Migraine under control: how to achieve a stable remission

Migraine under control: how to achieve a stable remission

Chapter 1: Understanding Migraine is the basis of a successful strategy

Migraine is not just a severe headache. This is a neurological disease, characterized by episodic attacks of intense headache, often accompanied by nausea, vomiting, increased sensitivity to light (photophobia) and sound (phonophobia). The importance of understanding migraine as a comprehensive state, and not just a symptom, is critically important for developing an effective management strategy and achieving remission.

1.1. Migraine classification: from aura to chronic shape

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

• Migraine with aura: It is an attack of headaches, which is preceded by neurological symptoms, known as aura. The aura may include visual disorders (for example, flickering lights, zigzag lines), sensory changes (for example, tingling or numbness) or speech disorders. The aura usually lasts from 5 to 60 minutes.
• Migraine without aura: This is the most common form of migraine, characterized by a headache without previous neurological symptoms.
• Chronic migraine: It is diagnosed in the presence of headaches for 15 or more days per month for more than 3 months, and at least 8 of these days must comply with the migraine criteria. Chronic migraine can significantly worsen the quality of life.
• Hemiplegic migraine: A rare form of migraine, accompanied by weakness or paralysis of one side of the body (hemiplegia). It can be hereditary (family hemiplegic migraine) or arise sporadically.
• Basilar migraine (now known as a migraine with an aura of brain stem): It is characterized by symptoms arising from the brain stem, such as dizziness, ears in the ears, double -gathering, dysarthria (speech impairment) and loss of coordination.
• Abdominal migraine: It is more common in children, characterized by episodic abdominal pain, accompanied by nausea, vomiting and pallor. Headache may be absent.

The exact classification of migraines is important for choosing the right treatment and prognosis.

1.2. Physiology of migraines: multifactorial mechanism

The migraine development mechanism is complicated and is not fully studied. It is believed that it is based on the interaction of several factors:

• Trigeminal-vascular system: This system includes the trigeminal nerve (V cranial nerve), which is responsible for the sensitivity of the face and head, and blood vessels surrounding the brain. Activation of the trigeminal nerve leads to the release of neuropeptides, such as CGRP (calcitonin-hen-tied peptide), which cause the expansion of blood vessels of the brain and inflammation, which leads to a headache.
• Crimely spreading depression (CRD): This is a wave of electrical activity, which spreads through the cerebral cortex and can initiate migraines with an aura. KRD can activate the trigeminal-vascular system and cause headache.
• The role of genetics: Migraine has a genetic predisposition. People who have relatives with migraine have a higher risk of developing this disease. Certain genes were associated with migraine, but the exact mechanism of genetic influence has yet to be found.
• Neurotransmitter: Neurotransmitters, such as serotonin, dopamine and glutamate, play a role in the development of migraine. Changes in the levels of these neurotransmitters can affect pain and brain function.
• Inflammation: Inflammation in the brain and surrounding tissues can play a role in the development of migraine. Inflammatory mediators can activate pain receptors and enhance headache.

Understanding these mechanisms allows you to develop more targeted methods for treating migraine.

1.3. Migraine triggers: identification of individual factors

Migraine triggers are factors that can provoke a migraine attack of predisposed people. Triggers vary from man to person, and it is important to identify their own triggers in order to avoid them. The most common migraines triggers include:

