How to get rid of migraines forever: complete leadership

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How to get rid of migraines forever: complete leadership

I. Understanding migraines: fundamental aspects

  1. Migraine definition:

    Migraine is a neurological disease characterized by intense headaches, often pulsating, which can be accompanied by nausea, vomiting and increased sensitivity to light (photophobia) and sound (phonophobia). Migraine is not just a severe headache; This is a complex state that affects various aspects of human life. Its diagnosis and treatment require a comprehensive approach, taking into account the individual characteristics of the body and factors provoking attacks.

  2. Explanation and influence on life:

    Migraine is one of the most common neurological diseases. According to the World Health Organization, about 15% of the world’s population suffers from migraine. It has a significant negative impact on the quality of life, leading to a decrease in working capacity, passing working days, limiting social activity and deterioration of mental health. Chronic migraine, when headaches occur 15 or more days a month, even more seriously undermines the human ability to function normally.

  3. Types of migraines:

    • Migraine with aura: The attack of a headache is preceded by an aura – a set of neurological symptoms, such as visual disorders (flickering lights, zigzags, field fields), sensory disorders (numbness, tingling in the limbs), speech difficulties or motor disorders. The aura usually lasts from 5 to 60 minutes and takes place before the start of a headache.
    • Migraine without aura: The most common type of migraine. A headache occurs without any previous neurological symptoms.
    • Chronic migraine: Headaches occur 15 or more days a month for at least 3 months, and at least 8 of these days correspond to the criteria of migraine.
    • 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 sporadic (for the first time).
    • Ophthalmoplegic migraine: A rare form of migraine, characterized by paralysis of the eye muscles, which leads to double in the eyes (diplopia).
    • Basial migraine (now called migraine with the aura of the brain stem): The aura is characterized by symptoms emanating from the brain trunk, such as dizziness, ears, dysarthria (speech impairment), diplopia (double -gathering) and violation of consciousness.
    • Abdominal migraine: It is more common in children. It is characterized by abdominal pain, nausea, vomiting and lack of headache.

  4. Causes of migraines: multifactorialness:

    The exact causes of migraines have not been fully studied, but it is believed that genetic factors and environmental factors play a role in its development. The main theories of migraine pathogenesis include:

    • Vascular theory: It was previously believed that migraine is associated with narrowing and expansion of blood vessels of the brain. However, this theory does not explain all aspects of migraines.
    • Neurovascular theory: A more modern theory, suggesting that migraine is the result of a complex interaction between the nervous system and blood vessels of the brain. The trigeminal nerve (trigeminal nerve), which is responsible for the sensitivity of the face, plays a key role in the development of migraine. 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 and inflammation in the brain.
    • Genetic predisposition: The presence of a family history of migraine significantly increases the risk of the development of the disease. Genes associated with migraine have been identified, but their role in the pathogenesis of the disease is still studied.
    • Neurotransmitter: Violations in the levels of neurotransmitters, such as serotonin, dopamine and norepinephrine, can play a role in the development of migraines.

  5. Migraines triggers: individual sensitivity:

    Migraine triggers are factors that can provoke an attack of headache in predisposed people. Triggers are individual, and the same factor can cause migraine in one person, but not influence the other. It is important to keep a headache diary in order to identify their individual triggers. The most common triggers include:

    • Food triggers:
      • Sustained cheeses: They contain a thyramin that can affect the level of neurotransmitters.
      • Processed meat products: Contain nitrates and nitrites that can expand the blood vessels.
      • Chocolate: Contains caffeine and phenylethylamine, which can provoke migraine in some people.
      • Alcohol: Especially red wine that contains tramine and sulfites.
      • Artificial sweeteners: Aspartam and other artificial sweeteners can be migraine triggers.
      • Glutamate sodium (MSG): It is often used as an amplifier of taste in Asian cuisine and processed products.
    • Environmental factors:
      • Weather changes: Changes in atmospheric pressure, temperature and humidity can provoke migraines.
      • Bright light: Flickering light, sunlight and fluorescent lamps can cause migraine.
      • Strong smells: Spirits, chemicals, smoke and other strong smells can be triggers.
      • Noise: Loud sounds and constant noise can provoke migraines.
    • Hormonal factors:
      • Menstruation: A decrease in estrogen levels before menstruation can cause migraine (menstrual migraine).
      • Pregnancy: Migraine can improve or worsen during pregnancy.
      • Menopause: Hormonal changes during menopause can aggravate migraines.
      • Hormonal contraceptives: Reception of hormonal contraceptives can affect the frequency and intensity of migraine.
    • Life lifestyle factors:
      • Stress: Stress is one of the most common migraine triggers.
      • Lack of sleep: The disadvantage or excess of sleep can provoke migraines.
      • Passing of food intake: Unregular nutrition and a pass of eating can lead to a decrease in blood sugar and cause migraine.
      • Dehydration: Inadequate fluid consumption can be a migraine trigger.
      • Physical strain: Intensive physical activity can provoke migraines.
    • Medications:
      • Some vasodilating drugs: For example, nitroglycerin.
      • Some drugs for pressure: For example, reservoir.
      • Excessive use of painkillers: It can lead to a drug-induced headache (Rebound Headache).

