Migraine: Free from pain forever

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Migraine: Free from pain forever

Chapter 1: Understanding Migraine – more than just a headache

Migraine is not just a severe headache. This is a complex neurological disease that can manifest itself with a variety of symptoms that significantly worsen the quality of life. Despite the widespread opinion that migraine is a “simple” headache, it is a serious violation that requires a comprehensive approach to diagnosis and treatment.

1.1 The difference between headache and migraine:

It is important to understand the difference between the usual headache of tension and migraine. The headache of tension is often described as a dull, pressing pain, covering the whole head. It is usually associated with stress, tension of the muscles of the neck and shoulders and is rarely accompanied by other symptoms. Migraine, on the contrary, is characterized by pulsating pain, often localized on one side of the head, and is accompanied by many other symptoms, such as:

  • Nausea and vomiting: These symptoms can be so strong that a person cannot function normally.
  • Sensitivity to light (photophobia): Bright light can significantly enhance pain and cause discomfort.
  • Sensitivity to sound (phonophobia): Loud sounds can be unbearable during a migraine attack.
  • Sensitivity to smells (osmophobia): Certain smells, even weak, can provoke or strengthen a migraine attack.
  • Visual violations (aura): About a third of people suffering from migraine, visual disorders arise before the attack, such as flashing lights, zigzag lines, loss of vision or distortion of vision.
  • Fatigue and weakness: A sense of strong fatigue and weakness can last a few days after an attack.
  • Problems with concentration: Migraine can complicate the concentration of attention, thinking and memorization.
  • Dizziness: Some people experience dizziness or a sense of rotation during a migraine attack.

1.2 phases of migraines:

Migraine usually passes through several phases, although not every person experiences all the phases:

  • Prodromal phase (warning): This phase can begin a few hours or days before the attack and is characterized by changes in mood, fatigue, irritability, increased appetite or thirst.
  • Aura: This phase occurs in approximately 25-30% of people suffering from migraine. It usually lasts from 5 to 60 minutes and is characterized by spectacular, sensory or motor disorders.
  • Phase of the headache: This is the main phase of migraine, characterized by pulsating pain, usually on one side of the head. This phase can last from 4 to 72 hours.
  • The postrome phase: After the head of a headache, a person can feel tired, weak, depressed or, conversely, excited. This phase can last up to 24 hours.

1.3 Types of migraines:

There are several types of migraines, the most common of which:

  • Migraine with aura: It is accompanied by auditory, sensory or motor disorders before an attack of headache.
  • Migraine without aura: Not accompanied by aura.
  • Chronic migraine: Headaches occur 15 or more days a month for at least three months, and at least 8 of these days correspond to migraine criteria.
  • Hemiplegic migraine: A rare type of migraine, accompanied by weakness or paralysis of one side of the body.
  • Ophthalmoplegic migraine: A rare type of migraine, accompanied by paralysis of the muscles that control the movement of the eyes.
  • Basial migraine: It is accompanied by symptoms associated with impaired brain barrel, such as dizziness, double -gathering, speech impairment and coordination.

1.4 Factors provoking migraines:

Certain factors can provoke a migraine attack. Identification and avoidance of these factors are an important part of migraine management. The most common triggers include:

  • Stress: Stress is one of the most common migraine triggers.
  • Changes in sleep mode: The lack of sleep, an excess of sleep or a change in sleep mode can provoke a migraine attack.
  • Some food and drinks: These include sustained cheeses, treated meat, chocolate, alcohol (especially red wine) and products containing sodium glutamate (MSG).
  • Weather changes: Changes in atmospheric pressure, temperature or humidity can provoke a migraine attack.
  • Hormonal changes: In women, migraine attacks are often associated with the menstrual cycle, pregnancy or menopause.
  • Bright light, loud sounds, strong smells: These sensory incentives can provoke a migraine attack.
  • Passing of food intake: Passing for eating can lead to a drop in blood sugar and provoke a migraine attack.
  • Dehydration: The lack of fluid in the body can provoke a migraine attack.
  • Medicines: Some drugs, such as vasodilating agents, can provoke a migraine attack.

