Migraine: the road to recovery and forever

Migraine: the road to recovery and forever

I. Understanding of migraines: deeper than just a headache

Migraine is much more than just a severe headache. This is a neurological disease characterized by attacks of intense, pulsating pain, usually on one side of the head. However, migraine is a comprehensive state that includes a wide range of symptoms that can seriously disrupt the quality of human life. In order to effectively fight migraine, a deep understanding of its mechanisms, symptoms and factors provoking attacks is necessary.

A. The neurological basis of migraines:

The migraine is based on a complex complex of neurochemical and vascular changes in the brain. Many theories are trying to explain the mechanism of the development of migraines, but not one of them is exhaustive. The most recognized theories include:

1. Trigeminal vascular system: This theory assumes that activation of the trigeminal nerve (Nervus trigeminus), the largest cranial nerve, plays a key role. Activation of the trigeminal nerve leads to the release of neuropeptides, such as CGRP (calcitonin-hen-tied peptide), which cause inflammation and expansion of blood vessels in the solid brain shell (Dura Mater), a membrane surrounding the brain. This expansion and inflammation irritate the nerve endings, causing pain. That is why the drugs blocking CGRP have been effective in the treatment of migraines.

2. Cortical Spgging Depression (CSD): This theory assumes that a wave of neuronal and glial depolarization, slowly spreading along the cerebral cortex, triggers a chain of events leading to migraine. CSD can be associated with an aura that often preceding a headache for migraine with aura. It is believed that CSD activates the trigeminal vascular system and releases inflammatory substances.

3. The role of serotonin: Serotonin, neurotransmitter, playing an important role in the regulation of mood, sleep and pain, is also associated with migraine. The level of serotonin can change during a migraine attack, which can affect the activation of the trigeminal vascular system and pain. Preparations affecting serotonin levels, such as tripatans, are effective in the treatment of acute migraine attacks.

4. Genetic predisposition: Migraine has a pronounced genetic component. People who have relatives suffering from migraine have a higher risk of developing this disease. Although the specific genes responsible for migraine are not yet fully identified, the studies have shown the connection between certain genetic options and an increased risk of migraine development. For example, researchers have identified genes associated with the function of ion channels and a glutamate transmission that can play a role in the pathogenesis of migraines.

5. Mitochondria dysfunction: Some studies have shown the relationship between migraine and dysfunction of mitochondria, cell energy stations. Mitochondrial dysfunction can lead to a decrease in energy metabolism in the brain, increased susceptibility to stress factors and activation of pain pathways.

B. Classification of migraines:

International Headache Society Society classifies migraines into several subtypes, based on the presence or absence of an aura and the frequency of attacks:

1. Migraine without aura (Common Migraine): This is the most common type of migraine, characterized by headache attacks, which usually last from 4 to 72 hours. The headache is usually pulsating, medium or severe intensity, and intensifies with physical activity. Related symptoms can include nausea, vomiting, photophobia (sensitivity to light) and sound (sensitivity to sounds).

2. Migraine with aura (Classic Migraine): This type of migraine is characterized by the presence of aura, neurological symptoms that precede the headache or accompany it. The aura usually develops gradually within 5-20 minutes and lasts no more than 60 minutes. The most common types of aura include:

   • Visual aura: It may include flickering lights, zigzag lines, scotomas (blind spots) or loss of vision.
   • Sensory aura: May include numbness, tingling or weakness in one side of the body.
   • Speech aura: It may include difficulties with speech or understanding of speech.
   • Motor aura: Rarely, but can include weakness in one side of the body (hemiplegic migraine).

3. Chronic migraine: It is diagnosed in the presence of headaches for 15 or more days a month for more than 3 months, and at least 8 of these days correspond to migraine criteria. Chronic migraine can be very exhausting and significantly reduce the quality of life.

4. Episodic migraine: It is defined as a headache of less than 15 days a month.

5. Rare types of migraines: There are other, more rare types of migraines, such as hemiplegic migraine, basic migraine (migraine with stem aura) and ophthalmoplegic migraine.