II. Migraine Diagnostics: Key Stages

  1. Anamnesis collection: a detailed description of the symptoms:

    Migraine diagnosis begins with a detailed history of the anamnesis. The doctor asks questions about the nature of the headache (localization, intensity, duration, pulsating or pressing in nature), accompanying symptoms (nausea, vomiting, photophobia, phonophobia), the presence of aura, triggers, family history of migraine and the effect of headache on everyday life. It is important to describe your symptoms as accurately and in detail so that the doctor can make the correct diagnosis.

  2. Neurological examination: Exclusion of other diseases:

    A neurological examination allows other diseases that can cause headaches. The doctor checks vision, hearing, coordination, reflexes, muscle strength and sensitivity. If a neurological examination reveals any deviations, additional studies may be required.

  3. Headache diary: identification of triggers and treatment effectiveness:

    Keeping a headache diary is an important tool for the diagnosis and treatment of migraine. In the diary it is necessary to record the date and time of the beginning of the headache, its intensity (for example, on a scale of 1 to 10), localization, concomitant symptoms, possible triggers (for example, food, drinks, stress, weather changes), medications taken and their effectiveness. The headache diary helps to identify individual triggers and evaluate the effectiveness of various treatment methods.

  4. Additional research: when are they necessary?

    In most cases, the diagnosis of migraine is made on the basis of an anamnesis and neurological examination. Additional studies such as MRI (magnetic resonance imaging) or CT (computed tomography) of the brain are usually not required, but can be prescribed in the following cases:

    • Atypical symptoms: Unusual or new symptoms that do not correspond to a typical migraine picture.
    • Neurological deficits: Weakness, numbness, speech or vision, which do not pass after an attack of headache.
    • The sudden beginning of a headache: Sudden and severe headache, especially if it is accompanied by fever, shackled neck or impaired consciousness.
    • Changing the nature of the headache: The gradual deterioration of a headache or a change in its character.
    • Age older than 50 years: The first occurrence of migraine at the age of older than 50 years requires the exclusion of other diseases.

  5. Differential diagnosis: Exclusion of other types of headache:

    It is important to exclude other types of headache that migraine can imitate, such as:

    • Headache of tension: The most common type of headache, characterized by dull, pressing or compressing pain in the head.
    • Closter headache: Intensive, one -sided headache that occurs in series (clusters) lasting from several weeks to several months.
    • Sinus headache: Headache caused by inflammation of the sinus of the nose (sinusitis).
    • Headache caused by high blood pressure: It can be a symptom of a hypertensive crisis.
    • A headache caused by a brain tumor: A rare cause of headache, which is usually accompanied by other neurological symptoms.
    • Cervicogenic headache: Headache associated with problems in the cervical spine.
    • Medicine-induced headache (Rebound Headache): Headache that occurs due to excessive use of painkillers.

