Hello. Thank you for posting your query at DoctorSpring.com
I have noted the details of your daughter and my replies are below.
1. If sumatriptan is not helping in reducing the headache, then, other options are rizatriptan tablets. The usual dose is 10 mg and it can be repeated after one hour if the headache does not subside with one tablet. For more severe headache and nausea, injection tramadol and ondansetron can be given in the ER.
In addiiton, as she has frequent episodes, she should be started on preventive medications, such as topiramate, divalproex or beta blockers.
2. It is uncommon, however, about 5-10% of patients do have this type of increased frequency of attacks.
3. The increased frequency could be due to an unknown trigger or just be a natural course of the disease, until the medications start having full effect.
4. The absence of headache would signify the end of attack/episode.
Please keep me informed about the MRI brain report. She should also undergo an MR angiogram along with that.
Dr. Sudhir Kumar MD (Medicine), DM (Neurology)
Senior Consultant Neurologist