• Food triggers: Certain products and drinks can cause migraine. These include:
  • Sustained cheeses (for example, Chedder, Bree, Parmesan)
  • Treated meat (for example, sausage, bacon, ham)
  • Chocolate
  • Alcohol (especially red wine and beer)
  • Sodium glutamate (MSG)
  • Artificial sweeteners (for example, aspartam)
  • Enzymed products (for example, sauerkraut, kimchi)
• Stress: Stress is one of the most common migraine triggers. Both acute and chronic stress can cause attacks.
• Changes in sleep mode: Lack of sleep, excess sleep or a change in sleep schedule can provoke migraines.
• Weather changes: Changes in atmospheric pressure, temperature, humidity and wind can cause migraine in some people.
• Hormonal changes: In women, hormone levels associated with the menstrual cycle, pregnancy and menopause can be migraine triggers.
• Sensory incentives: Bright light, loud sound, strong smells and flickering lights can provoke migraines.
• Physical stress: Intensive physical exercises, weight lifting and other types of physical stress can cause migraine.
• Missed meals: Passing for food intake or starvation can lead to a decrease in blood sugar, which can provoke migraines.
• Dehydration: Insufficient fluid consumption can cause migraine.
• Medicines: Some drugs, such as oral contraceptives and vasodilators, can cause migraine.

Maintenance of a headache diary can help identify individual migraine triggers. Write down the start and end time of the headache, symptoms, potential triggers and taken medications.

Chapter 2: Migraine treatment strategies: from stopping to prevention

Migraine treatment includes two main approaches: stopping acute attacks and preventive treatment.

2.1. Relocation of sharp migraine bouts:

The purpose of stopping acute migraine attacks is to relieve pain and other symptoms as quickly as possible.

• Right -up painkillers: Preparations such as Ibuprofen, Naroxen and Paracetamol can be effective for migrants of migraine light and moderate attacks. It is important to take them as soon as possible after the start of a headache.
• Combined drugs: Preparations containing a combination of painkillers (for example, paracetamol or aspirin) and caffeine can be more effective than painkillers taken separately.
• TRIPTA: Triptans are specific drugs for the treatment of migraine, which affect serotonin receptors in the brain. They are effective for stopping moderate and heavy migraine attacks. Triptans are produced in various forms, including tablets, nasal sprays and injections. Examples of triptans: summptor, risatriciptan, intrigripan, gymitrippan, eletripan, frutitriciptan and al -Prevripeptan. It is important to consult a doctor to determine which tripan is most suitable for you. Triptans are contraindicated to people with cardiovascular diseases.
• Ergotamines: Ergotamins are another class of drugs for the treatment of migraines that narrow the blood vessels in the brain. They are less effective than triptans and have more side effects. Ergotamins are usually used only in cases where triptans are ineffective or contraindicated.
• Dihydroergotamin (DGE): DGE is a form of ergotamine, which can be introduced intravenously or intramuscularly. It can be effective in severe migraine attacks that do not respond to other treatment methods.
• Anti -rate drugs: Anti -rate drugs, such as meteclopramide and coolroperazin, can help alleviate nausea and vomiting, which often accompany migraine. They can be used in combination with painkillers.
• Non -drug methods: Non -drug methods, such as rest in a quiet dark room, applying a cold compress to the head and massage, can also help relieve pain and other symptoms of migraines.

It is important to discuss with the doctor the best strategy for stopping acute migraine attacks, given the severity and frequency of seizures, as well as the presence of concomitant diseases. Excessive use of painkillers can lead to abusiness headache (headaches caused by drugs).

2.2. Preventive treatment of migraines:

Preventive treatment of migraines is aimed at reducing the frequency, severity and duration of seizures. It is recommended for people who have frequent, heavy or disabled migraines.

