Migraine – the most severe and unpleasant type of headache. She has been tormenting humanity for many years. Napoleon, Caesar, Nietzsche, Freud, Chopin, Tchaikovsky, Bulgakov suffered from migraines. Today, the problem of the occurrence and treatment of migraine is also relevant due to its wide prevalence.
Migraine (hemicrania) – It is a chronic disease of the nervous system. Characteristic signs of migraine are attacks of severe headache, which often occur in only one half of the head, and very rarely in both. Migraine pain is the second most common after tension headache.
Migraine periods. Signs of a migraine attack
During a migraine attack, 4 periods are distinguished: prodromal period, aura, migraine cephalgia (pain attack), postdromal. Sometimes before a migraine attack, aura phenomena are inherent. The aura is manifested by visual symptoms - loss of visual fields, luminous figures, as well as olfactory and gustatory sensations. The course of a migraine attack with aura is more severe, but less common.
A migraine attack is often preceded by nausea, dizziness, and vomiting. Migraine can occur in the form of a vegetative crisis with palpitations, numbness of the extremities, chills, fluctuations in blood pressure, and increased urination. Before a migraine attack, there is often a feeling of anxiety.
Do you know Points for quick headache relief?
Over the years, there is a transformation of migraine, as a result of which the number of attacks decreases.
Among all patients who do not feel the aura, 90% feel nausea before the headache, 50% vomit, 50-95% feel photophobia and 61-98% feel sound-phobia.
Migraine. Causes of migraine attacks
Predisposition to migraine may be hereditary. But in a migraine attack, triggers play an important role – provoking factors.
Migraine triggers include:
- stressful situations;
- Food products containing the substance tyramine (smoked meats, bananas, citrus fruits, red wines and chocolate);
- physical overexertion;
- taking oral contraceptives or other medications;
- sleep disturbance;
- premenstrual syndrome;
- change in weather conditions (decrease in air temperature).
The fewer triggers a person has, the less frequently migraine attacks occur.
Headache in the eyes and forehead: causes and remedies
Complications that may occur after a migraine attack
A migraine attack can provoke complications, which include status migraine and migraine stroke.
Migraine status – This is a series of consecutive severe prolonged attacks, where one attack lasts more than 72 hours. In this case, the headache, which was previously localized in one side of the head, becomes bilateral and has a bursting character. With such migraine attacks, repeated vomiting is possible, so this condition requires urgent hospitalization and treatment in a hospital due to dehydration, which can have negative consequences.
Migraine stroke – this is a "catastrophic" a form of migraine in which there are neurological symptoms that are flickering in nature.
Treatment of chronic migraine. Which drugs should be chosen
Over the past 20 years, the mechanisms of pathophysiology, pharmacology and epidemiology of migraine have been studied. The use of new drugs became possible after determining the role of the mediator serotonin in the development of a migraine attack.
Relief of a migraine attack. Treatment and prevention of migraine
Today, there are 3 classes of drugs that have been scientifically proven to be effective in treating migraine.
These are 5HT1 agonists (triptans), dopamine receptor antagonists and prostaglandin inhibitors. When stopping a migraine attack, selective serotonin agonists are the basic drugs.
Triptans – a new type of drugs that have high selectivity for serotonin receptors. By acting on postsynaptic serotonin receptors of the vascular wall, triptans provoke constriction of cerebral blood vessels, which are greatly dilated. When This reduces the stimulation of pain receptors in the vascular wall, and this helps to reduce pain.
Treatment of migraine attacks with botulinum therapy. What is important to know?
The treatment of migraine with triptans blocks the process of pain transmission at the level of the spinal nucleus of the trigeminal nerve. Triptans include sumatriptan, zolmitriptan, eletriptan, etc.
It is assumed that with a central mechanism of action, a prolonged effect is observed, which contributes to a decrease in the number of headaches and the severity of associated symptoms.
The efficacy of triptans in migraine has been confirmed in studies. Triptans are effective during any period of a migraine attack, but their early use is preferable.
It is important to remember that triptans at the recommended doses do not have side effects, but they are contraindicated in hypertension, heart disease, and renal and hepatic failure.
In order to prevent recurrence of a migraine attack, experts recommend a rational and regular diet, which will exclude chocolate, cocoa, citrus fruits, nuts, beans, cheeses, tomatoes, celery, champagne, dry red wine and beer. If possible, it is necessary to limit the influence of irritating factors – such as loud sound, TV, telephone and radio.
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