C. Symptoms of migraines: the variety of manifestations:

Symptoms of migraines can vary greatly from person to person and from an attack to an attack. In addition to headache, the following symptoms may be present:

1. Headache: Usually pulsating, strong and localized on one side of the head. It can intensify with physical activity.

2. Nausea and vomiting: Often accompanying headache and can be very exhausting.

3. Photophobia and sound: Sensitivity to light and sounds that make people look for dark and quiet places.

4. Osmophobia: Sensitivity to smells, even weak.

5. Dizziness and violation of equilibrium: They can occur during a migraine attack.

6. Fatigue and weakness: They can persist for several days after the attack.

7. Cognitive disorders: They may include difficulties with concentration, memory and speech.

8. Aura: Neurological symptoms preceding or accompanying headache (only with migraine with aura).

9. Prodrome symptoms: Often, patients can notice changes in the mood, fatigue, difficulties with concentration, tension in the neck or increased sensitivity to light, noise or smells a few hours or even days before the start of the headache. This can be a useful signal for taking preventive measures.

D. Factors provoking migraines (triggers):

Many factors can provoke a migraine attack. Identification and avoidance of triggers can help reduce the frequency and intensity of attacks. Common triggers include:

1. Stress: It is one of the most common migraine triggers.

2. Changes in sleep mode: The lack of sleep, an excess of sleep or change in the schedule of sleep can provoke a migraine attack.

3. Food: Some products and drinks such as aged cheeses, treated meat, chocolate, red wine and caffeine can cause migraine in some people.

4. Passing of food intake: Unregular nutrition and a pass of eating can lead to a decrease in blood sugar, which can provoke migraines.

5. Dehydration: Insufficient fluid intake can contribute to the development of migraine.

6. Weather changes: Projects of atmospheric pressure, temperature and humidity can be migraine triggers.

7. Hormonal changes: In women, migraine is often associated with a menstrual cycle, pregnancy and menopause.

8. Bright light and loud sounds: They can cause migraine in sensitive people.

9. Smells: Strong smells, such as perfumes, smoke and chemicals, can be migraine triggers.

10. Medicines: Some drugs, such as oral contraceptives and vasodilators, can cause migraine.

II. Migraine diagnosis: the key to proper treatment

The exact diagnosis of migraine is the first step towards effective treatment. Since migraine can have a variety of symptoms, and headaches can be caused by various causes, it is important to consult a doctor to exclude other possible diseases and confirm the diagnosis.

A. The collection of anamnesis and physical inspection:

The doctor will begin with a detailed collection of an anamnesis, including questions about the nature of the headache, its frequency, duration, intensity, concomitant symptoms, factors provoking attacks, and family history. The doctor will also conduct a physical examination to exclude other possible causes of headaches, such as high blood pressure, vision problems or neurological diseases. It is important to provide the doctor as complete information about his symptoms and lifestyle in order to help him make the correct diagnosis.

B. Keeping a headache diary:

Keeping a headache diary is a valuable tool for the diagnosis and treatment of migraine. The following information should be recorded in the diary:

1. The date and time of the beginning of the headache.
2. The nature of the pain (pulsating, pressing, aching, etc.).
3. The intensity of pain (on a scale from 0 to 10).
4. Localization of pain (one side of the head, both sides, forehead, nape, etc.).
5. Related symptoms (nausea, vomiting, photophobia, sound, etc.).
6. Possible triggers (stress, food, weather, etc.).
7. Medicines taken to relieve pain, and their effectiveness.
8. The duration of the headache.

The headache diary will help the doctor determine the patterns in your migraine attacks, identify triggers and evaluate the effectiveness of treatment.

C. Neurological examination:

A neurological examination can be carried out to assess the function of the nervous system. The examination may include verification of vision, hearing, coordination, reflexes, muscle strength and sensitivity. A neurological examination is usually normal in migraine, but can help exclude other neurological diseases.

D. Additional research:

In most cases, the diagnosis of migraine is enough to collect an anamnesis and physical examination. However, in some cases, the doctor may prescribe additional studies, such as:

1. Magnetic resonance tomography (MRI) of the brain: MRI can be prescribed to exclude structural abnormalities of the brain, such as tumors, aneurysm or hemorrhage.

2. Computed tomography (CT) of the brain: CT can be prescribed in emergency cases when it is necessary to quickly eliminate hemorrhage in the brain.

3. Blood tests: Blood tests can be prescribed to exclude other diseases that can cause headache, such as infections or autoimmune diseases.

E. Differential diagnosis:

It is important to differentiate migraines from other types of headaches, such as headache of tension, cluster headache, headache associated with diseases of the cervical spine, and headache caused by other diseases. Proper diagnosis is crucial for choosing the most effective treatment.

III. Migraine treatment: individual approach

Migraine treatment should be individual and take into account the characteristics of each patient, including the frequency, intensity and duration of seizures, concomitant diseases and preferences of the patient. Migraine treatment includes two main approaches:

A. Treatment of acute attacks:

The purpose of treating acute attacks is to rapidly relieve pain and related symptoms. Medicines for the treatment of acute attacks should be taken as soon as possible after the start of headache.

