Editing Headache (section)

=== Migraines ===
[[Migraines|Migraine]] can be somewhat improved by lifestyle changes, but most people require medicines to control their symptoms.<ref name=Goadsby /> Medications are either to prevent getting migraines, or to reduce symptoms once a migraine starts.{{citation needed|date=June 2021}}

Preventive medications are generally recommended when people have more than four attacks of migraine per month, headaches last longer than 12 hours or the headaches are very disabling.<ref name=Goadsby /><ref name="UTD Migraine Tx">{{cite report | vauthors = Bajwa ZH, Sabahat A | title = Preventive Treatment of Migraine in Adults. | work = UptoDate | veditors = Swanson JW | location = San Francisco, CA. | publisher = Wolters Kluwer <!-- | access-date = 24 April 2014 --> }}</ref> Possible therapies include beta blockers, antidepressants, anticonvulsants and NSAIDs.<ref name="UTD Migraine Tx" /> The type of preventive medicine is usually chosen based on the other symptoms the person has. For example, if the person also has depression, an antidepressant is a good choice.{{citation needed|date=June 2021}}

Abortive therapies for migraines may be oral, if the migraine is mild to moderate, or may require stronger medicine given intravenously or intramuscularly. Mild to moderate headaches should first be treated with [[acetaminophen]] (paracetamol) or NSAIDs, like [[ibuprofen]]. If accompanied by nausea or vomiting, an antiemetic such as metoclopramide (Reglan) can be given orally or rectally. Moderate to severe attacks should be treated first with an oral [[triptans|triptan]], a medication that mimics [[serotonin]] (an agonist) and causes mild vasoconstriction. If accompanied by nausea and vomiting, parenteral (through a needle in the skin) triptans and antiemetics can be given.<ref>{{cite journal | vauthors = Láinez MJ, García-Casado A, Gascón F | title = Optimal management of severe nausea and vomiting in migraine: improving patient outcomes | journal = Patient Related Outcome Measures | volume = 4 | pages = 61–73 | date = October 2013 | pmid = 24143125 | pmc = 3798203 | doi = 10.2147/PROM.S31392 | doi-access = free }}</ref>

Sphenopalatine ganglion block (SPG block, also known nasal ganglion block or [[pterygopalatine ganglion]] blocks) can abort and prevent migraines, tension headaches and cluster headaches. It was originally described by American ENT surgeon Greenfield Sluder in 1908. Both blocks and neurostimulation have been studied as treatment for headaches.<ref>{{cite journal | vauthors = Boss KW, Przkora R, Kumar S | title = Sphenopalatine ganglion: block, radiofrequency ablation and neurostimulation - a systematic review | journal = The Journal of Headache and Pain | volume = 18 | issue = 1 | pages = 118 | date = December 2017 | pmid = 29285576 | pmc = 5745368 | doi = 10.1186/s10194-017-0826-y | doi-access = free }}</ref>

Several complementary and alternative strategies can help with migraines. The American Academy of Neurology guidelines for migraine treatment in 2000 stated [[relaxation training]], electromyographic feedback and [[cognitive behavioral therapy]] may be considered for migraine treatment, along with medications.<ref>{{cite journal | vauthors = Silberstein SD | title = Practice parameter: evidence-based guidelines for migraine headache (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology | journal = Neurology | volume = 55 | issue = 6 | pages = 754–762 | date = September 2000 | pmid = 10993991 | doi = 10.1212/wnl.55.6.754 | doi-access = free }}</ref>