• Beta blockers: Beta blockers, such as propranolol and metoprolol, are often used to prevent migraine. They help reduce heart rate and blood pressure, which can reduce the risk of migraine.
• Calcium channel blockers: Calcium channel blockers, such as fluanarisine, can be effective for the prevention of migraine, especially migraines with an aura.
• Antidepressants: Certain antidepressants, such as amitriptylin and wenlafaxin, can be used to prevent migraine. They help to increase the level of serotonin and norepinephrine in the brain, which can reduce pain sensitivity.
• Anticonvulsants: Some anticonvulsants, such as topiramate and valproic acid, are effective for migraine prevention. They help stabilize electrical activity in the brain.
• CGRP antagonists: CGRP antagonists are a new class of drugs for migraine prevention that block the effect of calcitonin-gen-tied peptide (CGRP), neuropeptide, which plays an important role in the development of migraine. Examples of CGRP antagonists: Erenumab, Freanzumab, Galkanzumab and Eptynesumab. They are introduced in the form of injections once a month or once every three months.
• Botulinotherapy (Botox): Botox injections can be effective for the prevention of chronic migraine (headache for 15 or more days per month). Botox is inserted into the muscles of the head and neck, which helps to relax muscles and reduce pain sensitivity.
• Nutricevtiki: Some nutticians, such as magnesium, riboflavin (vitamin B2) and Q10 coenzyme, can be useful for migraine prevention. However, additional studies are needed to confirm their effectiveness.
• Non -drug methods: Non-drug methods, such as a change in lifestyle, cognitive-behavioral therapy and biological feedback, can also be effective for migraine prevention.

The choice of preventive treatment depends on individual factors, such as the frequency and severity of attacks, concomitant diseases and tolerance of drugs. It is important to discuss the best strategy for preventive treatment with the doctor. Preventive treatment takes time to achieve the effect, so it is important to be patient and continue treatment for several months before evaluating its effectiveness.

2.3. Non -drug approaches to migraine management:

Non -drug approaches play an important role in managing migraine, especially in combination with drug therapy.

• Life change change:
  • Regular sleep mode: Try to go to bed and wake up at the same time every day, even on weekends.
  • Healthy nutrition: Eat regularly and avoid missing meals. Limit the consumption of products that are migraine triggers.
  • Regular physical exercises: Regular moderate physical exercises, such as walking, swimming or cycling, can help reduce the frequency and severity of migraine attacks.
  • Sufficient fluid consumption: Drink enough water during the day to avoid dehydration.
  • Stress management: Use relaxation methods such as meditation, yoga or tai-chi to reduce stress.
• Cognitive-behavioral therapy (KPT): KPT is a type of psychotherapy that helps people change their thoughts and behavior in order to better cope with stress and pain. KPT can be effective for the prevention of migraine and improve the quality of life of people with migraine.
• Biological feedback: Biological feedback is a method that helps people learn to control physiological functions, such as heart rate, blood pressure and muscle tension. Biological feedback can be effective for reducing the frequency and severity of migraine attacks.
• Acupuncture: The acupuncture is a traditional Chinese medical practice, which includes the introduction of thin needles into certain points on the body. Acupuncture can be effective for reducing the frequency and severity of migraine attacks.
• Massage: Massage can help relax muscles and reduce tension, which can help relieve headache associated with migraine.
• Meditation and relaxation: Meditation and relaxation techniques can help reduce stress and improve the general health, which can reduce the frequency and severity of migraine attacks.
• Wearing sunglasses: Wearing sunglasses in bright light can help prevent migraine caused by photosensitivity.
• Avoiding strong smells: Avoid strong smells, such as perfumes, paints and cleaners that can provoke migraines.

It is important to discuss the best non -drug approaches to migraine management with a doctor or other qualified specialist.

Chapter 3: Monitoring and Correction of Treatment Strategy

Achieving stable migraine remission is a dynamic process that requires constant monitoring and adjusting the treatment strategy.

3.1. Keeping a headache diary:

Keeping a headache diary is an important tool for monitoring the effectiveness of migraine treatment. The following information should be recorded in the diary:

• The date and time of the beginning and end of the headache
• Head of headache (for example, on a scale from 1 to 10)
• Concomitant symptoms (for example, nausea, vomiting, photosensitivity, sound sensitivity)
• Potential triggers (for example, food products, stress, weather changes, sleep disturbances)
• Accepted drugs and their effectiveness
• Other factors that may be related to headache

Analysis of the headache diary can help identify the patterns and triggers of migraines, as well as evaluate the effectiveness of treatment.