1. Anesthetic drugs:

   • Nonsteroidal anti -inflammatory drugs (NSAIDs): Such as Ibuprofen, steady and ketoprofen, can be effective for migrants of migraine light and moderate attacks.

   • Paracetamol (acetaminophen): It can be effective for light and moderate migraine attacks, especially in combination with other drugs.

2. TRIPTA:

   • Triptans are specific drugs for the treatment of migraine, which act by narrowing of blood vessels in the brain and blocking the release of substances that cause inflammation. Triptans are effective for moderate and strong migraine attacks. Available in various forms, including tablets, nasal sprays and injections. Examples of triptans: summptor, risatriciptan, zolmitriptan, naratriptan, frutriptan and ethletriptan.
     • Side effects of triptans: They may include nausea, dizziness, drowsiness and a feeling of constraint in the chest. Triptans are contraindicated to people with diseases of the heart and blood vessels.

3. Digidrérgotamine (DHE):

   • Dhe is another drug for the treatment of migraine, which acts by narrowing of blood vessels in the brain. Dhe is available in the form of injections and nasal spray. It can be effective in severe migraine attacks that do not respond to other drugs.

4. Antimetics:

   • Anthematics are drugs that help reduce nausea and vomiting, often accompanying migraines. Examples of anti -emitics: metoclopramide, coolropezine and ondansetron.

5. Combined drugs:

   • Some drugs combine several active ingredients, for example, NSAIDs and caffeine. These drugs can be more effective than individual drugs in the treatment of acute migraine attacks.

B. Preventive treatment:

The purpose of preventive treatment is to reduce the frequency, intensity and duration of migraine attacks. Preventive treatment is recommended for people whose migraine occurs often (for example, more than 4 days a month) or if attacks greatly violate their quality of life.

1. Beta blockers:

   • Beta blockers, such as propranolol and metoprolol, are used to treat high blood pressure, but can also be effective in migraine prevention. It is believed that they act by blocking the effects of adrenaline, which can provoke migraines.

2. Antidepressants:

   • Some antidepressants, such as amitriptylin and wenlafaxin, can be effective in migraine prevention. It is believed that they act by increasing the level of serotonin and norepinephrine in the brain, which can help reduce pain sensitivity.

3. Anticonvulsants:

   • Some anticonvulsants, such as topiramate and valproic acid, can be effective in migraine prevention. It is believed that they act by stabilizing electrical activity in the brain.

4. Calcium channel blockers:

   • Calcium channel blockers, such as fluanarisine, can be effective in the prevention of migraine with an aura. It is believed that they act by preventing the narrowing of blood vessels in the brain.

5. Botulinic toxin injections (Botox):

   • Botox is approved for the treatment of chronic migraine. Botox injections are introduced into the muscles of the head and neck to reduce muscle tension and pain sensitivity.

6. Monoclonal antibodies to CGRP (calcitonin-hen-tied peptide):

   • These drugs, such as Erenumab, Fremanezumab, Galkanzumab and Eptynesumab, block CGRP or its receptor, which helps to prevent migraine. Introduced in the form of injections.

7. Other drugs:

   • Magnesium, Coenzyme Q10 and Riboflavin are food supplements that can be effective in migraine prevention in some people.

C. Non -drug treatment methods:

In addition to drugs, there are non -drug treatment methods that can help reduce the frequency and intensity of migraine attacks.

1. Life change change:

   • Regular sleep mode: Try to go to bed and wake up at the same time every day, even on weekends.

   • Healthy nutrition: Eat regularly and avoid passage of food intake. Limit the consumption of products and drinks that can provoke migraines.

   • Regular physical exercises: Regular physical exercises can help reduce stress and improve the overall health.

   • Reducing stress: Use relaxation methods such as meditation, yoga or deep breathing to reduce stress.

   • Sufficient fluid consumption: Drink enough water during the day to avoid dehydration.

2. Biological feedback (biofidBEC):

   • Biofidback is a method that helps people learn to control their physiological functions, such as heart rate, blood pressure and muscle tension. Biofidback can be effective in reducing the frequency and intensity of migraine attacks.

3. Acupuncture:

   • Acupuncture is a traditional Chinese medicine, which includes the introduction of thin needles into certain points on the body. Acupuncture can be effective in reducing the frequency of migraine attacks.

4. Massage:

   • Massage can help reduce muscle tension and stress, which can contribute to migraine alleviation.

