Migraine: Change your life and forget about pain forever

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Migraine: Change your life and forget about pain forever

Understanding migraines: more than just a headache

Migraine is a neurological disease characterized by intense, pulsating headaches, often accompanied by nausea, vomiting and increased sensitivity to light and sound (photophobia and phonophobia). This is a state that can significantly worsen the quality of human life, affecting his performance, social activity and general well -being. It is important to understand that migraine is not just a “severe headache”, but a complex disorder that requires an individual approach to diagnosis and treatment.

Migraine Diagnostics: Key to Effective Treatment

Migraine diagnosis is based mainly on clinical data collected during a thorough anamnesis and neurological examination. The doctor will ask you questions about the nature of the headache, its duration, frequency, accompanying symptoms, as well as the presence of triggers and provoking factors.

  • Anamnesis: An important stage of diagnosis is a detailed description of the headache. The doctor will clarify:

    • Localization of pain: One -sided (hemicracies) or bilateral. Migraine is most often manifested on one side of the head, but it can be bilateral.
    • The nature of the pain: Pulsating, pressing, drilling, bursting. Migraine is often described as pulsating pain.
    • The intensity of pain: Assessment of the intensity of pain on the visual analogue scale (yours) from 0 to 10.
    • Duration of pain: A typical migraine lasts from 4 to 72 hours without treatment.
    • The frequency of seizures: The number of seizures per month.
    • Aura: Visual, sensory or motor disorders preceding headaches.
    • Related symptoms: Nausea, vomiting, photophobia, phonophobia, osmophobia (sensitivity to smells).
    • Triggers: Factors provoking migraine attacks (stress, food, drinks, weather changes, hormonal vibrations).
    • Family history: The presence of migraine in relatives of the first degree of kinship.

  • Neurological inspection: Inspection allows other possible causes of headache. The doctor will check:

    • Cloud-brain nerves: Inspection of pupils, fields of vision, facial sensitivity, motor function.
    • Motor function: Checking strength and coordination of movements.
    • Sensitivity: Checking various types of sensitivity (tactile, pain, temperature).
    • Reflexes: Checking tendon reflexes.

  • Differential diagnosis: It is important to exclude other diseases that can cause headache, such as:

    • Headache of tension: More often bilateral, pressing, not pulsating, is not accompanied by nausea and vomiting.
    • Closter headache: Intensive, one -sided pain around the eye, accompanied by lacrimation, runny nose, redness of the face.
    • Brain tumors: A headache, progressing over time, accompanied by other neurological symptoms.
    • Meningitis: Headache, fever, rigidity of the occipital muscles.
    • Subarakhnoid hemorrhage: Sudden, very severe headache.
    • Sinusit: Headache associated with the infection of the upper respiratory tract, accompanied by nasal congestion, pain in the face.
    • Glaucoma: Head pain in the forehead and eyes, accompanied by impairment of vision.

  • Instrumental research methods: In most cases, with typical migraines, additional studies are not required. However, in the presence of “red flags” (unusual symptoms, progressing headache, changes in the neurological status), the doctor may prescribe:

    • MRI of the brain: To exclude structural changes, such as tumors, aneurysms, malformations of blood vessels.
    • CT brain: To exclude hemorrhage or fractures of the skull.
    • Lumbal puncture: To exclude meningitis or subarachnoid hemorrhage.

Types of migraines: a variety of manifestations

Migraine is classified into several types, each of which has its own characteristics:

  • Migraine with aura: It is characterized by the presence of transient neurological symptoms (auras) preceding or accompanying headache. The aura usually lasts from 5 to 60 minutes and may include:

    • Visual symptoms: Flickering lights, zigzag lines, scotomas (dark spots in sight), loss of vision.
    • Sensory symptoms: Numbness or tingling in hands, legs or face.
    • Speech disorders: Difficulties with the selection of words, slurred speech.
    • Motor disorders: Weakness in the limbs (rarely).

  • Migraine without aura: The most common type of migraine, in which headache is not accompanied by aura.

  • Chronic migraine: A headache that occurs 15 or more days a month for more than 3 months, while at least 8 days a month, headache corresponds to migraine criteria.

