgality), which have recently received approval by the Therapeutics Goods Administration (TGA) but they are not PBS subsidised yet.
- Therefore, they are very costly at the moment.
- These treatments are monoclonal antibodies and they work by blocking CGRP, which is a protein involved in the transmission of pain.
- These treatments are given by subcutaneous injections (under the skin) usually once a month and they can be administered at home. CGRP receptor antagonists (gepants) These are currently in development and they have shown promise in phase III clinical trials.
CGRP receptor antagonists (gepants)
- These are currently in development and they have shown promise in phase III clinical trials.
Perth Migraine Specialist
Reducing the impact of migraine on your life
When we look at your situation, it’s all about reducing the impact. And if you are suffering from migraine, you will know very well that migraine affects how you go about your day-to-day life.
- Debilitating effect on simple activities:
I have heard many stories of people who couldn’t even go about simple household chores because of their intense migraines. For others, even recreational things like reading a book, or watching television, becomes almost impossible and at least painful because of the migraine attacks.
- Social life:
You often have to miss family activities or cancel functions because of the unpredictability of migraine attacks. Debilitating migraines reduce your ability to spend quality time with your family. In the long run, that in itself becomes an emotional burden, so when we treat you for migraine, we are always working towards less discomfort, and a better quality of life.
- Vocational impact:
If your migraine attacks last for days, they hinder your ability to succeed at work or attend school.
The sensitivity to light, sound and noise may mean missing social gatherings altogether. And that in itself can lead to isolation, so it is important to look into treatment options so you can live your life at the fullest.
Migraines can often be accompanied by feelings of hopelessness and helplessness, which can be signs of depression. So when patients ask me why I have chosen to specialise in migraine treatment as a neurologist, it’s also because of this. In the bigger scheme of things, we are not just here to fix your symptoms. We are here to help you live the best possible life with your loved ones and in your community.
How can I get treatment for my migraine?
At a practical level, these are the steps to find out if I can help you with migraine treatment:
- GP Referral:
You will need a current referral letter from your General Practitioner.
- Neurological Consultation:
I will take a detailed history from you and perform a neurological examination. It will be very helpful if you can bring along your headache diary and a list of all the medications you have tried in the past.
Migraine is diagnosed based on your clinical history, physical examination findings and where relevant, investigation findings to exclude other causes of headaches that may mimic migraines.
I will discuss with you the various treatment options available to you and the most appropriate treatment for you based on your migraine frequency and severity as well as what treatment you may have had in the past.
Why choose Dr Susan Ho in Mt Lawley, Perth?
I would say the best reason to choose me is my ongoing commitment to quality care, based on my extensive career and my sub-specialty qualifications.
Qualifications: I am a Fellow of the Royal Australasian College of Physicians (FRACP) with specialist qualification in Neurology since 1994.
Experience: I have been treating a lot of patients with migraines since commencing private practice at Mount Lawley Perth 20 years ago. I have a sub-specialty interest in treating chronic migraines and I have been administering Botox for the prevention of chronic migraines ever since the medication became subsidised by PBS in 2014.
I am a member of the Australian New Zealand Headache Society as well as the International Headache Society. My affiliations with these organisations mean that I have access to the most up-to-date information on the latest developments and advances in headache and migraine management.