5. Cognitive-behavioral therapy (KPT):

   • KPT is a type of psychotherapy that helps people change negative thoughts and behavior that migraines can contribute. KPT can be effective in reducing the frequency and intensity of migraine attacks.

6. Wear with filters: Wearing special glasses with filters that block certain lengths of light waves (especially blue and green) can reduce sensitivity to light and reduce the frequency of migraines.

7. Neurostimulation: There are portable devices for neurostimulations that are aimed at influencing certain nerves or areas of the brain to reduce the frequency and intensity of migraines. Examples are transcranial magnetic stimulation (TMS) and stimulation of the vagus nerve (VNS).

D. Pregnancy and migraine:

Migraine treatment during pregnancy requires a special approach, since many drugs are contraindicated in pregnant women.

1. Non -drug methods: Are a preferred option for treating migraines during pregnancy.

2. Anesthetic drugs: Paracetamol is considered safe for use during pregnancy, but NSAIDs should be avoided, especially in the third trimester.

3. Other drugs: Triptans and other medicines for migraine should be used with caution during pregnancy and only as prescribed by a doctor.

IV. Life and migraine: long -term strategy

A change in lifestyle plays an important role in the long -term management of migraine. Understanding their triggers and taking measures to avoid them, as well as maintaining a healthy lifestyle can significantly reduce the frequency and intensity of seizures.

A. Identification and avoidance of triggers:

Making a headache diary can help identify migraine triggers. After triggers are identified, you should try to avoid them.

1. Food triggers:

   • Avoid products and drinks that can provoke migraines, such as aged cheeses, treated meat, chocolate, red wine and caffeine.
   • Eat regularly and avoid passage of food intake.
   • Drink enough water during the day to avoid dehydration.

2. Environmental factors:

   • Avoid bright light, loud sounds and strong smells.
   • Try to avoid weather drops.

3. Stress:

   • Use relaxation methods such as meditation, yoga or deep breathing to reduce stress.
   • Do regular physical exercises.
   • Protise enough time and rest.

4. Hormonal changes:

   • In women, migraine is often associated with a menstrual cycle, pregnancy and menopause. Discuss with the doctor the possibilities of treatment that can help cope with hormone-dependent migraines.

B. Maintaining a healthy lifestyle:

Maintaining a healthy lifestyle can help reduce the frequency and intensity of migraine attacks.

1. Regular sleep: Try to go to bed and wake up at the same time every day, even on weekends.

2. Healthy nutrition: Eat in a balanced and regularly.

3. Regular physical exercises: Do moderate physical exercises for at least 30 minutes a day, most days of the week.

4. Reducing stress: Use relaxation methods such as meditation, yoga or deep breathing to reduce stress.

5. Sufficient fluid consumption: Drink enough water during the day to avoid dehydration.

C. Alternative and additional methods:

Some people find relief from migraine using alternative and additional treatment methods. It is important to discuss these methods with a doctor to make sure that they are safe and do not interact with other medicines.

1. Acupuncture: It can be effective in reducing the frequency of migraine attacks.

2. Massage: It can help reduce muscle tension and stress.

3. Phytotherapy: Some herbs, such as white -skinned and ginger, can be effective in the prevention and treatment of migraines.

4. Vitamins and minerals: Magnesium, Coenzyme Q10 and Riboflavin can be effective in the prevention of migraine in some people.

5. Aromatherapy: Some essential oils, such as lavender and peppermint, can help reduce stress and relieve headache.

V. Life with migraine: Psychological aspect

Migraine can have a significant impact on the psychological state of a person. Chronic pain, unpredictability of seizures and limitation of activity can lead to anxiety, depression and social insulation. It is important to consider the psychological aspect of migraines and seek help, if necessary.

A. The influence of migraines on mental health:

1. Anxiety: The constant expectation of migraine attacks can cause anxiety and anxiety.

2. Depression: Chronic pain and limitation of activity can lead to depression.

3. Social isolation: Migraine can complicate participation in social activity and lead to isolation.

4. Reducing the quality of life: Migraine can significantly reduce the quality of human life.

B. Psychological support:

1. Psychotherapy: Cognitive-behavioral therapy (KPT) can help people change the negative thoughts and behavior that migraines can contribute.

2. Support groups: Participation in support groups can help people with migraine feel less isolated and receive support from other people suffering from this disease.

3. Relaxation techniques: Meditation, yoga and deep breathing can help reduce stress and anxiety.

4. Self -help: Reading books and articles about migraine, keeping a headache diary and observing a healthy lifestyle can help people better cope with migraine.

