Migraine: Find your way to complete deliverance

Migraine: Find your way to complete deliverance

I. Understanding of migraines: deeper than just a headache

A. Definition and classification of migraines:

1. Migraine: a complex neurological disease: Migraine is much more than just a severe headache. This is a complex neurological disorder, characterized by repeating attacks with a pulsating headache, often accompanied by other symptoms, such as nausea, vomiting, sensitivity to light (photophobia) and sound (phonophobia). The difference between migraines and the usual headaches of tension lies in its intensity, duration and concomitant symptoms.

2. Migraine with aura and without aura: two main types: Migraine is classified into two main types: migraine with aura and migraine without aura.

   • Migraine without aura (ordinary migraine): This is the most common type of migraine, which accounts for about 70-80% of all cases. The attack begins with a headache, which is usually pulsating, one -sided (affects one side of the head) and medium or severe intensity.
   • Migraine with aura (classic migraine): Migraine with an aura is characterized by the presence of transient neurological symptoms called aura that occurs before or during an attack of headache. The aura usually lasts from 5 to 60 minutes and can include visual disturbances (flickering lights, zigzag lines, vision fields), sensory disorders (numbness, tingling), speech disorders (difficulty with speech) or motor disorders (weakness).

3. Rare types of migraines: In addition to the main types, there are more rare forms of migraines, such as:

   • Hemiplegic migraine: It is characterized by a weakness of one side of the body (hemiparesis) during an attack.
   • Ophthalmoplegic migraine: Causes paralysis of the muscles that control the movement of the eyes.
   • Basial migraine (migraine with an aura of brain stem): Causes symptoms emanating from the brain trunk, such as dizziness, double -gathering, impaired coordination, noise in the ears and loss of consciousness.
   • Abdominal migraine: It is more common in children and is characterized by pain in the abdomen, nausea and vomiting without headache.
   • Chronic migraine: It is diagnosed in the presence of headaches for 15 or more days per month, at least 8 of which correspond to the criteria of migraine.

B. Causes and risk factors of migraine:

1. Genetic predisposition: Migraine has a strong genetic component. If you have close relatives suffering from migraine, the probability of its development increases significantly. Studies have identified several genes associated with an increased risk of migraine development.

2. Neurological factors:

   • Trigeminal nervous system: It is believed that the trigeminal nervous system, which is responsible for the transmission of pain signals from face and head to the brain, plays a key role in the pathophysiology of migraine. Activation of the trigeminal nervous system leads to the release of neuropeptides, such as CGRP (calcitonin-hen-tied peptide), which causes inflammation and expansion of blood vessels in the brain, which leads to a headache.
   • Dysfunction of ion channels: Violations in the work of ion channels in the brain that control the electrical activity of neurons can also contribute to the development of migraine.
   • Changes in neurotransmitters: The instability of neurotransmitters, such as serotonin, dopamine and norepinephrine, are also associated with migraine.

3. Migraine triggers: Many factors can provoke a migraine attack of predisposed people. Triggers are individual and can vary from person to person. Common triggers include:

   • Dietary triggers: Some products and drinks such as aged cheeses, treated meat, chocolate, red wine, beer, caffeine (both excess and cancellation), aspartam and sodium glutamate (MSG) can provoke migraines.
   • Ecological triggers: Weather changes (pressure drops, strong wind, storms), bright light, flickering light, loud sounds, strong smells (perfumes, chemicals, smoke) and changes in height can cause migraine.
   • Hormonal changes: In women, migraine is often associated with hormonal changes occurring during the menstrual cycle, pregnancy and menopause. The use of hormonal contraceptives can also affect the frequency and intensity of migraine.
   • Stress and anxiety: Stress, both physical and emotional, is a common migraine trigger. Anxiety and depression can also aggravate migraines.
   • Lack of sleep or excess sleep: Changes in sleep mode, such as lack of sleep, pouring, changing time zones or a shift schedule, can provoke migraines.
   • Missed meals: Passing meals or long breaks between meals can lead to a drop in blood sugar, which can cause migraine.
   • Physical activity: Intensive physical exercises, especially in hot weather, can provoke migraines.
   • Dehydration: Insufficient fluid consumption can lead to dehydration, which can cause headache and migraine.
   • Some drugs: Some drugs, such as vasodilators and contraceptives, can provoke migraines.