  • Hemiplegic migraine: A rare type of migraine, accompanied by weakness of one side of the body (hemiparesis). It can be family (hereditary) or sporadic.

  • Ophthalmoplegic migraine: A rare type of migraine, accompanied by paralysis of the eye muscles, leading to double eyes (diplopia).

  • Basial migraine: A rare type of migraine, characterized by symptoms that occur due to impaired brain stem function, such as dizziness, ears, double-gathering, impaired movement coordination.

  • Migraine without headache (quiet attack): The presence of symptoms of migraine, such as aura, nausea, vomiting, photophobia, sound, but without headache.

Migraine triggers: identification and avoidance

Migraine triggers are factors that can provoke an attack of headache in susceptible people. The identification and avoidance of triggers is an important part of the prevention of migraine. Triggers can be different for each person, and their exact definition requires attentive self -observation and maintaining a headache diary.

  • Food triggers:

    • Sustained cheeses: They contain thyramin, an amino acid that can cause narrowing and expansion of the vessels of the brain.
    • Chocolate: Contains phenylethylamine, another substance that can provoke migraine.
    • Red wine: Contains thyramin, histamine and sulfites.
    • Caffeine: Although caffeine can relieve headache in small doses, its excessive consumption or a sharp rejection of caffeine can provoke a migraine attack.
    • Processed meat: Contains nitrites and nitrates that are used as preservatives.
    • Artificial sweeteners: Aspartem can be a trigger for some people.
    • Food additives: Glutamate sodium (MSG) can cause headache in sensitive people.

  • Weather factors:

    • A change in atmospheric pressure: Sudden pressure drops associated with a change in the weather can provoke migraines.
    • Heat and humidity: Dehydration caused by heat can be a trigger.
    • Cold: The effect of cold, especially on the head and neck, can cause headache.
    • Strong wind: The wind can cause tension in the muscles of the neck and head, which can lead to migraine.

  • Stress: Stress is one of the most common migraine triggers. Both acute and chronic stress can provoke attacks.

  • Hormonal changes:

    • Menstruation: A decrease in estrogen levels before menstruation can cause migraine.
    • Pregnancy: In many women, migraine decreases during pregnancy, but in some it may intensify.
    • Menopause: Hormonal vibrations during menopause can provoke migraines.
    • Hormonal contraceptives: Reception of hormonal contraceptives can affect the frequency and intensity of migraine attacks.

  • Environmental factors:

    • Bright light: Fluorescent light, flickering light, sunlight.
    • Loud sounds: Noise, loud music.
    • Strong smells: Spirits, perfumes, chemicals.
    • Smoking: Active and passive smoking.

  • Other triggers:

    • Lack of sleep: Lack of sleep or a change in sleep mode.
    • Passing of food intake: Hunger can cause a decrease in blood sugar, which can provoke migraines.
    • Dehydration: Insufficient fluid consumption.
    • Physical strain: Intensive physical exercises.
    • Change in the regime of the day: Trips to other time zones.
    • Some drugs: Vasodilators.

Headache diary: your personal tool

Making a headache diary is a valuable tool for identifying triggers, tracking the effectiveness of treatment and monitoring the course of migraine. In the diary it should be noted:

  • The date and time of the beginning of the headache.
  • The duration of the headache.
  • Localization and nature of pain.
  • The intensity of pain (according to yours).
  • Related symptoms (nausea, vomiting, photophobia, phonophobia).
  • Accepted drugs and their effectiveness.
  • Possible triggers (food, drinks, stress, weather, sleep).
  • Menstrual cycle (for women).

Analysis of the headache diary will help you and your doctor determine your individual triggers and develop an effective plan for treatment and prevention.

Migraine treatment: integrated approach

Migraine treatment includes two main directions: stopping attacks and prevention.

  • Relocation of seizures (abortive treatment): The goal is to stop the migraine attack as quickly as possible. Medicines for stopping attacks are most effective if they are taken at an early stage of headache.

    • Analgesic drugs (analgesics):

      • Nesteroid anti -inflammatory drugs (NSAIDs): Ibuprofen, Neproksen, Ketoprofen. Effective for migrants of migraine.
      • Paracetamol: It can be effective for migrants of migraine, especially in combination with NSAIDs or caffeine.

