Migraine: Get rid of pain forever

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Migraine: Get rid of pain forever

I. Understanding of migraines: deeper than just a headache

  1. Definition and characteristics of migraines:

    Migraine is much more than an ordinary headache. This is a complex neurological disease, characterized by repeating attacks of intense pulsating pain, usually on one side of the head. The pain is often accompanied by other symptoms such as nausea, vomiting, increased sensitivity to light (photophobia), sound (phonophobia) and odors (osmophobia). Migraine can significantly worsen the quality of life, affecting the ability of a person to work, study and perform everyday tasks. It is important to note that migraine is not just a nuisance, but a serious disease that requires professional diagnosis and treatment.

  2. Differences between migraine and other types of headaches:

    Not all headaches are migraine. It is important to distinguish between migraines from other types of headaches, such as headache of tension, cluster headache and sinus headache.

    • Headache of tension: It is usually described as a dumb, squeezing pain, covering the whole head. It is usually not accompanied by nausea, vomiting or increased sensitivity to light and sound.
    • Closter headache: It is characterized by intense, piercing pain in the area of one eye, accompanied by lacrimation, redness of the eye and nasal congestion. Closter headaches usually occur in clusters lasting from several weeks to several months, with periods of remission between them.
    • Sinus headache: Associated with infection or inflammation of the sinuses. The pain is usually felt in the face, forehead and around the eyes.

    Key distinctive signs of migraines: intense pulsating pain, often on one side of the head, accompanied by nausea, vomiting, photophobia and phonophobia.

  3. Types of migraines: with an aura and without aura:

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

    • Migraine with aura: It is characterized by temporary neurological disorders called aura, which usually arise before the start of a headache. The aura can manifest itself in the form of visual disturbances (flickering lights, zigzags, loss of vision fields), sensory disorders (numbness, tingling) or speech disorders.
    • Migraine without aura: The most common type of migraine, not accompanied by aura.

    Other types of migraines include:

    • Chronic migraine: Headaches occur 15 or more days a month for at least three months, and at least 8 days a month correspond to migraine criteria.
    • Hemiplegic migraine: A rare type of migraine, causing weakness or paralysis (hemiplegy) on one side of the body.
    • Ophthalmoplegic migraine: A rare type of migraine causing muscle paralysis that control the movement of the eyes.
    • Basial migraine: It is characterized by symptoms that occur due to disorders in the brain stem, such as dizziness, double-gathering, dysarthria and loss of coordination.

  4. Stages of migraines: Prodromal, aura, headache and postrome:

    Migraine often proceeds in several stages:

    • Prodromal stage (warning phase): It may occur a few hours or days before the start of a headache. Symptoms may include mood changes, irritability, fatigue, difficulties with concentration of attention, constraint of the neck and increased sensitivity to light and sound.
    • Aura (for some people): As described above, the aura is temporary neurological disorders that usually occur before the start of a headache.
    • Stage of headache: It is characterized by intense pulsating pain, usually on one side of the head, accompanied by nausea, vomiting, photophobia and phonophobia.
    • The postrome stage (recovery phase): It can last several hours or days after the end of the headache. Symptoms may include fatigue, weakness, difficulties with concentration of attention and mood changes.

  5. The influence of migraines on the quality of life:

    Migraine can have a significant negative impact on the quality of life. Frequent migraine attacks can lead to:

    • Reducing labor and study productivity: Migraine can complicate the concentration of attention, the implementation of working and educational tasks.
    • Relationships problems: Migraine can cause irritability, fatigue and social isolation, which can adversely affect relationships with family and friends.
    • Emotional problems: Migraine can lead to anxiety, depression and a feeling of hopelessness.
    • Financial difficulties: Migraine can lead to missed working days and treatment costs.

II. Factors contributing to the emergence of migraines: triggers and genetics

  1. Genetic predisposition to migraine:

    Migraine often has a genetic component. If you have first -line relatives (parents, brothers, sisters) with migraine, you have an increased risk of developing this disease. Studies show that several genes can be associated with migraine, but the exact inheritance mechanisms are still studied. A genetic predisposition does not mean that you will have a migraine, but makes you more susceptible to the effects of triggers.

  2. Migraines triggers: external and internal factors:

    Migraine triggers are factors that can provoke a migraine attack of susceptible people. Triggers can be different for different people, and not all triggers cause migraine every time. It is important to identify your personal triggers in order to try to avoid them.

