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Neurosciences Institute

Headache

Cluster, tension, migraine, sinus – no matter what kind of headache you have, all headache sufferers agree – headaches are a pain. Geisinger's team of headache specialists meets headaches “head on.”

Our team of specialists will work with you to identify what type of headache you have and develop a treatment plan customized for you. We understand that each patient experiences their headache symptoms differently – from nagging, constant pain to sharp, debilitating pain – which is why your physician will develop, explain and help you follow your unique treatment plan designed to provide the most effective relief and management of your symptoms with minimal side effects.

At Geisinger Wyoming Valley we offer headache infusion therapy. Headache infusion therapy is a unique outpatient treatment strategy for headache patients not available at most headache centers nationwide. Some patients will only use the infusion center one time while others will use it intermittently to maintain control of their headaches. Headache infusion uses Intravenous medications, given for a set period of time each day for up to three days in a row.

INFUSION THERAPY

Goals | Candidates | Complications | Side Effects



The goal of infusion therapy is to:

  • Reduce headache intensity and frequency
  • Help patients get out of medication rebound headache by providing treatment at the same time they stop their overused medications
  • Discover what medications with what mechanisms of action will help that individual’s headaches. This provides the headache specialist important information to create a more effective acute headache and preventive treatment program.

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Candidates for headache infusion therapy include:

  • Chronic daily headache patients without medication overuse who have failed multiple preventive and abortive agents and who are disabled by their headaches but do not require or want inpatient treatment
  • Chronic daily headache patients with medication overuse who can be detoxified safely from daily “rebounding medication” as an outpatient without risk of withdrawal. This would include patients taking daily triptans, over the counter agents, low dose butalbital and those on a non-daily use of opiates
  • Patient with frequent but not daily headaches who are frustrated by their lack of response to medications
  • Migraine headache lasting more than 24 hours and not responding to typical medications (status migraine)
  • Patients experiencing a prolonged aura
  • Cluster headache exacerbation
  • New daily persistent headache

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Possible complications of infusion therapy:

  • Unrelieved pain-The goal of infusion therapy is to treat the patient’s current headache so they leave infusion feeling better. The long term goal is to reset the brain’s neuro-chemicals so that the brain can heal itself and patients can go from very frequent headaches to minimal headaches. This may take time to see clinically (especially in individuals with daily headache for many years) so do not be discouraged if your pain is not dramatically different after only three days of infusion. It should improve over the days and weeks to come.
  • Unrelieved withdrawal symptoms-This should not be an issue for most infusion center patients as those who are on very addicting medications will not go through this outpatient program

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Untoward side effects of treatment include:

  • Drowsiness – is very common that is why each patient needs to have transportation.
  • Akathesia – is a side-effect of dopamine blocking agents. It’s a feeling as if you are crawling out of your skin. This is easily treated with antihistamine products.
  • Dystonia – very rare side effect of dopamine blocking agents in which your muscles or face get contorted. This is treated with antihistamine products.
  • Chest pain – some of the infusion medications can produce chest tightness which is rarely ever cardiac. All patients are given an EKG prior to infusion to make sure there are no medication contraindications.
  • Hypotension – some of the medications may produce low blood pressure. To counteract this you will receive continuous intravenous fluids as well as having repetitive blood pressure measurements
  • Phlebitis at intravenous site – any time an intravenous line is placed there is risk for the development of inflammation or a superficial clot around the IV site. This rarely needs further management outside of heat compress and maybe some anti-inflammatory medications. Very rarely a deep vein thrombus can arise and this will need more aggressive treatment with possible blood thinners.

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If you’re one of the millions of people who suffer migraines or recurring headaches, call 800-275-6401 today to schedule an appointment.