III. Migraine treatment: integrated approach

  1. Relocation of an attack: drugs to relieve pain:

    Migraine treatment is aimed at facilitating pain during an attack (eranding an attack) and preventing future attacks (preventive treatment). Migraines are used to stop the attack:

    • Anesthetic drugs:
      • Nonsteroidal anti -inflammatory drugs (NSAIDs): Ibuprofen, steady, diclofenac. Effective with mild and moderate migraines.
      • Paracetamol: Less effective than NSAIDs, but can be used for intolerance to NSAIDs.
    • TRIPTA: Special preparations for the treatment of migraine, which affect serotonin receptors in the brain. Effective with moderate and strong migraines. Examples of triptans: summptor, risatriciptan, zolmitriptan, naratriptan, eletripan, frutripitan, al -Prepereptan. Triptans are contraindicated to people with cardiovascular diseases.
    • Ergotamines: Outdated drugs for the treatment of migraines that narrow the blood vessels. They have many side effects and are rarely used.
    • Combined drugs: Contain a combination of painkillers and caffeine. It can be effective in migraines, but can lead to drug-induced headaches with frequent use.
    • Antimetics: Preparations to facilitate nausea and vomiting, which often accompany migraine. Examples: metoclopramide, domperidone.

  2. Preventive treatment: Prevention of future seizures:

    Preventive treatment of migraines is prescribed for people who have frequent (4 or more days a month) or severe migraine bouts that significantly affect the quality of life. The purpose of preventive treatment is to reduce the frequency, intensity and duration of migraine attacks. Preparations for the preventive treatment of migraine include:

    • Beta blockers: Propranolol, metoprolol. They are used to treat high blood pressure, but are also effective for the prevention of migraine.
    • Tricyclic antidepressants: Amititriptylin, NORTRIPTILIN. Used to treat depression, but are also effective for migraine prevention.
    • Anticonvulsants: Valproic acid, topiramate. They are used to treat epilepsy, but are also effective for migraine prevention.
    • Calcium channel blockers: Flunarizin. They are used to treat dizziness, but are also effective for migraine prevention.
    • Botulininic toxin (Botox): Introduced into the muscles of the head and neck to reduce the frequency of chronic migraine.
    • Monoclonal antibodies to CGRP: A new class of drugs for migraine prevention that block the action of CGRP (calcitonin-hen-tied peptide), which plays a key role in the development of migraine. Examples: Erenumab, Freanzumab, Galkanzumab, Eptinezumab.
    • Magnesium: Magnesium deficiency can contribute to the development of migraine. Reception of magnesium additives can help reduce the frequency of attacks.
    • Riboflavin (vitamin B2): It can help reduce the frequency and intensity of migraine.
    • Coenzim q10: It can help reduce the frequency of migraine.
    • Plant drugs: Some plant preparations, such as white -blood -cake (Petasites Hybridus), can be effective for the prevention of migraine, but it is necessary to consult a doctor before using them.

  3. Non -drug treatment methods: Additional opportunities:

    Non -drug methods of treatment can be effective both as an addition to drug treatment, and as an independent method for the treatment of migraine. These include:

    • Life change change:
      • Regular sleep: Try to go to bed and wake up at the same time every day, even on weekends.
      • Regular nutrition: Do not miss food meals and eat regularly.
      • Sufficient fluid consumption: Drink enough water during the day.
      • Stress management: Use relaxation methods such as meditation, yoga or tai-chi.
      • Regular physical exercises: Regular moderate physical exercises can help reduce the migraine frequency.
      • Refusal of smoking: Smoking can provoke migraines.
      • Alcohol use restriction: Especially red wine.
      • Avoiding famous triggers: Keeping a headache diary will help to identify individual triggers, which should be avoided.
    • Biological feedback (biofidbek): A method that allows you to learn how to control the physiological functions of the body, such as heart rate, blood pressure and muscle tension. Biofidbek can help reduce the frequency and intensity of migraine.
    • Acupuncture: The method of traditional Chinese medicine, which consists in introducing thin needles into certain points on the body. Acupuncture can help reduce the frequency and intensity of migraine.
    • Massage: Massage can help relax muscles and reduce stress, which can reduce the frequency of migraine.
    • Cognitive-behavioral therapy (KPT): The type of psychotherapy that helps change the negative thoughts and behavior that can contribute to the development of migraines.
    • Neurostimulation: The use of electric or magnetic pulses to stimulate nerves or brain. Some neurostimulating methods, such as transcranial magnetic stimulation (TMS) and stimulation of the vagus nerve (VNS), can be effective for the treatment of migraine.
    • Alternative treatment methods: Some people report an improvement when using alternative treatment methods such as herbal preparations, homeopathy and chiropractic, but their effectiveness has not been proven by scientific research. It is important to consult a doctor before using alternative treatment methods.

