Physician Assistant Alicia Choquette specializes in migraine management. After five years with a prominent neurology practice in San Diego, she joined Blackhawk Plastic Surgery in July 2019 to help with the expansion of the Blackhawk Migraine Center.

For some, migraines can be a minor nuisance, but for others they are a disabling, chronic condition that can wreak havoc on your life. If you are one of the 38 million Americans with migraine, you may be wondering, “what’s causing my migraine attacks? And is there anything I can do to stop them?”

While migraine is the most common neurological condition, it is often misunderstood or incorrectly diagnosed as a sinus or tension headache. If you have a headache accompanied by sensitivity to light, sound or odors, or if you get nauseous or vomit, you may have migraine and should talk to a specialist to get an accurate diagnosis. There are many treatment options available for acute attacks and preventative management that will decrease the number of headache days per month. The good news for migraineurs is there are new treatment options arising each year.

If migraines are prevalent in your family, your genetics can be a contributing factor. Though we can’t change our genetic makeup, we can change the environmental influences on those genes. By reducing certain factors and creating a healthy lifestyle we may be able to diminish the frequency and intensity of attacks. Four healthy habits a migraine patient should focus on are: 1) adequate fluid hydration with minimal caffeine intake, 2) regular exercise on most days of the week, 3) adequate sleep, and 4) proper nutrition. Avoid triggers such as alcohol, sulfites, smoked meats, chocolate and MSG. Other contributing factors may include hormonal fluctuations and change in barometric pressure (i.e. fog, extreme heat, or cold). Often for women, headaches improve after menopause, but this is not always the case.

When seen at the Blackhawk Migraine Center, we start by identifying the impact of your headaches on your life. The frequency and severity of your headaches will help us design an appropriate treatment plan. If you are missing work, school, or family functions throughout the month, a prevention medication is generally warranted. Effective prevention may include anti-depressants, anti-convulsant, anti-hypertensive medications, Botox, CGRP antagonists, and even migraine surgery.

Onabotulinumtoxin A, the same Botox that smooths facial wrinkles, also prevents the muscle contractions that can trigger your migraines. Botox is administered roughly every three months in seven specific head and neck muscles.

A new class of medications called CGRP antagonists (Calcitonin Gene-related Peptide) was FDA approved in 2018 for the treatment of migraine. CGRP is a large protein that transmits pain signals along the trigeminal nerve into the brain stem and through the brain itself during a migraine. The three new FDA approved medications help block the release of CGRP, preventing migraines. These medications are monthly self-injectables.

Migraine surgery refers to surgical decompression of one or several nerves in the head and neck which have been shown to trigger migraine symptoms. Migraine surgery is a highly individualized procedure. Studies have shown that up to 95% of patients undergoing surgery experience improvement or complete elimination of migraine headaches.

With one in four households affected by migraine, the most important thing to remember is that you are not alone, and with many effective treatment options available, there is hope. Blackhawk Plastic Surgery Migraine Center is here to help ease the burden of living with migraine by customizing a treatment plan that works for you.