Migraine is a chronic neurological disease that is characterized by recurrent severe headache. The hallmark is that the pain most often extends to only one half of the head. This is a very common problem. It is found in 10% of people. Attacks can occur rarely – several times a year, but in most patients they occur 1-2 times a week.
The beautiful half of humanity is more likely to suffer from bouts of severe headache. But many men face this problem. Another name for migraine is the disease of aristocrats. It is believed that headaches often occur in people who are engaged in mental work.
What it is?
Migraine is a neurological disease, the most frequent and characteristic symptom of which is episodic or regular severe and painful bouts of headache in one (rarely in both) half of the head.
At the same time, there are no serious head injuries, stroke, brain tumors, and the intensity and pulsating nature of pain is associated with vascular headache, and not with tension headache. Migraine headache is not associated with an increase or a sharp decrease in blood pressure, an attack of glaucoma, or an increase in intracranial pressure (ICP).
The very first symptoms that resemble a migraine were described by ancient healers of the time of the Sumerian civilization before the birth of Christ in 3000 BC.
It is noteworthy that migraine often becomes a companion of geniuses. This disease, like no other, loves active and emotional people who prefer mental work. For example, such outstanding personalities as Pontius Pilat, Pyotr Tchaikovsky, Edgar Po, Karl Marx, Anton Pavlovich Chekhov, Julius Caesar, Sigmund Freud, Darwin, Newton suffered from it. Has not bypassed a migraine party and modern celebrities. Suffering from headache attacks, such famous personalities as Whoopi Goldberg, Janet Jackson, Ben Affleck and others live and create.
Another curious fact (although it is not scientifically proven): people who tend to perfection suffer more often from migraines. Such personalities are ambitious and ambitious, their brains are constantly working. It’s not enough for them to do everything perfectly, they should be the best. Therefore, they are very responsible and conscientious about everything, working for themselves and for that guy. In fact, they are workaholics.
The mechanism of development of migraine headache
As you know, migraine is a special type of headache, the mechanism of development of which is unique and not similar to any other. Because most of the drugs for headaches are ineffective with migraine.
Migraine attack occurs in several consecutive phases:
- Spasm of the arterial vessels of the brain and the development of short-term hypoxia of the brain substance. The development of migraine aura is associated with this phase.
- Then dilation, or expansion, of all types of brain vessels occurs (arteries, veins, venules, arterioles and capillaries). In this stage, a typical throbbing headache develops.
- Swelling of the walls of blood vessels and perivascular space develops, which makes them rigid to the signals for reverse contraction. This phenomenon determines the duration of migraine headaches.
- The last stage is characterized by the reverse development of migraine and is also called post-migraine syndrome. For some time after the cessation of pain, the patient may complain of general weakness, fatigue, and a feeling of “staleness” in the head.
Despite the available data on the nature of migraine headache, new information appears every day, as this problem is being actively studied by scientists all over the world. For example, according to the latest medical publications, the hypothalamus of the brain plays a significant role in the pathogenesis of migraine, and this provides new opportunities for the invention of effective drugs for the treatment and prevention of migraine.
Causes of migraine
One of the mysteries are the causes of migraine. On the basis of long-term observations, it was possible to establish some regularities in the occurrence of seizures.
Both men and women suffer from migraines, but in women it occurs twice as often as men. There is a dependence of the incidence of the disease on the lifestyle, so it has been established that people who are socially active and ambitious, professions requiring high mental activity, as well as housewives are most susceptible to migraines. Cases of migraine are extremely rare among people in working professions whose activity is associated with constant physical activity.
The causes of migraine people suffering from it, include many factors, but in fact their direct influence on the development of the attack could not be established, so these factors can only be considered as predisposing, or “starting moment”, which occurs when the true cause of the disease appears. Causes of migraine include:
- Some types of products: hard aged cheeses, red wine, chocolate, mackerel fish, smoked meat, coffee;
- Stress or experienced psycho-emotional arousal .;
- Some types of medications, such as oral contraceptives;
- Sharp weather changes (meteorological form of migraine);
- Strong physical exertion;
- Premenstrual syndrome.
Usually, experienced patients know what provokes a migraine attack in them, and try to eliminate the influence of this factor, thus, they manage to reduce the frequency of attacks, but not completely get rid of them.
Depending on the symptoms of migraine, the disease is divided into the following types:
- hemiplegic (lost opportunity to perform an action with a hand or foot);
- migraine status (lasts more than one day).
- retinal (affects half of the head and eye area, perhaps a sharp decrease in vision);
- basilar (occurs in young women, is fraught with cerebral infarction in the absence of adequate treatment);
- ophthalmic (affects the visual organs, the eyelid overhangs, loss of visual function);
- abdominal (often occurs in children, youths, accompanied by cramps, abdominal pain);
In medical practice, there are also concepts of migraine with and without aura.
Without an aura, a patient has frequent headaches that can last from four hours to three days in a row. Pain sensations are fixed in a specific part of the head (at the point). Pain increases with physical activity, as well as intense mental activity.
With aura, it is accompanied by a large number of complex, sometimes mixed symptoms, which occur long before the attack or immediately with its onset.