C. Symptoms of migraines: a wide range of manifestations:

1. Migraine phases: A migraine attack usually consists of several phases:

   • PROMROM (Prevostniki): This phase occurs a few hours or days before the start of a headache and may include symptoms such as fatigue, irritability, mood change, traction to food, stiffness in the neck and frequent urination.
   • Aura (if present): Aura is transient neurological symptoms that occur before or during a headache. The most common types of auras are visual disorders, such as flickering lights, zigzag lines and fields of visual fields. Other symptoms of aura may include sensory disorders, speech disorders and motor disorders.
   • Headache: The headache for migraine is usually pulsating, one -sided (affects one side of the head) and medium or severe intensity. It can intensify with physical activity and be accompanied by nausea, vomiting, sensitivity to light (photophobia) and sound (phonophobia).
   • Postdrome (recovery): This phase occurs after the headache has subsided, and can include symptoms such as fatigue, weakness, difficulties with concentration of attention and change in mood.

2. Typical symptoms of migraines:

   • Rubbing headache: The most characteristic symptom of migraine is a pulsating headache, which is usually felt on one side of the head.
   • Nausea and vomiting: Nausea and vomiting are frequent migraine satellites.
   • Sensitivity to light (photophobia): Bright light can aggravate headache and cause discomfort.
   • Sensitivity to sound (phonophobia): Loud sounds can aggravate a headache and cause discomfort.
   • Dizziness: Dizziness and violation of equilibrium can occur during a migraine attack.
   • Nasal congestion: Nose congestion and runny nose can occur during a migraine attack.
   • Fatigue: Fatigue and weakness are common symptoms of both before and after an attack of migraine.
   • Difficulties with concentration: Difficulties with concentration of attention and memory problems can occur during an attack of migraine.
   • Change of mood: Changing mood, such as irritability, anxiety and depression, can occur before, during and after an attack of migraine.

II. Migraine diagnosis: the path to proper treatment

A. Anamnesis collection and physical inspection:

1. Detailed history: Migraine diagnosis begins with a detailed history of the anamnesis. The doctor will ask you about your symptoms, frequency and duration of headaches, triggers, family history of migraine and other concomitant diseases. It is important to provide the doctor as much information about your headaches as possible so that he can make the correct diagnosis.

2. Physical and neurological examination: The doctor will conduct a physical and neurological examination to exclude other causes of a headaches, such as brain tumors, aneurysm and other neurological disorders. A neurological examination includes an assessment of your strength, reflexes, coordination, sensitivity and mental status.

B. Migraine diagnostics criteria:

1. International Classification of the Headache (ICHD): To diagnose migraines, the criteria developed by the International Headache Society (ICHD) are used. These criteria help doctors make an accurate diagnosis and distinguish migraine from other types of headache.

2. Migraine criteria without aura: To diagnose migraines without aura, you need at least 5 headache attacks corresponding to the following criteria:

   • The headache lasts from 4 to 72 hours (without treatment or with ineffective treatment).
   • A headache has at least two of the following characteristics: one -sided localization, pulsating in nature, moderate or severe intensity, intensifies with ordinary physical activity (for example, walking or climbing the stairs).
   • During a headache, at least one of the following symptoms occurs: nausea and/or vomiting, photophobia and phonophobia.

3. Migraine criteria with aura: To diagnose migraines with an aura, you need at least 2 attacks corresponding to the following criteria:

   • The aura consists of at least one of the following reversible symptoms: visual, sensory, speech or motor disorders, stem symptoms (dizziness, double -gathering, coordination), retinal symptoms (flickering lights in one eye).
   • At least two of the following signs: one symptom of the aura spreads gradually within 5 or more minutes; and/or two or more symptoms of the aura arise sequentially; Each symptom of the aura lasts from 5 to 60 minutes; The aura is accompanied by a headache for 60 minutes, or a headache occurs simultaneously with the aura.

C. Additional research methods:

1. Neurovalization: In most cases, with typical migraine, neuroizoalization is not required. However, in some cases, when there is a suspicion of other diseases of the brain, the doctor may prescribe an MRI (magnetic resonance imaging) or CT (computed tomography) of the brain.

2. Laboratory research: Laboratory blood tests are usually not used to diagnose migraines, but can be prescribed to exclude other diseases that can cause headache.

3. Headache diary: Making a headache diary can be very useful for the diagnosis and treatment of migraine. The diary should record the date, start and end of the headache, headache intensity, symptoms that accompanied headache, triggers that could provoke headache, and the drugs that you took to relieve headaches.

III. Migraine treatment: an individual approach to relief and prevention

A. Migraines treatment goals:

1. Relief of pain and related symptoms: The main goal of the treatment of migraines is to relieve pain and other symptoms, such as nausea, vomiting, photophobia and phonophobia.