Chapter 2: Migraine Diagnostics: the Way to the Proper Treatment

The exact diagnosis of migraine is a key step towards effective treatment and pain relief. Self -diagnosis can be dangerous and lead to improper treatment.

2.1 seeking a doctor:

If you suspect migraine, you must consult a doctor, preferably a neurologist. The doctor will conduct a thorough examination and collect an anamnesis to exclude other possible causes of a headache, such as brain tumors, aneurysm or infection.

2.2 History:

The doctor will ask questions about the nature of the headache, its frequency, duration, accompanying symptoms and factors that provoke attacks. It is important to provide the doctor as complete information about his headache. Get a headache diary in which fix the date, the start and end of the attack, the intensity of pain, the accompanying symptoms, possible triggers and the accepted medicines.

2.3 Neurological inspection:

The doctor will conduct a neurological examination to evaluate the function of the nervous system. The inspection includes verification of vision, hearing, reflexes, coordination and sensitivity.

2.4 Additional studies:

In some cases, the doctor may prescribe additional studies, such as:

  • MRI of the brain: Magnetic resonance imaging (MRI) allows you to get detailed images of the brain and exclude other possible causes of a headache.
  • CT brain: Computed tomography (CT) also allows you to get images of the brain, but it is less informative than an MRI.
  • Blood tests: Blood tests can be prescribed to exclude other diseases that can cause headache.

2.5 Criteria for diagnostics of migraines (International Society for the Headache – ICHD):

To diagnose migraines, the criteria developed by the International Headache Society (ICHD) are used. These criteria help doctors establish an accurate diagnosis and choose the optimal treatment strategy. The main criteria for diagnosing migraine without aura:

  • At least 5 seizures corresponding to BD criteria.
  • The headache lasts from 4 to 72 hours (without treatment or with ineffective treatment).
  • The headache has at least two of the following characteristics:
    • One -sided localization (one side of the head)
    • Pulsating in nature
    • Moderate or strong intensity of pain
    • Deterioration in ordinary physical activity (for example, walking or climbing stairs)
  • During a headache, at least one of the following symptoms is observed:
    • Nausea and/or vomiting
    • Photophobia and phonophobia
  • Headache is not associated with other diseases.

Criteria for diagnosing migraines with aura include the presence of an aura preceding or accompanying headache.

Chapter 3: Treatment of Migraines: an individual approach to pain relief

Migraine treatment should be individual and take into account the type of migraine, frequency and intensity of seizures, concomitant diseases and personal preferences of the patient. There are two main approaches to the treatment of migraines: stopping attacks and prevention.

3.1 Escaining migraine attacks (acute treatment):

The relief of migraine attacks is aimed at relieving pain and related symptoms during the attack. Medicines for stopping migraine attacks are most effective if they are taken at an early stage of the attack.

  • Analgesic drugs (analgesics):
    • Nonsteroidal anti -inflammatory drugs (NSAIDs): Ibuprofen, Ketoprofen and Diclofenac can be effective with migrant migraine light and moderate attacks.
    • Paracetamol: Paracetamol can be effective with light migraine attacks, but it is less effective than NSAIDs, with stronger attacks.
    • Combined drugs: Drugs containing paracetamol, aspirin and caffeine can be effective for moderate migraine attacks. It is important to remember that the frequent use of combined drugs can lead to abusiness headache (drug-induced headache).
  • TRIPTA: Triptans are specific drugs for the treatment of migraines that affect serotonin receptors in the brain. They are effective for moderate and strong migraine attacks, especially if they are taken at an early stage of the attack. Triptans include summptor, risatriciptan, intrigipetan, zolmitriptan, alihriperiptan, frutitrippan and ethletriptan. Triptans should not be used for people with heart or vascular diseases.
  • Ergotamines: Ergotamines are older preparations for the treatment of migraine, which also affect serotonin receptors. They are less effective than triptans and have more side effects. Ergotamines should not be used for people with heart or blood vessels.
  • Antiometures (antiemetic drugs): Metoclopramide, coolropezin and domperidon can help alleviate nausea and vomiting, often accompanying migraine attacks. They can also improve the absorption of other drugs.
  • Digidrérgotamine (DHE): DHE is a derivative of ergotamine, which can be administered intravenously or intranasal for the treatment of strong migraine attacks.