    • TRIPTA: Specific antimygrenous drugs that narrow the blood vessels of the brain and reduce inflammation. Constantin, elegimitriptan, naratriptan, risatriciptan, aliripritan, ethletriptan, froveryptan. Triptans are the most effective drugs for stopping migraine attacks, but they are not suitable for people with certain diseases of the heart and blood vessels.

    • Ergotamines: Another class of antimygrenous drugs that narrow the blood vessels of the brain. Ergotamine, dihydroergotamine. Ergotamines are less effective than triptans and have more side effects.

    • Anti -rate drugs: Metoklopramide, Domperidon. They are used to facilitate nausea and vomiting, which often accompany migraine. Improve the absorption of other drugs.

    • Combined drugs: They contain a combination of analgesics, triptan or ergotamine with caffeine or antiemetic drug.

  • Prevention Migraines (Prevention Treatment): The goal is to reduce the frequency, intensity and duration of migraine attacks. Preventive treatment is recommended for people who have:

    • Frequent bouts of migraines (more than 4 times a month).

    • Long or heavy bouts of migraines that are poorly rejoiced.

    • Migraine, significantly worsening the quality of life.

    • Inability to take medicines to stop attacks.

    • Migraine prevention drugs:

      • Beta blockers: Propranolol, metoprolol. Used to reduce blood pressure and reduce the frequency of migraine attacks.
      • Tricyclic antidepressants: Amititriptylin, NORTRIPTILIN. They have an anesthetic and antidepressant effect.
      • Calcium channel blockers: Flunarizin, Verapamil. Prevent the narrowing of the blood vessels of the brain.
      • Anticonvulsants: Topiramate, valproic acid. Used to treat epilepsy, but are also effective in migraine prevention.
      • CGRP blockers: Erenumab, Freanzumab, Galkanzumab, Eptynesumab. A new class of drugs that block CGRP (calcitonin-hen-tied peptide), a substance that plays an important role in the development of migraines.
      • Botulinum toxin Type A (Botox): Introduced into the muscles of the head and neck to reduce the frequency of bouts of chronic migraine.

    • Non -drug methods of migraine prevention:

      • Life change change: Regular sleep, healthy nutrition, sufficient physical activity, decrease in stress.
      • Relaxation techniques: Meditation, yoga, tai-chi, progressive muscle relaxation.
      • Biological feedback (biofidbek): Learning control over physiological functions such as heart rhythm, blood pressure and muscle tension.
      • Acupuncture: The introduction of thin needles into certain points on the body to stimulate the nervous system and reduce pain.
      • Cognitive-behavioral therapy (KPT): Helps change the negative thoughts and behavior associated with migraine.
      • Massage: Relaxes the muscles of the neck and head, reduces tension and stress.
      • Vitamins and additives: Magnesium, riboflavin (vitamin B2), Coenzyme Q10, melatonin.

Innovative methods of treatment of migraines

In recent years, new migraine treatment methods have appeared, which offer additional opportunities for patients who do not respond to traditional treatment methods.

  • Neurostimulation: The use of electric or magnetic impulses to stimulate the nervous system and reduce pain.

    • Transcranial magnetic stimulation (TMS): The non -invasive method of stimulation of the brain using magnetic impulses.
    • Transcular stimulation of the trigeminal nerve (TCTN): Stimulation of the trigeminal nerve using electrodes located on the forehead.
    • Non -invasive stimulation of the vagus nerve (NSBN): Stimulation of the vagus nerve using a device applied to the neck.

  • Botox injections: Used to treat chronic migraines. Botox is inserted into the muscles of the head and neck to block nerve signals that cause pain.

  • Monoclonal antibodies to CGRP: A new class of drugs for migraine prevention that block CGRP (calcitonin-hen-tied peptide), a substance that plays an important role in the development of migraine.

Life with migraine: adaptation strategies

Life with migraine can be difficult, but there are strategies that will help you adapt to this state and improve the quality of life.