2. Reducing frequency, duration and intensity of seizures: Another important goal of treatment is to reduce the frequency, duration and intensity of migraine attacks.

3. Improving the quality of life: Migraine treatment should help improve the quality of life of people suffering from this disease, allowing them to lead a normal and active life.

4. Minimization of side effects of drugs: When choosing treatment, it is necessary to take into account the possible side effects of drugs and choose the safest and most effective options.

B. Treatment of acute migraine attacks:

1. Nonsteroidal anti -inflammatory drugs (NSAIDs): NSAIDs, such as Ibuprofen, Naroxen and Diclofenac, can be effective for alleviating pain with migrants of migraine. They work, reducing inflammation and pain.

2. TRIPTA: Triptans are a class of drugs specially designed for the treatment of migraine. They work by narrowing the blood vessels in the brain and blocking the release of neuropeptides that cause inflammation and pain. Triptans are most effective if they are taken at the beginning of the migraine attack. Examples of triptans include collapse, risatriciptan, intrigriptan, gyripriptan, ethletriptan and froverypantan.

3. Alkaloids Spores: Sporers alkaloids, such as ergotamine and dihydroergotamine (DGE), are old medicines for migraines, which also work, narrowing blood vessels in the brain. They are less effective than triptans and have more side effects.

4. Anti -rate drugs: Anti -rate drugs, such as meteclopramide and coolroperazin, can help alleviate nausea and vomiting, which often accompany migraine. They can also improve the absorption of other medicines for migraine.

5. Opioid analgesics: Opioid analgesics, such as codeine and tramadol, are not recommended for routine treatment of migraine, as they can cause addiction and aggravate headache (drug-induced headache). They can be used in rare cases when other treatment methods are ineffective.

6. CGRP Antagonists (heaps and ditans): Hypers (for example, Riemegepant, urogeepant) and ditans (for example, lasmiditan) are new classes of drugs for the treatment of acute migraine attacks. Hyans block the CGRP receptor, and ditans affect serotonin receptors. They can be especially useful for people who are contraindicated in tripatans.

C. Preventive treatment of migraines:

1. Beta blockers: Beta blockers, such as propranolol and metoprolol, are often used to prevent migraine. They work by blocking the effect of adrenaline and norepinephrine, which can help reduce the frequency and intensity of migraine attacks.

2. Calcium channel blockers: Calcium channel blockers, such as fluanarisine and verapamil, can also be used to prevent migraine. They work by blocking the intake of calcium in the cell, which can help reduce the excitability of neurons in the brain.

3. Tricyclic antidepressants: Tricyclic antidepressants, such as amitriptylin and Nordriciplin, can be effective for migraine prevention, especially in people with concomitant depression or anxiety. They work by increasing the level of serotonin and norepinephrine in the brain.

4. Antiepileptic drugs: Anti -epileptic drugs, such as topiramate and valproic acid, can be used to prevent migraine. They work, reducing the excitability of neurons in the brain.

5. Onabotulinumtoxina (Botox): Botox is approved for the prevention of chronic migraine (headaches for 15 or more days a month). It is introduced in the form of injections into the muscles of the head and neck and works, blocking the release of neurotransmitters that cause pain.

6. CGRP monoclonal antibodies: CGRP monoclonal antibodies, such as Erenumab, Fremanezumab, Galkanzumab and Eptinezumab, are new drugs for migraine prevention. They work by blocking CGRP (calcitonin-hen-tied peptide), neuropeptide, which plays a key role in the pathophysiology of migraine. These drugs are administered in the form of subcutaneous injections once a month or once a quarter (epinusumab is administered intravenously).

7. Magnesium: Magnesium can be useful for the prevention of migraine, especially in people with a low level of magnesium.

8. Riboflavin (vitamin B2): Riboflavin can help reduce the frequency and intensity of migraine attacks.

9. Coenzim q10: Coenzyme Q10 can be useful for the prevention of migraine, especially in children and adolescents.

D. Non -drug methods for treating migraines:

1. Avoiding triggers: The determination and avoidance of migraine triggers can help reduce the frequency of attacks. Keeping a headache diary can help you determine your triggers.

2. Regular sleep mode: Compliance with the regular sleep regime, go to bed and wake up at the same time every day, can help prevent migraine.

3. Regular meals: Passing meals or long breaks between meals can provoke migraines. Try to eat regularly to maintain a stable blood sugar.

4. Stress management: Stress is a common migraine trigger. The development of stress management techniques, such as meditation, yoga, tai-chi and deep breath, can help reduce the frequency of migraine attacks.