3.2 Preventive treatment of migraines:

Preventive treatment of migraine is aimed at reducing the frequency, intensity and duration of seizures. Preventive treatment is recommended for people in whom migraine attacks occur often (more than 4 times a month) or significantly worsen the quality of life.

  • Beta blockers: Propranolol, metoprolol and atenolol are often used to prevent migraine. They reduce heart rate and blood pressure.
  • Antidepressants:
    • Tricyclic antidepressants (TCA): Amititriptylin and Nectriptylin can be effective for the prevention of migraine. They affect the level of serotonin and norepinephrine in the brain.
    • Selective inhibitors of the reverse capture of serotonin (SIOS): SiOSS, such as fluoxetine and sertralin, can be useful for the prevention of migraine in people with depression or anxiety.
    • Reverse capture inhibitors of serotonin and norepinephrine (IOZSN): Wenlafaxin and dulcesetine can also be effective for the prevention of migraine.
  • Anticonvulsants: Topiramate and valproic acid are used to prevent migraine. They stabilize electrical activity in the brain.
  • Calcium channel blockers: Flunarizine can be effective for the prevention of migraine, especially in people with vestibular migraine.
  • Monoclonal antibodies to CGRP (Calcitonin Gene-RELEETED PEPTIDE): These new drugs, such as Erenumab, Fremanesumab, Galkanzumab and Eptynesumab, block CGRP or its receptor. CGRP is a protein that plays a role in the development of migraines. They are introduced subcutaneously or intravenously.
  • Botulotoxin (Botox): Botox can be effective for the treatment of chronic migraines (headaches are 15 or more days a month). It is inserted into the muscles of the head and neck.
  • Magnesium: Magnesium intake can be useful for the prevention of migraine, especially in people with magnesium deficiency.
  • Riboflavin (vitamin B2): Riboflavin can be effective for migraine prevention.
  • Coenzim q10: Coenzyme Q10 can be effective for migraine prevention.

3.3 Non -drug methods for treating migraines:

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

  • Biological feedback (BOS): Bos is a method that allows people to learn how to control physiological functions, such as heart rate, blood pressure and muscle tension. Bos can be effective for reducing the frequency and intensity of migraine attacks.
  • Cognitive-behavioral therapy (KPT): KPT is a type of psychotherapy that helps people change negative thoughts and behavior associated with migraine. KPT can be effective for reducing stress, anxiety and depression that can aggravate migraines.
  • Acupuncture: Acupuncture is a traditional Chinese medical practice in which thin needles are introduced into certain points on the body. Acupuncture can be effective for reducing the frequency and intensity of migraine attacks.
  • Massage: Massage can help relax the muscles of the neck and shoulders, reduce stress and relieve headache.
  • Physiotherapy: Physiotherapy can help improve posture, strengthen the muscles of the neck and shoulders and reduce muscle tension.
  • Relaxation techniques: Relaxation techniques, such as meditation, yoga and deep breathing, can help reduce stress and relieve headache.
  • Changes in the lifestyle: Making changes to the lifestyle, such as regular sleep, healthy nutrition and moderate physical activity, can help reduce the frequency and intensity of migraine attacks.

Chapter 4: Life with Migraine: Management Strategies and Prevention

Life with migraine can be complicated, but there are strategies that will help control the disease and improve the quality of life.