3.2. Regular consultations with a doctor:

Regular consultations with a doctor is an important part of migraine management. During the consultation, the doctor may:

• Assess the effectiveness of treatment
• Discuss side effects of drugs
• Make changes to the treatment plan, if necessary
• Answer your questions and solve any problems

It is recommended to visit a doctor every 3-6 months, or more often if you have any problems.

3.3. Correction of treatment based on monitoring:

Based on the information collected in the headache diary and during consultations with a doctor, you may need to adjust the treatment plan. This may include:

• Dose change
• Change of drugs
• Adding new drugs
• Change in lifestyle
• Use of non -drug treatment methods

It is important to work in close cooperation with the doctor to find the most effective treatment plan for you.

3.4. Patience and perseverance:

Achieving stable migraine remission can take time and demand patience and perseverance. It is important not to despair if treatment does not work right away. Continue to work with a doctor to find the most effective treatment plan for you.

Chapter 4: Special cases and related diseases

Migraine management can be more complicated in certain cases and in the presence of concomitant diseases.

4.1. Migraine in women:

Migraine is more common in women than in men. Hormonal changes associated with the menstrual cycle, pregnancy and menopause can be migraine triggers.

• Menstrual migraine: Migraine associated with the menstrual cycle can be more difficult to treat than other types of migraines. Treatment options include:
  • Taking painkillers or triptans at the beginning of menstruation
  • Hormonal therapy (for example, oral contraceptives or plasters with estrogen)
  • Preventive treatment of migraines
• Migraine during pregnancy: Some medicines for migraine are contraindicated during pregnancy. Treatment options during pregnancy include:
  • Non -drug treatment methods (for example, rest, applying a cold compress to the head)
  • Paracetamol
  • In some cases, triptans (after consulting a doctor)
• Migraine during menopause: Hormonal therapy can help reduce the frequency and severity of migraine attacks during menopause.

It is important to discuss with a doctor the treatment of migraine, given your hormonal status and reproductive plans.

4.2. Migraine in children and adolescents:

Migraine can also be found in children and adolescents. Migraine treatment in children and adolescents can be complicated, since some drugs used to treat migraines in adults are not suitable for children.

• Non -drug treatment methods: Non-drug methods of treatment, such as a change in lifestyle, cognitive-behavioral therapy and biological feedback, are an important part of the treatment of migraine in children and adolescents.
• Anesthetic drugs: Anesthetic drugs, such as Ibuprofen and Paracetamol, can be effective for migrants of migraine light and moderate attacks.
• TRIPTA: Some triptans are approved for use by adolescents.
• Preventive treatment: Preventive treatment can be recommended to children and adolescents with frequent, heavy or disabled migraine attacks.

It is important to work in close cooperation with a doctor specializing in the treatment of headaches in children in order to develop the most effective treatment plan for your child.

4.3. Migraine with concomitant diseases:

Migraine is often found along with other diseases, such as:

• Depression and anxiety: Depression and anxiety are often found in people with migraine. Treatment of depression and anxiety can help reduce the frequency and severity of migraine attacks.
• Irritable intestine syndrome (SRK): SRK is a disorder that affects the large intestine. SRK is often found in people with migraine.
• Fibromyalgia: Fibromyalgia is a disease that causes widespread muscle pain and fatigue. Fibromyalgia is often found in people with migraine.
• Arterial hypertension: Arterial hypertension (high blood pressure) can be associated with migraine. Some drugs used to treat migraines can increase blood pressure.
• Cardiovascular diseases: Some medicines for migraine are contraindicated for people with cardiovascular diseases.

In the presence of concomitant diseases, it is important to discuss a migraine treatment plan with a doctor, taking into account all your medical problems.

Chapter 5: New horizons in the treatment of migraines

Migraine studies are constantly developing, and new treatment methods appear.