5. Exercise: Regular moderate physical exercises can help reduce the frequency and intensity of migraine attacks.

6. Biological feedback: Biological feedback is a technique that allows you to learn how to control certain physiological functions, such as heart rate, blood pressure and muscle tension. Biological feedback can be effective for migraine prevention.

7. Acupuncture: Acupuncture is a traditional Chinese medical equipment that includes the introduction of thin needles into certain points on the body. Acupuncture can be effective for the prevention of migraine.

8. Massage: Massage can help reduce muscle tension and stress, which can help prevent migraine.

9. Cognitive-behavioral therapy (KPT): KPT is a type of psychotherapy that helps you change the negative thoughts and behavior that can aggravate migraines.

E. Individual treatment plan:

1. Consultation with a doctor: It is important to consult a doctor to develop an individual migraine treatment plan. The doctor will take into account your symptoms, frequency and intensity of seizures, concomitant diseases and preferences to choose the most suitable treatment methods.

2. Combining treatment methods: Often the most effective is the combination of drugs and non -drug methods for treating migraine.

3. Regular monitoring and adjustment of treatment: It is important to be regularly observed with a doctor in order to evaluate the effectiveness of treatment and adjust it if necessary.

IV. Migraine and concomitant diseases: an integrated approach to health

A. Related diseases in migraines:

1. Depression and anxiety: Migraine is often combined with depression and anxiety. People with migraine have a higher risk of developing these mental disorders, and vice versa. Depression and anxiety can aggravate migraines and complicate treatment.

2. Irritable intestine syndrome (SRK): SRK is a disorder characterized by abdominal pain, bloating, diarrhea and constipation. Migraine and SRK are often found together, and it is believed that they have common mechanisms.

3. Fibromyalgia: Fibromyalgia is a chronic disease characterized by common pain, fatigue and sleep problems. Migraine and fibromyalgia are often found together, and it is believed that they have common mechanisms.

4. Epilepsy: Migraine and epilepsy are neurological disorders that can sometimes be found together. Some types of migraines, such as hemiplegic migraine, can be associated with an increased risk of epilepsy.

5. Stroke: Some studies show that migraine with an aura may be associated with an increased risk of stroke, especially in women taking hormonal contraceptives and smokers.

6. Cardiovascular diseases: Some studies show that migraine can be associated with an increased risk of cardiovascular disease, such as myocardial infarction and stroke.

B. The relationship between migraine and related diseases:

1. General mechanisms: It is believed that migraine and concomitant diseases have general mechanisms, such as dysfunction of the nervous system, inflammation and genetic predisposition.

2. Directed connection: The relationship between migraine and concomitant diseases is often biconditional. For example, depression and anxiety can aggravate migraines, and migraine can aggravate depression and anxiety.

C. Migraine treatment in the presence of concomitant diseases:

1. Complex approach: In the treatment of migraines, people with related diseases need an integrated approach, which takes into account all conditions.

2. Choosing drugs: When choosing medicines for migraine, it is necessary to take into account possible interactions with drugs that a person takes to treat concomitant diseases.

3. Treatment of concomitant diseases: Treatment of concomitant diseases, such as depression, anxiety and IBS, can help reduce the frequency and intensity of migraine attacks.

V. Life with migraine: adaptation strategies and support

A. Adaptation strategies:

1. Planning: Planning your activities and taking into account possible migraine attacks can help you remain active and do what you like.

2. Rest: It is important to give yourself enough time for relaxation and restoration, especially after migraine attacks.

3. Communication: Communication with friends, family and colleagues about your migraine can help them understand your needs and provide you with support.

4. Self -help: There are many self-help resources that can help you cope with migraine, such as books, websites and online forums.

B. Support:

1. Family and friends: Support for family and friends can be very important for people suffering from migraine. They can help you in difficult times and provide emotional support.

2. Support groups: Support groups can provide you with the opportunity to meet with other people suffering from migraine, share their experience and get support.

3. Medical workers: Your doctor, neurologist and other medical workers can provide you with medical care and support.

C. Resources:

1. National organizations: There are many national organizations that provide information and support to people suffering from migraine.

2. Websites: There are many websites that provide information about migraine, including causes, symptoms, treatment and adaptation strategies.

3. Books: There are many books that provide information about migraine and methods of its treatment.

VI. Innovation in the treatment of migraines: a look into the future

A. New medications:

1. CGRP Antagonists: CGRP Antagonists are a new class of drugs for the treatment and prevention of migraine. They work by blocking CGRP, neuropeptide, which plays a key role in migraine pathophysiology.

