Migraines and PPS

From Richard L. Bruno, HD, PhD
Director, International Centre for Polio Education

Question:

I had polio at age 3 am now 69. I never needed assistive devices and had a normal childhood. I am now experiencing migraine headaches for multiple days in a row. Migraine medication doesn't work. Tramadol does not help. Do you think they are PPS-related? I am so tired of fighting the pain.

Dr. Bruno’s Response:

Left Sternocleidomastoid

The first question is "Are the headaches REALLY migraines?" Migraine may be neurology’s most misdiagnosed condition. Throbbing pain on one side of the head, light/sound sensitivity, nausea/vomiting, vertigo/dizziness and a visual aura/vision changes are diagnostic of migraine. But ALL of those symptoms except aura/vision changes can be caused by spasms in the muscles in the front (sternocleidomastoid muscles) and side (scalene muscles) of your neck that turn your head. Although migraines can last for days, they usually last around 4 hours. Muscle spasms and the pain they cause can last for weeks.

Migraines are not PPS-related, but muscle spasms in the neck and the upper back into your neck can be. But, just like PPS, there is no test for migraines and they have to be diagnosed by exclusion. My guess is that your doctor will examine your neck muscles to make sure spasm isn't the cause of the head pain.

Scalenes

If spasm is the cause, Valium (diazepam), heat and stretching can knock out the spasm and pain. Pain medication, like Tramadol, can help turn off muscle spasm pain, but without Valium usually isn't enough to get rid of spasm.

Talk to your doctor and get the right diagnosis to get the right treatment and medication.