Strategies to get rid of migraine once and for all

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Strategies to get rid of migraine once and for all

I. Understanding of migraines: the root cause and mechanisms

A. Definition and classification:

  1. Migraine: more than just a headache. Migraine is a neurological disease characterized by intense headaches, often accompanied by other symptoms, such as nausea, vomiting, sensitivity to light (photophobia), sound (phonophobia) and smells (osmophobia). It is important to understand that migraine is not just a severe headache, but a complex condition that affects various body systems.

  2. Migraine classification: Migraine is classified into several types, the most common of which are migraines with aura and migraine without aura. a. Migraine with aura: About 20-30% of people with migraine experience an aura-temporary neurological symptoms preceding headaches. The aura may include visual disorders (flickering lights, zigzag lines, blind spots), sensory changes (numbness, tingling) or speech disorders. The aura usually lasts from 5 to 60 minutes. B. Migraine without aura: This type of migraine is not accompanied by aura. The headache is usually intense, pulsating and localized on one side of the head, but can spread to both sides.

  3. Other types of migraines: There are other, less common types of migraines, such as: a. Chronic migraine: Headaches occur 15 or more days a month for more than three months, while at least eight days a month correspond to migraine criteria. B. Hemiplegic migraine: A rare type of migraine, causing temporary weakness or paralysis of one side of the body. C. Migraine of the brain stem: It is characterized by symptoms that occur from the brain stem, such as dizziness, double -gathering, dysarthria (speech impairment) and impaired coordination. D. Ophthalmoplegic migraine: A rare type of migraine that affects the muscles that control the movement of the eyes.

B. Pathophysiology of migraines: complex mechanism.

  1. Trigemins system: The main mechanism underlying migraines is the activation of the trigeminascular system. The trigeminal nerve is the main sensory nerve of the face and head. With migraine, the trestle-core nerve releases neuropeptides, such as CGRP (calcitonin-Gen Rected peptide), which cause the expansion of blood vessels in the membranes of the brain (durable cerebral membrane) and inflammation.

  2. Crossing cortical distribution depression (CSD): CSD is a wave of neuronal and glial depolarization, slowly spreading along the cerebral cortex. It is believed that CSD plays a role in the occurrence of aura and activation of the trigeminal nerve.

  3. CGRP role: CGRP plays a central role in the pathophysiology of migraine. It is a powerful vasodilator and participates in the transmission of pain signals. Medicines that block CGRP or its receptor turned out to be effective in the prevention and treatment of migraines.

  4. Genetic predisposition: Migraine is often inherited. Studies have shown that certain genes are associated with an increased risk of migraine development. However, genetics is not the only factor; Environmental factors also play an important role.

  5. Central sensitization: Repeating attacks of migraines can lead to central sensitization – a state of increased excitability of neurons in the central nervous system. This means that the brain becomes more sensitive to pain signals, which makes migraine more intense and frequent.

  6. Mitochondria dysfunction: Some studies have shown that the dysfunction of mitochondria, cellular organelles responsible for energy production can play a role in migraine pathophysiology.

C. Migraine triggers: identification and avoidance.

  1. Food triggers:
    a. Sustained cheeses: Contain thyramin, amino acid, which can cause narrowing and subsequent expansion of blood vessels. B. Processed meat: Contains nitrates and nitrites, which can also affect blood vessels. C. Chocolate: Contains thyramine, phenylethylamine and caffeine. D. Alcohol: Especially red wine containing tiramin and sulfites. E. Artificial sweeteners: Aspartam can cause migraine in some people. f. Citrus fruit: May contain an octamine. G. Glutamate sodium (MSG): A common food supplement, often used in Chinese cuisine.

  2. Ecological triggers:
    a. Weather changes: Surveys of atmospheric pressure, temperature or humidity. B. Bright light: Flickering light, sunlight. C. Strong smells: Spirits, chemicals, smoke. D. Noise: Loud sounds, constant noise.

  3. Triggers lifestyle:
    a. Stress: Physical or emotional stress. B. Lack of sleep or excess sleep: Violation of the sleep regime. C. Passing of food intake: Low blood sugar. D. Dehydration: Insufficient fluid consumption. E. Physical strain: Intensive exercises.

  4. Hormonal triggers:
    a. Menstruation: Changes in estrogen level. B. Pregnancy: Hormonal changes. C. Menopause: Reduction in estrogen levels. D. Hormonal contraceptives: Some tablets.

  5. Detection of triggers: Keeping a headache diary can help identify specific triggers associated with your migraines. Write down the date, time, headache intensity, accompanying symptoms, medicines, as well as possible triggers, such as food, weather, stress and sleep.