C. Communication with loved ones:

It is important to openly communicate with loved ones about your migraine. Explain to them how migraine affects your life and ask them about support.

D. Professional help:

If you are alarming, depression or other psychological problems associated with migraine, seek professional help to a psychologist or psychiatrist.

VI. Future of treatment with migraines: new horizons

Research in the field of migraine continues, and new methods of treatment appear that promise to improve the lives of people suffering from this disease.

A. New drugs:

1. Gepanti: A new class of drugs for the treatment of acute migraine attacks, which act by blocking CGRP. Hyander, such as Riemegepant and Urogepant, can be effective and well tolerated.

2. Lasmeditan: A selective agonist 5-HT1F receptor, which is used to treat acute migraine attacks. Unlike triptans, Lasmeditan does not narrow the blood vessels, which makes it safe for people with diseases of the heart and blood vessels.

B. New methods of neurostimulations:

1. Transcranial magnetic stimulation (TMS): The non -invasive method of stimulation of the brain, which can be effective in the prevention and treatment of migraine.

2. Stimulation of the vagus nerve (VNS): The method of stimulating the vagus nerve, which can be effective in the prevention and treatment of migraines.

C. Gene therapy:

Studies in the field of gene therapy can lead to the development of new migraine treatment methods, which will be aimed at correcting genetic defects associated with this disease.

D. Artificial intelligence:

Artificial intelligence can be used to develop personalized migraine treatment methods based on analysis of symptoms, triggers and treatment effectiveness.

VII. Myths and facts about migraine

There are many myths about migraines that can mislead and prevent the correct treatment. It is important to know the truth about migraine in order to effectively fight this disease.

A. common myths:

1. Myth: Migraine is just a severe headache.
   Fact: Migraine is a neurological disease that includes a wide range of symptoms, in addition to headaches.

2. Myth: Migraine is a psychosomatic disease.
   Fact: Migraine has a biological basis and is associated with changes in the brain.

3. Myth: Migraine is a female disease.
   Fact: Migraine is found in men and women, although women suffer from migraine more often than men.

4. Myth: Migraine is a rare disease.
   Fact: Migraine is a common disease that suffers from about 12% of the world’s population.

5. Myth: Migraine is not treated.
   Fact: Migraine can be successfully treated with drugs and non -drug methods.

6. Myth: Caffeine always causes migraine.
   Fact: Caffeine can be a trigger for some people, but for others it can relieve headache.

B. Important facts:

1. Migraine has a genetic component.
2. Migraine can cause disability.
3. Migraine treatment should be individual.
4. A change in lifestyle can help reduce the frequency and intensity of migraine attacks.
5. Psychological support is important for people with migraine.

VIII. Resources and support for people with migraine

There are many resources and organizations that can provide information, support and assistance to people suffering from migraine.

A. Migraine organizations:

1. American Migraine Foundation. Provides information about migraine, research and treatment.
2. Headache and Migraine Association Association: Offers resources for people with headaches and migraines, including information, support groups and educational programs.
3. International Society of the Headache (International Headache Society): An organization engaged in research and education in the field of headache.

B. Online resources:

1. Websites of medical organizations: Many medical organizations, such as Mayo Clinic and WebMD, provide information about migraines.
2. Online support groups: There are online support groups for people with migraine where you can communicate with other people suffering from this disease and share experience.

C. Doctors and specialists:

1. Neurologists: Specialize in the diagnosis and treatment of diseases of the nervous system, including migraine.
2. General practitioners: They can diagnose and treat migraines, as well as direct to specialists, if necessary.
3. Headache experts: Neurologists or general practitioners who have additional training in the field of headache.
4. Psychologists and psychiatrists: They can help people cope with the psychological problems associated with migraine.

IX. Tips for family and friends of people with migraine

If your loved one has migraine, there are many ways to support him and help him cope with this disease.

A. Understanding and sympathy:

1. Remember that migraine is a real disease. Do not treat migraines as a simple excuse or a way to avoid responsibility.
2. Show sympathy for the suffering of your loved one. Migraine can be very painful and exhausting.
3. Be patient and understanding. Migraine attacks can be unpredictable and violate plans.

B. Support and help:

1. Help your loved one to identify migraine triggers.
2. Create a calm and quiet environment during a migraine attack.
3. Help your loved one to receive the necessary medical care.
4. Offer support and encouragement.

C. Communication and openness:

1. Ask how you can help.
2. Be open to discuss problems related to migraine.
3. Remember that your presence and support can be very important for your loved one.

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