5.1. CGRP antagonists:

CGRP antagonists are a new class of drugs for migraine prevention that block the effect of calcitonin-gen-tied peptide (CGRP), neuropeptide, which plays an important role in the development of migraine. CGRP antagonists showed promising results in clinical trials and can be effective for people who do not respond to other treatment methods. There are two types of CGRP antagonists:

• Monoclonal antibodies to CGRP or its receptor: These drugs are administered as injections once a month or once every three months. Examples: Erenumab, Freanzumab, Galkanzumab and Eptinezumab.
• Hypers (small molecules of CGRP antagonists): These drugs are taken orally for stopping acute migraine bouts or for prevention (in some cases). Examples: Rimegepant, Ubrogeepant.

5.2. Neurostimulation:

Neurostimulation is a treatment method that includes the use of electric or magnetic impulses to stimulate nerves in the brain. Some methods of neurostimulation have shown promising results in the treatment of migraines:

• Transcranial magnetic stimulation (TMS): TMS uses magnetic impulses to stimulate nerves in the brain. TMS can be used to stop sharp migraine bouts or for prevention.
• Transcranial direct stimulation by current (TPST): TPST uses a weak electric current to stimulate nerves in the brain. TPST can be used to prevent migraine.
• Stimulation of the vagus nerve (SBN): SBN uses electrical impulses to stimulate the vagus nerve, which connects the brain to various organs of the body. SBN can be used to stop sharp migraine bouts or for prevention.

5.3. Other promising directions:

• Studies of the role of inflammation in migraines: Studies show that inflammation can play a role in the development of migraine. New treatment methods are being developed aimed at reducing inflammation in the brain.
• Genetic studies of migraines: Genetic studies help to understand the genetic predisposition to migraine. This can lead to the development of new treatment methods aimed at specific genetic targets.
• Telemedicine and digital technologies: Telemedicine and digital technologies can be used to improve access to migraine treatment and to monitor the effectiveness of treatment.

Migraine is a complex disease, but with the right approach and cooperation with the doctor, you can achieve stable remission and significantly improve the quality of life.

Chapter 6: Myths and Migraine’s Elings

Migraine is often surrounded by myths and errors that can impede the effective treatment and management of this disease. It is important to dispel these myths in order to improve understanding of migraines and contribute to a more adequate approach to its treatment.

6.1. “Migraine is just a severe headache”:

This is perhaps the most common and harmful myth. Migraine is not just a severe headache. This is a neurological disease characterized by a complex complex of symptoms, including headache, nausea, vomiting, photophobia, phonophobia and, in some cases, aura. Migraine can significantly affect everyday life and performance.

6.2. “Migraine is a psychological problem”:

Although stress and anxiety can be migraine triggers, this does not mean that migraine is a purely psychological problem. Migraine has clear physiological foundations associated with the activation of the trigeminal-vascular system, a cortical spreading depression and changes in neurotransmitter levels.

6.3. “People with migraine are simply looking for attention”:

This myth is especially offensive and incorrect. Migraine is a real disease that can cause significant suffering. People with migraine are not looking for attention, but simply try to cope with exhausting symptoms and improve their quality of life.

6.4. “Migraine can only be cured with medicines”:

Although medicines play an important role in the treatment of migraines, non-drug approaches, such as a change in lifestyle, cognitive-behavioral therapy and biological feedback, can also be effective for the prevention and relief of attacks. An integrated approach, including both medicinal and non -drug methods, is often the most effective.

6.5. “If you have a migraine, you just need to avoid all the triggers”:

Although the identification and avoidance of triggers can be useful, it is impossible and unrealistic to avoid all potential migraine triggers. Moreover, excessive restriction can lead to social isolation and deterioration of the quality of life. It is important to find a balance between the avoidance of famous triggers and maintaining a healthy and full -fledged lifestyle.

6.6. “Migraine passes with age”:

Although in some people the frequency and severity of migraine attacks can decrease with age, in others, migraines may remain a problem throughout life. Hormonal changes associated with menopause can both improve and worsen migraine in women.