II. Holistic approach to migraine treatment

A. Diet and nutrition: anti-inflammatory and migraine-specific diets.

  1. Anti -inflammatory diet:
    a. Increased consumption of omega-3 fatty acids: Contained in fatty fish (salmon, mackerel, sardines), linen seed, chia seeds and walnuts. Omega-3 fatty acids have anti-inflammatory properties. B. Increase in fruits and vegetable consumptions: They contain antioxidants that help fight inflammation. C. Avoiding processed foods: Processed products often contain additives, trans fats and refined carbohydrates that can increase inflammation. D. Reducing sugar consumption and refined carbohydrates: Sugar and refined carbohydrates can contribute to inflammation. E. Using anti -inflammatory spices: Turmeric, ginger, garlic and chili pepper have anti -inflammatory properties.

  2. Migraine-specific diet:
    a. Exclusion of potential triggers: Exclude products that you defined from the diet as triggers in your headache diary. B. Elimation diet: The temporary exclusion of certain groups of products, which are often associated with migraine, such as dairy products, gluten, citrus fruits, chocolate, caffeine and alcohol. Gradually return the products to the diet one by one to identify those that cause migraine. C. Ketogenic diet: Some studies have shown that a ketogenic diet, with a low carbohydrate content and a high fat content, can help reduce the frequency and intensity of migraines. D. Low constant diet: Histamine is a substance contained in some products, and can cause migraine in some people. Avoid products with a high histamine, such as aged cheeses, fermented products, smoked meat and fish.

  3. Moisturization:
    a. Sufficient water consumption: Dehydration can be a migraine trigger. Strive to drink at least 8 glasses of water per day. B. Electrolytes: Autominate electrolytes, especially after physical activity or in hot weather.

  4. Vitamins and minerals:
    a. Magnesium: Magnesium deficiency can contribute to migraines. Take additives with magnesium or use products rich in magnesium, such as dark green leafy vegetables, nuts and seeds. B. Riboflavin (vitamin B2): Riboflavin can help reduce the frequency and duration of migraine. C. Coenzim q10: Coenzyme Q10 is an antioxidant that can help improve the function of mitochondria and reduce migraine. D. Vitamin D: Vitamin D deficiency is associated with an increased risk of migraine development.

B. Stress management: relaxation methods and cognitive-behavioral therapy (KPT).

  1. Relaxation methods:
    a. Deep breath: Slow, deep breathing can help reduce stress and stress. B. Meditation: Meditation can help calm the mind and reduce stress. C. Yoga: Yoga combines physical exercises, breathing techniques and meditation, which can help reduce stress and improve flexibility. D. Progressive muscle relaxation: This technique includes consistent tension and relaxation of various muscle groups in the body. E. Preview: Visualization is the use of imagination to create a calm and relaxing environment. f. Aromatherapy: Some essential oils, such as lavender, chamomile and peppermint, have soothing properties.

  2. Cognitive-behavioral therapy (KPT):
    a. Identification of negative thoughts and beliefs: KPT helps to identify negative thoughts and beliefs that can contribute to stress and migraines. B. Change of thinking: KPT helps to change negative thoughts and beliefs to more positive and realistic. C. Development of overcoming skills: KPT teaches skills to overcome stress and control pain. D. Change in behavior: KPT can help change the behavior that migraines can contribute to, for example, an irregular sleep or a passage of eating.

  3. Biological feedback (BOS):
    a. Monitoring physiological indicators: Bos uses sensors to monitor physiological indicators, such as heart rate, muscle tension and skin temperature. B. Physiological performance management: Bos helps to learn to control these physiological indicators in order to reduce stress and stress.

  4. Other stress management methods:
    a. Diary maintenance: Keeping a diary can help you track your stress and emotions. B. Conducting time in nature: Time spent in nature can help reduce stress and improve mood. C. Hobby classes: Hobbies can help you relax and get distracted from stress. D. Social support: Communication with friends and family can help you cope with stress.

C. Physical activity: regular exercises and specialized techniques.

  1. Regular exercises:
    a. Aerobic exercises: Aerobic exercises, such as walking, running, swimming and cycling, can help reduce the frequency and intensity of migraines. B. Power training: Power training can help improve the general health and reduce stress. C. Regularity: It is important to do regularly to get the maximum benefit from exercises.

  2. Specialized techniques:
    a. Yoga: Yoga combines physical exercises, breathing techniques and meditation, which can help reduce stress and improve flexibility. B. Pilates: Pilates helps strengthen the muscles of the bark and improve posture. C. Tai-you: Tai-chi is a slow, smooth form of exercises that can help reduce stress and improve balance.