4.1 maintaining a headache diary:

Maintenance of a headache diary can help identify migraine triggers, evaluate the effectiveness of treatment and track progress. The diary should be recorded, the start and end time of the attack, the intensity of pain, concomitant symptoms, possible triggers and taken medications.

4.2 Aviation of triggers:

Identification and avoidance of migraine triggers are an important part of the management of the disease. Some common triggers include stress, changes in sleep mode, some food and drinks, weather changes, hormonal changes, bright light, loud sounds and strong smells.

4.3 Stress management:

Stress is one of the most common migraine triggers. Learning to manage stress can help reduce the frequency of migraine attacks. Effective stress management methods include relaxation techniques, yoga, meditation, physical exercises and psychotherapy.

4.4 regular sleep:

The lack of sleep or excess sleep can provoke a migraine attack. It is important to observe a regular sleep mode and sleep enough hours every night.

4.5 Healthy nutrition:

Some food and drinks can provoke a migraine attack. It is important to avoid these food and adhere to a healthy diet. It is recommended to avoid aging, processed meat, chocolate, alcohol (especially red wine) and products containing sodium glutamate (MSG).

4.6 Regular physical activity:

Moderate physical activity can help reduce stress and improve the general health. It is recommended to engage in physical exercises for at least 30 minutes a day, most days of the week.

4.7 Hydration:

Dehydration can provoke a migraine attack. It is important to drink enough fluid during the day.

4.8 Proper posture:

Poor posture can strain the muscles of the neck and shoulders, which can provoke a migraine attack. It is important to follow your posture and sit and stand straight.

4.9 ergonomics of the workplace:

An incorrectly organized workplace can strain the muscles of the neck and shoulders, which can provoke a migraine attack. It is important to organize your workplace correctly in order to avoid tension.

4.10 Support:

The presence of support from the family, friends and medical workers can help to cope with migraine. Join the support groups of people with migraine.

Chapter 5: New horizons in the treatment of migraines: innovations and prospects

Research in the field of migraine is constantly developing, and new methods of treatment appear that promise to improve the quality of life of people suffering from this disease.

5.1 Monoclonal antibodies to CGRP:

Monoclonal antibodies to CGRP (Calcitonin Gene-RELEETED PEPTIDE) are new drugs that block CGRP or its receptor. CGRP is a protein that plays a role in the development of migraines. These drugs showed promising results in clinical trials and are available for migraine prevention. They are a significant breakthrough in the treatment of migraines.

5.2 Gepanti:

Hyander is a class of drugs that are CGRP receptor antagonists. They are accepted orally to stop migraine attacks. Rimehepant and parrypant are approved for the treatment of migraine.

5.3 Nerivio Migra:

Nerivio Migra is a device for electroneuromodulation, which is attached to the hand and sends electrical impulses to stimulate nerves, which can help relieve pain in migraine. It is approved for the treatment of acute migraines in adults and adolescents.

5.4 transcranial magnetic stimulation (TMS):

TMS is a non -invasive procedure that uses magnetic impulses to stimulate certain areas of the brain. TMS can be effective for the treatment of migraine with an aura.

5.5 Stimulation of the vagus nerve (VNS):

VNS is a procedure that uses electrical impulses to stimulate the vagus nerve. VNS can be effective for the treatment of migraine.

5.6 Studies in the field of migraine genetics:

Studies in the field of migraine genetics help to understand the causes of the disease and develop new treatment methods. Several genes associated with migraine were identified.

5.7 Telemedicine:

Telemedicine can facilitate access to medical care for people suffering from migraine, especially for those who live in remote areas. Telemedicine allows doctors to consult, diagnose and treat migraine online.

Chapter 6: Myths and reality about migraines: We dispel the delusions

There are many myths and errors around migraines that can complicate the diagnosis and treatment of the disease. It is important to know the truth about migraine in order to get adequate medical care.