    • Dietary triggers:
      • Alcohol: Especially red wine.
      • Caffeine: Both excessive consumption and a sharp cessation of caffeine use.
      • Sustained cheeses: Contain tiramin.
      • Processed meat: Contains nitrates and nitrites.
      • Artificial sweeteners: Aspartam.
      • Food additives: Glutamate sodium (MSG).
      • Chocolate: Contains phenylethylamine.
      • Fermented and pickled products: Contain histamine.
    • Ecological triggers:
      • Weather changes: Pressure drops, temperature and humidity.
      • Bright light and flickering light.
      • Strong smells: Perfumes, smoke, chemicals.
      • Noise.
      • Height.
    • Physical triggers:
      • Fatigue.
      • Lack of sleep or excess sleep.
      • Overstrain.
      • Passing for eating.
      • Dehydration.
      • Changes in the mode of the day.
    • Emotional triggers:
      • Stress.
      • Anxiety.
      • Depression.
      • Excitement.
    • Hormonal triggers:
      • Menstruation.
      • Pregnancy.
      • Menopause.
      • Hormonal therapy.
      • Oral contraceptives.
    • Medical triggers:
      • Some medicines.
      • Infections.
      • Head injuries.
      • Snow problems (for example, apnea in a dream).

  3. Migraine mechanisms: the role of the brain and blood vessels:

    The exact mechanisms of migraine occurred are not fully studied, but it is believed that various factors participate in them, including:

    • Neuron activity: The abnormal activity of neurons in the brain, especially in the brain stem, can play a role in the occurrence of migraine.
    • Vasodilation and vasoconstriction: It is believed that the expansion (vasodilation) and narrowing (vasoconstriction) of blood vessels in the brain can contribute to the occurrence of a headache in migraine.
    • Inflammation: Inflammation in the brain and around blood vessels can play a role in the occurrence of migraine.
    • Neurotransmitter: Changes in the levels of neurotransmitters, such as serotonin and calcitonin-hen-tied peptide (CGRP), can play a role in the occurrence of migraine. CGRP is especially important, since it is released during migraine attacks and contributes to the expansion of blood vessels and inflammation.

  4. The role of inflammation and neurogenic inflammation in the pathogenesis of migraines:

    Inflammation plays an important role in the pathogenesis of migraines. Inflammation in the brain and around blood vessels can cause pain and other symptoms associated with migraine. Neurogenic inflammation is a type of inflammation that occurs as a result of the release of inflammatory substances from nerve endings. It is believed that neurogenic inflammation plays a key role in the occurrence of migraine. CGRP, as mentioned above, is an important mediator of neurogenic inflammation during migraine.

  5. The influence of hormones on migraine: estrogen and migraine in women:

    Hormones, especially estrogen, play an important role in migraines in women. Many women experience migraines associated with the menstrual cycle, pregnancy and menopause. Estrogen level fluctuations can provoke migraine attacks. A decrease in estrogen levels before menstruation is a common migraine trigger.

III. Migraine diagnostics: key steps and necessary research

  1. The importance of seeing a doctor to diagnose migraines:

    If you often experience headaches that affect your everyday life, it is important to consult a doctor for diagnosis. Self -diagnosis and self -medication can be dangerous and ineffective. The doctor can determine whether you have a migraine, to exclude other causes of a headache and develop an individual treatment plan.

  2. Anamnesis and physical examination: the primary stages of diagnosis:

    The first step in the diagnosis of migraine is a detailed history of the history. The doctor will ask you about your symptoms, frequency and duration of headaches, triggers, family history and other medical problems. A physical inspection will also be carried out, including a neurological examination.

  3. Neurological examination: Assessment of the nervous system:

    A neurological examination is necessary to assess the function of your nervous system. The doctor will check your reflexes, muscle strength, coordination, sensitivity and mental state. A neurological examination helps to exclude other neurological diseases that can cause headaches.

  4. Diagnostic migraine criteria: Correspondence of the international classification of headaches (ICHD):

    The diagnosis of migraine is made on the basis of diagnostic criteria developed by the International Headache Society (IHS) and published in the international classification of headaches (ICHD). ICHD criteria include:

    • Migraine without aura:

      • At least five attacks that meet the following criteria:
      • The duration of the headache is from 4 to 72 hours (without treatment or with ineffective treatment).
      • The headache has at least two of the following characteristics:
        • One -sided localization.
        • Pulsating in nature.
        • Moderate or severe intensity of pain.
        • It intensifies with ordinary physical activity or leads to avoiding 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.
      • Headache is not related to another disease.