  3. Cautions:
    a. Gradual increase in intensity: Start slowly and gradually increase the intensity of exercises. B. Avoid overstrain: The overstrain can be a migraine trigger. C. Moisturization: Drink enough water before, during and after training. D. Warm up and hitch: Wash before training and do a hitch after training. E. Consult a doctor: Consult a doctor before the start of any new exercise program, especially if you have any health problems.

  4. The benefits of physical activity:
    a. Reducing stress: Exercises help reduce stress. B. Improvement: Regular exercises can help improve sleep quality. C. Improving the level of endorphins: Exercises are released by endorphins that have painkillers. D. Improving blood circulation: Exercises improve blood circulation in the brain.

D. Sleep and hygiene of sleep: establishing a sequential schedule of sleep.

  1. Establishment of a sequential sleep schedule:
    a. Go to bed and wake up at the same time every day: Even on weekends. B. Create a relaxing routine before bedtime: For example, a warm bath, reading a book or listening to calm music. C. Avoid caffeine and alcohol before bedtime: Caffeine and alcohol can disrupt sleep. D. Avoid using electronic devices before bedtime: Blue light emitted by electronic devices can suppress the production of melatonin, hormone regulating sleep.

  2. Creating a favorable environment for sleep:
    a. Dark, quiet and cool room: Use the curtains or a mask for the eyes to darken the room. Use Berushi or white noise to drown out the noise. Support the cool temperature in the room. B. Convenient mattress and pillow: Invest in a convenient mattress and pillow. C. Using the bedroom only for sleep and sex: Do not work, do not watch TV and do not use electronic devices in the bedroom.

  3. Sleep disorders treatment:
    a. Insomnia: Consult a doctor if you have sleep problems. It can recommend cognitive-behavioral therapy for insomnia (KPT) or medicine. B. Obstructive Apnoe SNA Syndrome (SOAS): Soas is a condition in which breathing is interrupted during sleep. If you suspect that you have a Soas, consult a doctor.

  4. The consequences of a lack of sleep:
    a. Migraine trigger: The lack of sleep can be a migraine trigger. B. Strengthening pain: The lack of sleep can increase pain. C. Pituisance reduction: The lack of sleep can lead to a decrease in mood and irritability. D. Reducing cognitive functions: The lack of sleep can lead to a decrease in cognitive functions, such as concentration of attention and memory.

  5. Alternative methods for improving sleep:
    a. Melatonin: Melatonin is a hormone that regulates the dream. Take additives with melatonin only after consulting a doctor. B. Herbal remedies: Some herbal products, such as valerian, chamomile and lavender, can help improve sleep. Consult a doctor before taking any herbal remedies.

E. Alternative methods of treatment: acupuncture, massage and biofort.

  1. Acupuncture:
    a. Traditional Chinese medicine: The acupuncture is a technique used in traditional Chinese medicine, which includes the introduction of thin needles into certain points on the body. B. Reducing pain: The acupuncture can help reduce pain by releasing endorphins and other analgesic substances. C. Migraine frequency decrease: Some studies have shown that acupuncture can help reduce the frequency of migraine.

  2. Massage:
    a. Stress removal: Massage can help relieve tension in the muscles of the neck, shoulders and back. B. Improving blood circulation: Massage can help improve blood circulation in the brain. C. Reducing stress: Massage can help reduce stress. D. Various types of massage: There are various types of massage, such as Swedish massage, deep tissue massage and trigger acupressure.

  3. Biophy (BOS):
    a. Monitoring physiological indicators: Bos uses sensors to monitor physiological indicators, such as heart rate, muscle tension and skin temperature. B. Physiological performance management: Bos helps to learn to control these physiological indicators in order to reduce stress and stress. C. Migraine frequency decrease: Bos can help reduce the frequency and intensity of migraine.

  4. Other alternative treatment methods:
    a. Transcranial magnetic stimulation (TMS): TMS is a non -invasive method that uses magnetic impulses to stimulate nerve cells in the brain. B. Transcular stimulation of the vagus nerve (TSBN): TSBN is a non -invasive method that stimulates the vagus nerve through the skin. C. Phytotherapy: Some herbs, such as white -skinned and ginger, can help reduce migraine. Consult a doctor before taking any herbal remedies.