6.1 myth: Migraine is just a severe headache.

Reality: Migraine is a complex neurological disease that can be accompanied by various symptoms, such as nausea, vomiting, sensitivity to light, sound and smells.

6.2 myth: Migraine is a sign of character weakness.

Reality: Migraine is a medical condition that is not related to the character of a person.

6.3 myth: Migraine is a female disease.

Reality: Although migraine is more common in women, men and children also suffer from it.

6.4 Myth: Migraine is not treated.

Reality: Although migraine cannot be completely cured, there are effective treatment methods that can reduce the frequency, intensity and duration of seizures.

6.5 Myth: If you have a migraine, you can’t play sports.

Reality: Moderate physical activity can help reduce stress and improve the general health, which can help reduce the frequency of migraine attacks.

6.6 myth: all products containing tiramin provoke migraine.

Reality: Not all people suffering from migraine are sensitive to Tramin. The reaction to Tiramin is individual.

6.7 Myth: painkillers cause addiction.

Reality: With proper use, painkillers do not cause addiction. However, the frequent use of painkillers can lead to abusiness headache (drug-induced headache).

6.8 Myth: When migraine, you need to lie in a dark room and do nothing.

Reality: Although rest in a quiet dark room can help relieve pain, it is important to remain active and lead a normal life.

6.9 Myth: Migraine passes with age.

Reality: In some people, the frequency of migraine attacks can decrease with age, but in others, attacks can continue throughout life.

6.10 Myth: Migraine is just a headache of tension.

Reality: Migraine and headache of tension are different types of headaches that have different symptoms and require different treatment.

Chapter 7: Resources and support for people suffering from migraine: We find help and information

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

7.1 Medical specialists:

  • Neurologists: Neurologists are doctors specializing in the diagnosis and treatment of diseases of the nervous system, including migraines.
  • General practitioners: General practitioners can diagnose and treat migraines, as well as direct to a neurologist if necessary.
  • Physiotherapy: Physiotherapists can help improve posture, strengthen the muscles of the neck and shoulders and reduce muscle tension.
  • Psychologists and psychotherapists: Psychologists and psychotherapists can help cope with stress, anxiety and depression that migraine can aggravate.

7.2 organizations:

  • American headache. Provides information about migraines and other types of headache.
  • National Headache Foundation: Provides information, support and resources for people suffering from headache.
  • Migraine Research Foundation: Finances research in the field of migraine.
  • European Headache Federation: Unites European societies involved in the study and treatment of headaches.

7.3 Websites:

  • AmericanMigraineFoundation.org: It contains a lot of useful information about migraine, including articles, videos and podcasts.
  • Headaches.org: Provides information, support and resources for people suffering from headache.
  • NIH.gov (National Institute of Neurological Disorders and Stroke): Contains information about migraines from the National Institute of Neurological Disorders and Stroke.

7.4 Books:

  • “Heal Your Headache: The 1-2-3 Program for Taking Charge of Your Pain” by David Buchholz: The book on how to identify and avoid migraine triggers.
  • “The Migraine Miracle: A Sugar-Free, Gluten-Free, Ancestral Diet to Reduce Inflammation and Relieve Your Headaches for Good” by Josh Turknett: A book about a diet for the prevention of migraine.
  • “Migraine Brain: Your Guide to Optimizing Brain Health and Feeling Better” by Carolyn Bernstein: A book on how to improve brain health and relieve migraine.

7.5 support groups:

Joining the support group of people with migraine can help you feel not lonely and get support from other people who understand what you are experiencing.

7.6 Applications for smartphones:

There are applications for smartphones that help to track headaches, identify triggers and monitor treatment.

7.7 Social networks:

There are online communities and groups on social networks, where people with migraine can communicate, share experience and receive support.

Remember that with the correct diagnosis, treatment and strategies for managing migraine, you can significantly improve the quality of life and gain freedom from pain.

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