  • Accept your migraine: The understanding that migraine is a chronic disease, and not just headache, is the first step to adaptation.
  • Develop an action plan: Agree with the doctor a plan for treatment and prevention, which is right for you.
  • Manage stress: Mix relaxation techniques, such as meditation, yoga or tai-chi.
  • Observe sleep mode: Try to go to bed and wake up at the same time every day.
  • Ask regularly: Do not skip food meals and avoid starvation.
  • Drink enough water: Dehydration can provoke migraines.
  • Avoid triggers: Identify your individual triggers and try to avoid them.
  • Report your migraine: Tell your loved ones, friends and colleagues about your migraine and how she affects you.
  • Keep a headache diary: This will help you track your attacks, identify triggers and evaluate the effectiveness of treatment.
  • Join the support group: Communication with other people suffering from migraine can be very useful.
  • Seek professional help: If you experience difficulties with managing your migraine, contact a doctor, psychologist or psychotherapist.

Alternative methods for treating migraines

Some people find relief from migraine using alternative treatment methods. It is important to remember that the effectiveness of these methods is not always confirmed by scientific research, and before their use it is necessary to consult a doctor.

  • Iglowerie (acupuncture): The introduction of thin needles into certain points on the body to stimulate the nervous system and reduce pain.
  • Massage: Relaxes the muscles of the neck and head, reduces tension and stress.
  • Herbs and additives: Some herbs and additives, such as ginger, chamomile, peppermint, can help alleviate the symptoms of migraines.
  • Aromatherapy: The use of essential oils, such as lavender, rosemary, eucalyptus, to reduce stress and stress.
  • Homeopathy: The treatment system based on the principle of “like this treats this.”

Myths about migraines

There are many myths about migraines that can impede the effective treatment and control of this disease. It is important to dispel these myths and get reliable information about migraine.

  • Myth: Migraine is just a severe headache.

    • Fact: Migraine is a complex neurological disease that can be accompanied by many other symptoms, such as nausea, vomiting, photophobia, phonophobia, osmophobia.

  • Myth: Migraine is a psychological problem.

    • Fact: Migraine is a physiological disease caused by changes in the brain.

  • Myth: Migraine is a female disease.

    • Fact: Although migraine is more common in women, men can also suffer from this disease.

  • Myth: Migraine is just an occasion to miss work or study.

    • Fact: Migraine can be very disabled and significantly worsen the quality of human life.

  • Myth: Migraine can be cured.

    • Fact: Migraine is a chronic disease that cannot be cured, but can be successfully controlled by treatment and prevention.

  • Myth: Migraine medicines are addictive.

    • Fact: Most drugs used to treat migraine do not cause addiction.

Migraine and pregnancy: special considerations

Migraine can influence the course of pregnancy and vice versa. In many women, migraines decrease during pregnancy, especially in the second and third trimesters, due to the stable level of estrogen. However, in some women, migraines may increase during pregnancy or first arise.

Migraine treatment during pregnancy requires special attention, since many drugs used to treat migraine are contraindicated in pregnant women. It is important to discuss with the doctor safe migraine treatment options during pregnancy.

  • Safe methods for treating migraines during pregnancy:
    • Paracetamol: It is considered relatively safe for use during pregnancy, but it should be taken in a minimum effective dose.
    • NSAIDs (non -steroidal anti -inflammatory drugs): The reception of NSAIDs should be avoided, especially in the third trimester of pregnancy, since they can cause problems with the heart and vessels of the fetus.
    • Anti -rate drugs: Some antiemetic drugs, such as metoclopramide and domperidone, are considered safe for use during pregnancy.
    • Non -drug treatment methods: Relaxation, massage, acupuncture, biological feedback.

Migraine in children and adolescents

Migraine can occur in children and adolescents, but its manifestations may differ from migraine in adults. In children, migraines are often accompanied by abdominal pain, nausea and vomiting. The headache can be bilateral and last less than in adults.

Migraine treatment in children and adolescents requires a special approach. It is important to avoid drugs that can be dangerous for children, and use non-drug methods of treatment, such as a change in lifestyle, relaxation techniques and cognitive-behavioral therapy.

Migraine and concomitant diseases

Migraine is often combined with other diseases such as depression, anxious disorder, irritable intestines and fibromyalgia. The presence of concomitant diseases can complicate the treatment of migraine and worsen the quality of the patient.

It is important to consider the presence of concomitant diseases when developing a treatment plan for migraine. Treatment of concomitant diseases can help reduce the frequency and intensity of migraine attacks.

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