III. Medication of migraines: acute and preventive drugs

A. Sharp (abortive) drugs: cessation of migraine attacks.

  1. Simple analgesics:
    a. Acetaminophen (paracetamol): Effective with mild and moderate migraines. B. Nonsteroidal anti -inflammatory drugs (NSAIDs): Ibuprofen, steady, diclofenac. NSAIDs reduce inflammation and pain.

  2. TRIPTA:
    a. The mechanism of action: Triptans are selective agonists of serotonin receptors 5-HT1B/1D. They narrow the blood vessels in the brain and block the release of CGRP. B. Examples: Sumatiptan, Rateskyan, Grilletttant, RaolPantant, Frietype and Frietant, Frierytan, Almatiptan. c. Output forms: Tablets, nasal sprays, injections. D. Side effects: The feeling of composure in the chest, nausea, dizziness, fatigue. E. Contraindications: Cardiovascular diseases, uncontrolled hypertension, stroke.

  3. Dihydroergotamin (DGE):
    a. The mechanism of action: DGE is an agonist of serotonin, dopamine and adrenergic receptors. It narrows blood vessels in the brain. B. Output forms: Injections, nasal spray. C. Side effects: Nausea, vomiting, diarrhea, abdominal pain. D. Contraindications: Cardiovascular diseases, uncontrolled hypertension, pregnancy.

  4. Hypers (CGRP antagonists):
    a. The mechanism of action: Hyans block the CGRP receptor, thereby preventing the expansion of blood vessels and the transmission of pain signals. B. Examples: Rimegepant, parrypant. C. Side effects: Nausea, fatigue.

  5. Ditans (selective agonists 5-HT1F receptors):
    a. The mechanism of action: Lasmiditan selectively activates 5-HT1F receptors, without causing narrowing of blood vessels. B. Side effects: Dizziness, sedative effect.

  6. Anti -rate funds:
    a. Examples: Metoklopramide, cool reupererine. B. Usage: They are used to facilitate nausea and vomiting, often accompanying migraines.

  7. Combined drugs:
    a. Examples: Acetaminophene/Aspirin/caffeine (Excedrin Migraine). B. Usage: The combination of analgesics and caffeine can be more effective than individual drugs.

B. Preventive drugs: a decrease in the frequency and severity of seizures.

  1. Beta blockers:
    a. The mechanism of action: Propranolol, metoprolol, Atenolol. Reduce heart rate and blood pressure. B. Side effects: Fatigue, dizziness, bradycardia, depression. C. Contraindications: Asthma, bradycardia, hypotension.

  2. Tricyclic antidepressants (TCA):
    a. The mechanism of action: Amititriptylin, NORTRIPTILIN. Affect the level of serotonin and norepinephrine in the brain. B. Side effects: Dry mouth, constipation, drowsiness, weight gain. C. Cautions: They can cause drowsiness.

  3. Anticonvulsants:
    a. The mechanism of action: Topiramate, valproic acid, sofa. Stabilize electrical activity in the brain. B. Side effects: Topiramate: weight loss, speech impairment, tingling in the limbs. Valproic acid: weight gain, hair loss, liver damage. C. Cautions: Valproic acid is contraindicated during pregnancy.

  4. Calcium channel blockers:
    a. The mechanism of action: Flunarizin. The flow of calcium in cells is blocked, which can reduce neurons excitability. B. Side effects: Equity of weight, drowsiness, depression.

  5. Injections of botulinum toxin type A (Botox):
    a. The mechanism of action: Botox injections block the release of neurotransmitters, which can reduce muscle voltage and pain signals. B. Usage: Approved for the treatment of chronic migraines (15 or more head pain per month). C. Side effects: Pain at the injection, weakness of the neck muscles.

  6. Monoclonal antibodies to CGRP or its receptor:
    a. The mechanism of action: Erenumab, Freanzumab, Galkanzumab, Eptynesumab. Block CGRP or its receptor, preventing the expansion of blood vessels and the transmission of pain signals. B. Output forms: Injections. C. Side effects: Reactions at the injection site, constipation.

  7. Other drugs:
    a. Clonidine: Alpha-blocker. B. Magnesium: Magnesium deficiency can contribute to migraines. C. Riboflavin (vitamin B2): It can help reduce the frequency and duration of migraine. D. Coenzim q10: An antioxidant that can help improve the function of mitochondria and reduce migraine.