  4. Individual treatment plan: Cooperation with a doctor:

    Migraine treatment should be individual and adapted to the needs of each patient. It is important to cooperate with the doctor in order to develop an effective treatment plan, which includes medication and non -united methods. Regularly visit a doctor to assess the effectiveness of treatment and make the necessary adjustments.

  5. When to seek emergency medical help:

    In most cases, migraine does not require emergency medical care. However, in the following cases, consult a doctor immediately:

    • Sudden and severe headache, which differs from ordinary migraine attacks.
    • Headache, accompanied by fever, constraint of the neck, impaired consciousness, weakness, numbness, impaired speech or vision.
    • Headache after head injury.
    • A headache that does not pass after taking painkillers.
    • Deterioration of headache or the appearance of new symptoms.

IV. Migraine and related diseases: relationships and management

  1. Depression and anxiety: general mechanisms and treatment:

    Migraine often accompanies depression and anxiety. There is a bippable relationship between these states: migraine can increase the risk of depression and anxiety, and depression and anxiety can aggravate migraines. The general mechanisms underlying this connection include violations in the levels of neurotransmitters, such as serotonin, and general genetic factors. Treatment of depression and anxiety can help reduce the frequency and intensity of migraine, and vice versa. Treatment may include antidepressants, psychotherapy (for example, cognitive-behavioral therapy) and a change in lifestyle.

  2. Cardiovascular diseases: risks and precautions:

    Migraine, especially migraine with an aura, can be associated with an increased risk of cardiovascular disease, such as stroke, myocardial infarction and angina pectoris. This may be due to inflammation, impaired endothelium function and increased platelet aggregation. People with migraine and cardiovascular diseases need to carefully monitor their condition and take measures to reduce the risk of cardiovascular complications, such as control of blood pressure, cholesterol and weight, refusal of smoking and regular physical exercises. Some drugs for the treatment of migraine, such as tripatans and ergotamines, are contraindicated for people with cardiovascular diseases.

  3. Epilepsy: General genetic factors:

    Migraine and epilepsy have some general genetic factors and neurophysiological mechanisms. People with migraine have increased risk of epilepsy, and vice versa. Some anticonvulsants, such as valproic acid and topiramate, are used to treat both migraines and epilepsy.

  4. Irritated intestines (SRK): The axis “Intestinal-MOZG”:

    Migraine often accompanies the syndrome of irritable intestines (SRK). There is an axis of the “intestines-Moscow” that binds the intestines and brain through the nervous system, the immune system and the endocrine system. Disorders in the intestinal microbioma, intestinal inflammation and changes in the intestinal function can affect the function of the brain and contribute to the development of migraine. Treatment of SRK can help reduce the frequency and intensity of migraine, and vice versa. Treatment may include a change in diet, probiotics, antispasmodics and antidepressants.

  5. Other related diseases: asthma, allergies, apnea syndrome in a dream:

    Migraine can be associated with other related diseases such as asthma, allergies and apnea syndrome in a dream. Inflammation and respiratory disorders associated with these diseases can contribute to the development of migraines. Treatment of these diseases can help reduce the frequency and intensity of migraine.

V. Migraine in special groups of the population: individual approaches

  1. Migraine in children and adolescents: early diagnosis and treatment:

    Migraine can occur in children and adolescents. In children, migraine can appear differently than in adults. For example, in children there is more often an abdominal migraine, characterized by abdominal pain, nausea and vomiting without headache. Early diagnosis and treatment of migraines in children are important to prevent chronic disease and improve the quality of life. Treatment may include painkillers, lifestyle changes and preventive treatment.

  2. Migraine and pregnancy: the safety of drugs:

    Migraine can improve, worsen or remain unchanged during pregnancy. It is important to discuss with a doctor the treatment of migraine during pregnancy in order to avoid taking drugs that can be harmful to the fetus. Some painkillers, such as paracetamol, are considered relatively safe during pregnancy. Triptans and NSAIDs should be used with caution and only as prescribed by a doctor. Non -drug methods of treatment, such as relaxation, massage and acupuncture, can be useful during pregnancy.