    • Migraine with aura:

      • At least two attacks that meet the following criteria:
      • The aura consists of at least one of the following reversible symptoms:
        • Visual symptoms.
        • Sensory symptoms.
        • Speech symptoms.
        • Motor symptoms.
        • Stem symptoms.
        • Symptoms of retina.
      • At least two of the following characteristics:
        • At least one symptom of the aura gradually develops within 5 minutes or more.
        • Each symptom of the aura lasts from 5 to 60 minutes.
        • At least one symptom of the aura is one -sided.
        • The headache begins within 60 minutes after the aura.
      • Headache is not related to another disease.

  5. Additional studies: when are MRI and CT of the brain needed?

    In most cases, migraine is diagnosed on the basis of an anamnesis and physical examination. Additional studies, such as an MRI or CT of the brain, are usually not required. However, they can be prescribed if there is a suspicion of another disease causing headaches, for example:

    • Unusual or atypical symptoms.
    • The sudden beginning of a severe headache.
    • Headaches that worsen over time.
      • Neurological disorders (weakness, numbness, change in vision).
    • Suspicion of a brain tumor, aneurysm or other structural violation.

  6. Maintaining a headache diary: help in diagnosis and identification of triggers:

    Keeping a headache diary can be a very useful tool for the diagnosis and treatment of migraine. In the diary you should record:

    • The date and time of the beginning and end of the headache.
    • Description of headache (localization, intensity, character).
    • Related symptoms (nausea, vomiting, photophobia, phonophobia).
    • Possible triggers (food, drinks, stress, weather changes).
    • The medicines that you took and their effectiveness.
    • Your menstrual cycle (if you are a woman).

    Analysis of the headache diary will help the doctor make the correct diagnosis, identify your personal triggers and develop an effective treatment plan.

IV. Migraine treatment: an integrated approach to getting rid of pain

  1. Migraine treatment goals: reduction of frequency, intensity and duration of seizures:

    The main goal of the treatment of migraine is to improve the quality of life of the patient by:

    • Reducing the frequency of migraine attacks.
    • Reducing the intensity of pain during attacks.
    • Reducing the duration of migraine attacks.
    • Improving control of symptoms accompanying headache.
    • Preventing the transition of episodic migraine into chronic.

  2. Two main types of treatment: acute treatment and preventive treatment:

    Migraine treatment includes two main approaches:

    • Acute treatment (abortive treatment): Aims to relieve pain and other symptoms during a migraine attack. Acute treatment is most effective if you start as early as possible after the start of a headache.
    • Preventive treatment (preventive treatment): Aimed at reducing the frequency, intensity and duration of migraine attacks. Preventive treatment is prescribed to patients with frequent or severe migraine attacks, which significantly affect their quality of life.

  3. Acute treatment of migraines: drugs to relieve pain during an attack:

    • Analgesic drugs (analgesics):
      • Nonsteroidal anti -inflammatory drugs (NSAIDs): Ibuprofen, steady, diclofenac. Effective for migrants of migraine.
      • Acetaminophen (paracetamol): It can be effective with light migraine attacks, but less effective than NSAIDs.
      • Combined analgesics: Contain a combination of acetaminophen, aspirin and caffeine. It can be effective for moderate and strong migraine attacks.
    • TRIPTA:
      • Selective agonists of serotonin receptors (5-HT1B/1D).
      • Sumatiptan, Rateskyan, Grilletttant, RaolPantant, Frietype and Frietant, Frierytan, Almatiptan.
      • Very effective for moderate and strong migraine attacks.
      • Contraindicated to patients with coronary heart disease, stroke or a history of ischemic attack.
    • Dihydroergotamin (DGE):
      • The agonist of serotonin, adrenergic and dopamine receptors.
      • Available in the form of a nasal spray or injection.
      • It can be effective for migraine that does not respond to tripatans.
      • It has more side effects than triptans.
      • Contraindicated to patients with coronary heart disease, uncontrolled hypertension and peripheral vascular diseases.
    • Antimetics (antiemetic drugs):
      • Metoclopramide, prohlorperazine, ondansetron.
      • They help reduce nausea and vomiting, which often accompany migraine.
      • Metoklopramide can also improve the absorption of other drugs taken to treat migraine.
    • Hepanths (CGRP Antagonists):
      • UrueGepant, Romegepant.
      • Block the action of CGRP, which plays an important role in the occurrence of migraine.
      • Effective in acute treatment of migraines.
      • They have less side effects than triptans.
    • Dantants (selective agonists 5-HT1F receptors):
      • Lasmiditan.
      • Activate 5-HT1F receptors, which leads to inhibiting the release of CGRP and other neuropeptides.
      • Effective in acute treatment of migraines.
      • They do not cause vasoconstriction, which makes them safe for patients with cardiovascular diseases.