C. Development of a personalized treatment plan:

  1. Consultation with a doctor: It is important to consult a doctor to develop a personalized migraine treatment plan.
  2. Assessment of the medical history: The doctor will assess your medical history to identify the possible causes and triggers of migraine.
  3. Definition of treatment goals: The doctor will help you determine the purpose of treatment, such as a decrease in the frequency, intensity and duration of migraine attacks.
  4. Choosing drugs: The doctor will choose medications that are best suited for you, based on your medical history, migraine severity and possible side effects of drugs.
  5. Monitoring the effectiveness of treatment: The doctor will monitor the effectiveness of treatment and make the necessary adjustments.
  6. Accounting for lifestyle: The doctor will help you make changes to the lifestyle, such as diet, physical activity and stress management that can help reduce migraine.

IV. Advanced strategies and new methods for treating migraines

A. Neuromodulation: stimulation of the nervous system to relieve migraine.

  1. Transcranial magnetic stimulation (TMS):
    a. The mechanism of action: TMS uses magnetic impulses to stimulate or suppress the activity of nerve cells in the brain. B. Usage: TMS can be used to treat acute migraines or for the prevention of migraine. C. Procedure: TMS is held in the doctor’s office or in the clinic. The patient sits in a chair, and a coil is applied to his head, which generates magnetic impulses. D. Side effects: Headache, discomfort at the place of stimulation.

  2. Transcular stimulation of the vagus nerve (TSBN):
    a. The mechanism of action: TSBN stimulates the vagus nerve through the skin, which can help reduce the frequency and intensity of migraine. B. Usage: TSBN can be used to treat acute migraines or for the prevention of migraine. C. Procedure: TSBN is carried out using a portable device, which is attached to the neck. The device generates electrical impulses that stimulate the vagus nerve. D. Side effects: Skin irritation, discomfort in the place of stimulation.

  3. Stimulation of a large occipital nerve (SBZN):
    a. The mechanism of action: SBZN stimulates the large occipital nerve, which passes through the back of the head. Stimulation of this nerve can help reduce the pain and migraine. B. Usage: SBNN is used to treat chronic migraines. C. Procedure: SBZN is carried out surgically. The doctor implants the electrodes next to the large occipital nerve. The electrodes are connected to the pulse generator, which is implanted under the skin. D. Side effects: Infection, pain in the implantation, migration of electrodes.

B. Innovative drugs and clinical studies:

  1. New CGRP antagonists: Studies of the new CGRP antagonists are ongoing, which can be more effective or have less side effects.
  2. Selective agonists 5-HT1F receptors: Lasmiditan is the first representative of the new class of drugs that selectively activates 5-HT1F receptors. The research of other 5-HT1F receptor agonists continues.
  3. Genotherapy: Genotherapy is a promising direction in the treatment of migraine. It can allow purposefully affect the genes that play a role in the pathophysiology of migraine.
  4. Clinical trials: Participation in clinical trials can give access to new treatment methods that are not yet approved for wide use.

C. Accurate medicine in the treatment of migraines: adaptation of therapy to genetics and biomarkers.

  1. Genetic testing: Genetic testing can help identify genes that are associated with an increased risk of migraine development. This information can help doctors develop a more personalized treatment plan.
  2. Biomarkers: Biomarkers are measurable substances in the blood, urine or other biological fluids that may indicate the presence of a disease or condition. Identification of migraine biomarkers can help doctors diagnose migraines more accurately and monitor the effectiveness of treatment.
  3. Pharmacogenomy: Pharmacogenomy studies how human genes affect his reaction to drugs. This information can help doctors choose medicines that are most effective and safe for a particular person.

D. Telemedicine and care for migraine: remote monitoring and support.

  1. Remote consultations: Telemedicine allows patients to receive consultations with a doctor remotely, through a video conference or phone. This can be especially useful for people who live in remote areas or have limited mobility.
  2. Remote monitoring: Remote monitoring devices can be used to track the symptoms of migraine, such as the frequency, intensity and duration of headaches. This information can help doctors track the effectiveness of treatment and make the necessary adjustments.
  3. Online support programs: There are online support programs that offer educational materials, self-help tools and the ability to communicate with other people suffering from migraine.

V. Practical tips and resources for life with migraine

A. Maintenance of a headache diary: tracking triggers and symptoms.

  1. What to write down:
    a. The date and time of the beginning and end of the headache: This will help you track the frequency and duration of seizures. B. The intensity of pain: Use the scale from 0 to 10, where 0 is the lack of pain, and 10 is the most severe pain that you have ever experienced. C. Localization hurts: Describe where exactly the head hurts (for example, on the one hand, on both sides, in the forehead, in the back of the head). D. The nature of the pain: Describe the nature of the pain (for example, pulsating, pressing, dull, acute). E. Related symptoms: Mark any concomitant symptoms such as nausea, vomiting, sensitivity to light (photophobia), sound

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