  3. Migraine and menopause: hormonal changes and treatment:

    Hormonal changes during menopause can aggravate migraines in some women. Hormonal therapy can help reduce the frequency and intensity of migraine, but it is necessary to discuss the risks and advantages of hormone therapy with the doctor. Other treatment methods, such as antidepressants, anti -vocalonal antibodies to CGRP, can also be effective for migraine prevention during menopause.

  4. Migraine in the elderly: features and precautions:

    Migraine can occur in the elderly. It is important to exclude other diseases that can cause headaches in older people. In the treatment of migraines in older people, it is necessary to take into account age -related changes in the function of the liver and kidneys, as well as interaction with other drugs that they can take. Dosage of drugs can be lower than that of young people.

  5. Migraine and sports: the influence of physical exertion:

    Physical activity can be both a trigger or a method of migraine prevention. Intensive physical activity can provoke migraines in some people. Regular moderate physical exercises, such as walking, swimming or yoga, can help reduce the frequency of migraine. It is important to avoid dehydration and overwork during physical exertion.

VI. Promising directions in the treatment of migraines: new opportunities

  1. New drugs: monoclonal antibodies to CGRP and heinlets:

    Monoclonal antibodies to CGRP (Erenumab, Freanzumab, Galkanzumab, Eptynesumab) and Heverni (Riemhegepant, Arrogupant)-new classes of drugs for the prevention and treatment of migraines that block the effect of CGRP (calcitonin-tied peptide), which plays a key role in the development of development migraines. These drugs showed high efficiency and safety in clinical trials and are a promising direction in the treatment of migraine.

  2. Neurostimulation: transcranial magnetic stimulation (TMS) and stimulation of the vagus nerve (VNS):

    Transcranial magnetic stimulation (TMS) and stimulation of the vagus nerve (VNS) – non -invasive methods of neurostimulation, which can be effective for the treatment of migraine. TMS uses magnetic impulses to stimulate certain areas of the brain, and VNS uses electrical impulses to stimulate the vagus nerve.

  3. Gene therapy: The future treatment of migraines?

    Gene therapy is a promising direction in the treatment of many diseases, including migraine. Gene therapy is aimed at correcting genetic defects that can contribute to the development of migraine. Studies in the field of genetic therapy of migraines are in the early stages, but in the future it can become an effective method of treating this disease.

  4. Artificial intelligence (AI): Diagnostics and personalized treatment:

    Artificial intelligence (AI) can be used to diagnose and personalized treatment of migraines. AI can analyze large volumes of data about patients with migraine to identify risk factors, predict headaches and develop individual treatment plans.

  5. Microbioma research: new targets for therapy:

    Studies of the intestinal microbioma can identify new targets for migraine treatment. Changes in the intestinal microbioma can affect the function of the brain and contribute to the development of migraine. Probiotics, prebiotics and other methods of changing the intestinal microbioma can be effective for the treatment of migraine.

VII. Life with migraine: adaptation strategies and support

  1. Creating a supporting environment: family, friends, employer:

    It is important to create a supporting environment for people with migraine. Family, friends and employer should understand the nature of migraines and its influence on everyday life. They can help in managing triggers, providing recreation and support during attacks, as well as creating favorable conditions at work.

  2. Support groups: Exchange of experience and information:

    Support groups can be useful for people with migraine. In support groups, you can exchange experience and information with other people suffering from migraine, receive emotional support and learn new adaptation strategies.

  3. Self -help: Methods of control of pain and stress:

    Self -help plays an important role in managing migraine. Methods of control of pain and stress, such as relaxation, meditation, yoga and biophydbek, can help reduce the frequency and intensity of migraine attacks.

  4. Planning and preparation for an attack: readiness for unforeseen situations:

    It is important to plan and prepare for a migraine attack. It is necessary to always have painkillers at hand, avoid known triggers, create a calm and dark atmosphere during an attack, and also think in advance what to do if the attack arises in an inappropriate place or at the wrong time.

  5. Bar: Improving the awareness of migraine:

    It is important to increase awareness of migraine in society. Migraine is often underestimated and stigmatized. The spread of information about migraine, its causes, symptoms and methods of treatment can help improve the understanding and support of people suffering from this disease. A lawyer can also contribute to the financing of migraine studies and the development of new treatment methods.

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