  4. Preventive treatment of migraines: Medicines to reduce the frequency of seizures:

    • Beta blockers:
      • Prophanolol, metoprolol, atenolol.
      • Reduce the frequency of migraines, blocking the effect of adrenaline and norepinephrine.
      • They can cause fatigue, dizziness and reduction of blood pressure.
    • Antidepressants:
      • Tricyclic antidepressants (TCA): Amititriptylin, NORTRIPTILIN.
      • Selective inhibitors of the reverse capture of serotonin (SIOS): Fluoxetine, sertraline, paroxetine.
      • Selective inhibitors of the reverse capture of serotonin and norepinephrine (SIOSSN): Venlafaxin, Dulcosetin.
      • Reduce the frequency of migraines, affecting the levels of neurotransmitters in the brain.
      • Tits can cause dry mouth, constipation, drowsiness and weight gain.
      • SiOSS and SIOSSN can cause nausea, insomnia and sexual dysfunction.
    • Anticonvulsants:
      • Topiramate, Valproevaya Olotta, Divalpiex sodium.
      • Reduce the frequency of migraines, stabilizing electrical activity in the brain.
      • Topiramate can cause weight loss, violation of cognitive functions and paresthesia.
      • Walproic acid and sodium sodium sodium can cause weight, hair loss and liver damage.
    • Calcium channel blockers:
      • Flunarizin, Verapamil.
      • Reduce the frequency of migraines, blocking the flow of calcium into brain cells and blood vessels.
      • They can cause drowsiness, constipation and weight gain.
    • Monoclonal antibodies to CGRP or CGRP receptor:
      • Erenumab, Fremanesezumab, Galkaneesezumab, Eptinezumab.
      • Block CGRP or its receptor, which leads to a decrease in migraine frequency.
      • They are administered as injections once a month or once every three months (epinosumab is administered intravenously every three months).
      • Usually well tolerated, but can cause reactions at the injection site and constipation.
    • Botulinum toxin Type A (Botox):
      • Introduced into the muscles of the head and neck every three months.
      • Effective for the treatment of chronic migraine.
      • It is believed that it reduces the frequency of migraines, blocking the release of neurotransmitters involved in the occurrence of pain.
      • It can cause weakness of the neck muscles and headaches of tension.

  5. Non -drug methods for treating migraines: alternative and additional therapy:

    Non -drug treatment methods can be effective for reducing the frequency, intensity and duration of migraine attacks, as well as to improve overall well -being.

    • Life change change:
      • Regular sleep: Observe sleep mode, go to bed and get up at the same time every day.
      • Healthy nutrition: Eat regularly, do not skip food meals. Limit the consumption of processed products, caffeine and alcohol.
      • Physical activity: Regular physical exercises can help reduce the migraine frequency.
      • Hydration: Drink enough water during the day.
      • Stress management: Use stress management methods such as yoga, meditation, tai-chi or deep breath.
    • Biological feedback (BOS):
      • The teaching method that allows you to control physiological processes, such as heart rate, muscle voltage and skin temperature.
      • Bos can help reduce the migraine frequency, teaching patients to relax and control their physiological reactions to stress.
    • Iglowerie (acupuncture):
      • The traditional Chinese treatment method, which consists in introducing thin needles into certain points on the body.
      • Acupuncture can help reduce the frequency of migraines, stimulating the release of endorphins and affecting the nervous system.
    • Massage:
      • Massage can help reduce muscle tension and stress, which can reduce the migraine frequency.
    • Cognitive-behavioral therapy (KPT):
      • A psychotherapeutic approach aimed at changing negative thoughts and behavior that can contribute to migraine.
      • KPT can help patients learn to cope with stress, anxiety and depression, which are often associated with migraine.
    • Supplements:
      • Magnesium: It can help reduce the migraine frequency in some people.
      • Riboflavin (vitamin B2): It can help reduce the frequency and intensity of migraine.
      • Coenzim q10: It can help reduce the frequency of migraine.
      • Melatonin: It can help improve sleep and reduce the migraine frequency.
      • Bukvica (Petasites Hybridus): It can help reduce the frequency and intensity of migraine.
      • Before taking any additives, you need to consult a doctor.
    • Neurostimulation:
      • Transcranial magnetic stimulation (TMS): The non -invasive method of brain stimulation using magnetic impulses.
      • Transcular stimulation of the trigeminal nerve (TCTN): The non -invasive method of stimulation of the trigeminal nerve using electrical impulses.
      • Penettlement stimulation (STO): Invasive method of stimulation of the occipital nerve using an implantable device.
      • Neurostimulation can help reduce the frequency and intensity of migraine.