2. Laser therapy: Low -intensity laser therapy (NILT) showed promising results in the treatment of migraines.

3. Neuromodulation: Neuromodulation is a treatment method that uses electrical or magnetic impulses to stimulate certain areas of the brain. Some neuromodulation devices, such as transcranial magnetic stimulation (TMS) and percutaneous stimulation of the supraorbital nerve (Chssson), are approved for the treatment of migraine.

B. Research:

1. Genetics of migraines: Studies in the field of migraine genetics are aimed at identifying genes that predispose people to the development of migraine. This can lead to the development of new methods of treatment aimed at these genes.

2. Pathophysiology Migraine: Studies in the field of migraine pathophysiology are aimed at understanding the mechanisms that cause migraine. This can lead to the development of new treatment methods aimed at these mechanisms.

C. The future of migraine treatment:

1. Personalized medicine: In the future, the treatment of migraine can be more personalized, based on the genetic profile, the medical history and the lifestyle of each person.

2. New methods of treatment: New migraine treatment methods are being developed, which will be more effective and have less side effects.

VII. Myths and misconceptions about migraines: we dispel the outdated performances

A. Common myths:

1. Myth: Migraine is just a severe headache. Fact: as mentioned earlier, migraine is a complex neurological disease, and not just an enhanced version of the usual headache. It is characterized by many symptoms in addition to pain.

2. Myth: Migraine is a psychological problem. Fact: Although stress and psychological factors can be triggers, migraine has a biological basis associated with changes in the brain and nervous system.

3. Myth: Only women suffer from migraine. Fact: although migraine is more common in women, men also suffer from this disease. Hormonal factors play a role, but migraine is not an exclusively “female” ailment.

4. Myth: Migraine can be “just endured.” Fact: Migraine can be exhausting and significantly worsen the quality of life. Treatment, both acute and preventive, can significantly improve the condition.

5. Myth: There are universal medicines for migraines that work for everyone. Fact: triggers and the effectiveness of treatment are individual. What helps one person may not help another. An individual approach is required.

6. Myth: Products with a high content of tyramine (for example, cheese, chocolate) always cause migraine. Fact: Although these products are potential triggers, they do not affect everyone, and their effects can depend on the dose and individual sensitivity.

7. Myth: Migraine is a sign of a serious brain disease. Fact: in most cases, migraine is not associated with serious structural anomalies in the brain. However, it is important to consult a doctor in order to exclude other possible causes of headache.

8. Myth: Migraine will pass with age. Fact: Migraine can decrease in some people with age, especially after menopause in women, but this is not always the case. Many people have a chronic problem throughout their lives.

B. Why is it important to dispel myths:

1. Stygma prevention: Lying myths helps to reduce the stigma associated with migraine, and contributes to a more sympathetic attitude to people suffering from this disease.

2. Timely appeal for help: Knowing the truth about migraine encourages people to seek medical help in the early stages, which can improve the results of treatment.

3. Increased treatment: Understanding the biological basis of migraine helps people to be more committed to prescribed treatment and lead a healthy lifestyle.

4. More effective communication with doctors: Informed patients interact better with their doctors and can jointly develop effective treatment plans.

VIII. Additional aspects of migraines: questions and answers

A. Migraine in children and adolescents:

1. Symptoms: Symptoms of migraines in children may differ from symptoms in adults. They can include shorter attacks, abdominal pain, vomiting and dizziness.

2. Treatment: Migraine treatment in children should be careful and take into account their age and weight. Non -drug methods, such as avoiding triggers and stress management, are especially important.

3. Abdominal migraine: Abdominal migraine is characterized by periodic pain in the abdomen, nausea and vomiting without headache. It is more common in children.

B. Migraine and pregnancy:

1. Symptoms changes: Symptoms of migraines can change during pregnancy. In some women, migraine improves, while in others it worsens.

2. Treatment: Migraine treatment during pregnancy should be safe for the mother and child. Many medicines for migraine are contraindicated during pregnancy.

3. Non -drug methods: Non -drug methods, such as relaxation and massage, can be especially useful during pregnancy.

C. Migraine and menopause:

1. Hormonal changes: Hormonal changes during menopause can affect migraine.

2. Hormonal therapy: Hormone therapy can affect migraine. In some women, hormonal therapy improves migraine, while in others it worsens it.

3. Other treatment methods: Other treatment methods, such as non -drug methods and preventive drugs, can be useful during menopause.

D. Migraine and lifestyle:

1. Diet: Diet plays an important role in managing migraine. It is important to avoid triggers and there is a healthy, balanced diet.

2. Dream: A sufficient amount of sleep is important to prevent migraine. Try to sleep for 7-8 hours every night