6.7. “All methods of treatment of migraine are equally effective for everyone”:

Migraine treatment is an individual process. What is effective for one person may not work for another. It is important to work in close cooperation with the doctor in order to find the most effective treatment plan for you, taking into account your individual needs and features.

6.8. “Migraine is a hereditary disease, and nothing can be done with it”:

Migraine has a genetic predisposition, but this does not mean that nothing can be done with it. A healthy lifestyle, effective treatment and proper care can significantly improve the condition and reduce the effect of migraine on your life.

Chapter 7: Resources and support for people with migraine

Life with migraine can be difficult, but it is important to remember that you are not alone. There are many resources and support groups that can help you deal with this disease and improve your quality of life.

7.1. Doctors and medical specialists:

• Neurologists: Neurologists are doctors specializing in the treatment of diseases of the nervous system, including migraine.
• Headache experts: Some neurologists specialize in the treatment of headaches.
• General practitioners: Your general practitioner can help you diagnose and treat migraines, as well as direct you to a neurologist or headache specialist, if necessary.
• Psychologists and therapists: Psychologists and therapists can help you cope with stress, anxiety and depression, which often accompany migraine.
• Physiotherapy: Physiotherapists can help you improve posture, relieve tension in the muscles of the neck and shoulders, as well as teach you exercises for relaxing and removing pain.
• Acupuncture: Acupuncture can use acupuncture to reduce the frequency and severity of migraine attacks.

7.2. Organizations and associations:

• American headache. Provides information about migraines and other types of headache, as well as a list of doctors specializing in the treatment of headache.
• National Headache Foundation: Provides information about migraines and other types of headache, as well as resources for people with headache.
• INTERNATIONAL HEADACHE SOCREETY Association: An international organization engaged in the promotion of research and education in the field of headache.

7.3. Support groups:

Support groups provide the opportunity for people with migraine to communicate with each other, share experience and receive support. Support groups can be personal or online.

7.4. Online resources:

• Websites of medical organizations (for example, Mayo Clinic, NHS): Provide information about migraine and its treatment.
• Forums and online communities for people with migraine: Provide the opportunity to communicate with other people suffering from migraine and share experience.
• Applications for tracking headache: They help to track headaches, triggers and medicines.

7.5. Books and Articles:

There are many books and articles about migraines that can help you learn more about this disease and how to manage it.

Remember that you are not alone in your fight against migraine. Contact your doctors, medical specialists, organizations, support groups and online resources.

Chapter 8: Life with migraine: adaptation strategies and self -help

Migraine can have a significant impact on your life, but there are many ways to adapt and improve your quality of life.

8.1. Self -education:

Find out as much as possible about migraine, its causes, triggers and treatment methods. The more you know, the better you can control your condition.

8.2. Holding a healthy lifestyle:

• Regular sleep mode: Try to go to bed and wake up at the same time every day, even on weekends.
• Healthy nutrition: Eat regularly and avoid missing meals. Limit the consumption of products that are migraine triggers.
• Regular physical exercises: Regular moderate physical exercises can help reduce the frequency and severity of migraine attacks.
• Sufficient fluid consumption: Drink enough water during the day to avoid dehydration.
• Stress management: Use relaxation methods such as meditation, yoga or tai-chi to reduce stress.

8.3. Triggers Management:

Identify your personal migraines triggers and try to avoid them. Keeping a headache diary can help you determine your triggers.

8.4. Creating a favorable environment:

Create a favorable environment for people with migraine in your home and at work. This may include:

• Using curtains or blinds to reduce the amount of light.
• The use of Berusha or headphones to reduce the amount of noise.
• Avoiding strong smells.
• Ensuring a comfortable temperature.

8.5. Planning and organization:

Plan your business so that you have enough time to relax and relax. Organize your workplace in such a way that you are convenient and comfortable.

8.6. Message about your needs:

Do not be afraid to report your needs to your friends, family, colleagues and employers. Explain to them what migraine is and how it affects your life. Ask them about