  6. Personalized treatment plan: The importance of an individual approach:

    Migraine treatment should be personalized and take into account the individual needs and preferences of the patient. It is important to find a doctor who has the experience of treating migraines and is ready to work with you to develop a treatment plan that will be effective and safe for you. The treatment plan may include a combination of drugs, non -drug methods of treatment and changes in lifestyle. It is important to regularly evaluate the effectiveness of the treatment plan and make the necessary adjustments.

  7. When to seek emergency medical help in migraine:

    In most cases, migraine does not require emergency medical care. However, it is important to seek emergency help if you have the following symptoms:

    • The sudden beginning of a severe headache, especially if it is accompanied by fever, constraint of the neck, a change in the mental state, weakness, numbness, impaired speech or vision.
    • A headache that differs from your ordinary migraines.
    • Headache after head injury.
    • A headache that worsens over time.
    • A headache that does not respond to ordinary medicines.

V. Life with migraine: symptoms management and prevention of attacks

  1. Identification and avoidance of triggers: the key to preventing migraine:

    As mentioned earlier, the identification and avoidance of triggers is an important part of migraine management. Keeping a headache diary can help you determine your personal triggers. After you have identified your triggers, try to avoid them as much as possible.

  2. Stress management strategies: reducing the impact of stress on migraine:

    Stress is a common migraine trigger. The use of stress management strategies can help reduce the migraine frequency.

    • Regular physical exercises.
    • Relaxation techniques (yoga, meditation, deep breathing).
    • A sufficient dream.
    • Healthy diet.
    • Hobbies and classes that you like.
    • Communication with friends and family.
    • Appeal to a psychologist or psychotherapist.

  3. The importance of a healthy lifestyle: sleep, nutrition and physical activity:

    A healthy lifestyle can help reduce the frequency of migraine and improve overall well -being.

    • Dream: Observe sleep mode, go to bed and get up at the same time every day. Sleep enough (7-8 hours a day). Create comfortable sleeping conditions (darkness, silence, coolness).
    • Nutrition: Eat regularly, do not skip food meals. Limit the consumption of processed products, caffeine and alcohol. Drink enough water during the day.
    • Physical activity: Regular physical exercises can help reduce the migraine frequency. Choose a type of physical activity that you like and do it regularly (at least 30 minutes a day).

  4. Support and informing: resources for people with migraine:

    Life with migraine can be complicated. It is important to have support and information to cope with this disease.

    • Communicate with other people suffering from migraine.
    • Join the support groups.
    • Look for information about migraines on the Internet, books and magazines.
    • Contact the doctor if you have any questions or problems.
    • Remember that you are not alone, and there are people who understand you and are ready to help.

  5. Myths and reality about migraine: debunking of common misconceptions:

    There are many myths about migraine. It is important to know the truth about this disease in order to get the right treatment and support.

    • Myth: Migraine is just a headache.
    • Reality: Migraine is a complex neurological disease that is characterized by repeating attacks of intensive pain, often accompanied by other symptoms, such as nausea, vomiting, photophobia and phonophobia.
    • Myth: Migraine is just to attract attention.
    • Reality: Migraine is a real disease that can significantly worsen the quality of life.
    • Myth: Migraine can be cured.
    • Reality: Migraine cannot be cured, but it can be successfully treated and controlled.
    • Myth: Migraine medicines are always effective.
    • Reality: Migraine medicines are not always effective, and it may take time to find the right treatment.
    • Myth: Migraine is a female disease.
    • Reality: Migraine is more common in women than in men, but men can also suffer from migraine.

  6. Prevention of migraine chronization: Prevention of the transition to a chronic form:

    Chronic migraine is a migraine in which headaches occur 15 or more days a month for at least three months. Prevention of the transition of episodic migraine into chronic is an important purpose of treatment.

    • Treat migraine at an early stage.
    • Do not abuse medicines for headache.
    • Avoid migraine triggers.
    • Manage stress.
    • Observe a healthy lifestyle.
    • Contact the doctor if you have any questions or problems.

VI. New Migraine treatment methods: promising developments and future therapy

  1. Research in the field of CGRP and migraines: new drugs and targets:

    CGRP plays an important role

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