The most basic symptoms of migraine in women and men are throbbing, paroxysmal pain in the half of the head, lasting from 4 to 72 hours. When bending, the pain intensifies – this is an excessive expansion of blood vessels.
A migraine attack can be preceded by aura – various neurological symptoms: vestibular, motor, sensory, auditory, visual. The visual aura occurs more often than others, when a person sees a lot of bright flashes in the left or right visual field, there is a loss of fragments of the visual field or distortion of objects.
So, the main signs of migraine are as follows:
- Migraine precursors – weakness, feeling of unmotivated fatigue, inability to concentrate, impaired attention. After attacks, post-stroke is sometimes observed – drowsiness, weakness, pallor of the skin.
- Nausea is an important symptom that helps to distinguish migraine pain from other types of pain. This symptom always accompanies seizures and is sometimes so pronounced that it comes to gagging. In this case, the patient’s condition is subjectively easier, for a few minutes it becomes easier. If vomiting does not bring relief, and pain does not subside within a few days, then this may be a sign of migraine status and requires inpatient treatment.
- The nature of migraine pain is different from other headaches – starting from the temple, a throbbing and pressing pain gradually covers half of the head, spreading to the forehead and eyes.
- In 10% of cases of migraine in women, it occurs during menstruation and lasts a day or two from its beginning. One third of all women who have this disease suffer from menstrual migraine.
- With a migraine, there are always one or more associated symptoms – photophobia, nausea, vomiting, fear of fear, impaired smell, sight or attention.
- Oral contraceptives and other drugs that affect the hormonal balance, including hormone replacement therapy, can significantly increase the risk of an attack, in 80% of cases it intensifies its intensity.
- The arteries in the temple area are tense and pulsating, pain and tension are aggravated by movement, so patients transfer the principle in bed in a quiet and dark room to minimize the amount of external stimuli.
- Irritability, anxiety, fatigue, drowsiness, pallor or redness of the skin, anxiety and depression are symptoms associated with migraines that may or may not appear in each individual case.
- One-sided pain can alternate from an attack to an attack, covering the left, then the right side of the head or occipital region.
According to medical research, women suffer from migraines more often, experiencing an average of 7 attacks per month against 6 attacks in men, the duration of attacks is 7.5 hours for women, and for men – 6.5 hours. The reasons for the attack in women are changes in atmospheric pressure, air temperature and other climate changes, and in men – intense physical exertion. The symptoms associated with migraines also differ: women are more likely to have nausea and olfactory impairment, and men have photophobia and depression.
How to relieve pain at home?
With minor manifestations of migraine, pain can be relieved from an attack without medication, for which it is necessary:
- allowed yourself to sleep;
- cold and hot shower;
- mimic gymnastics;
- washing head;
- head and neck massage;
- yoga classes;
The simplest available means of alleviating the suffering of migraine at home are over-the-counter analgesics, over-the-counter, containing Ibuprofen, Nurofen, Aspirin, Paracetamol (the latter is the least effective), acting faster and stronger in the form of effervescent forms.
To reduce the manifestations of nausea or vomiting, you can use antiemetics, including in the form of rectal suppositories. Antiemetic drugs, promoting the absorption of analgesics from the gastrointestinal tract, enhance their action.
How to treat migraine?
At home, the treatment of migraine involves two main areas – the relief of an already developed attack, and the prevention of the appearance of attacks in the future.
Relief of attack. Only a neurologist can prescribe any means for pain relief during a migraine attack, it depends on the intensity and their duration. If the attack is moderate or mild and lasts no more than 2 days, then the doctor prescribes simple analgesics, possibly combined.
- Combination preparations containing codeine, paracetamol, phenobarbetal and metamizole sodium.
- NSAIDs (ibuprofen), paracetamol (contraindicated in pathologies of the kidneys and liver), acetylsalicylic acid (can not be taken with a tendency to bleeding and with gastrointestinal diseases).
- If the intensity of the pain is high, the duration of the attacks is more than 2 days, then Triptans are prescribed for migraine (a list of all modern triptans, prices, how to take them correctly). They are available in candles, solutions, sprays, infections.
- Non-selective agonists – Ergotamine, etc.
- Auxiliary psychotropic drugs – domperidone, metoclopramide, chlorpromazine.
Triptans are drugs developed 20 years ago and derived from serotonin. They act in several directions at once:
- Triptans affect the blood vessels selectively, reducing the painful pulsation only in the brain, without affecting the rest of the vascular system of the body.
- They act only on special producing substances (receptors) that provoke the appearance of pain, their number is reduced – the pain also goes away.
- They have a pronounced analgesic effect, reducing the sensitivity of the trigeminal nerve.
In the classic version of migraine with aura, Papazol, taken in the first minutes, can help. Someone helps a hot bath, someone is exposed to the cold, and the third is facilitated by the pressure chamber.
Experimental treatments for migraine
Experimental methods include treatment with hypnosis, electronic devices, special adhesive plaster. However, there is no evidence of their effectiveness and more research is needed.
In connection with disruption of cellular metabolism and activation of lipid peroxidation, which occurs in the pathogenesis of migraine, along with the conventional medical treatment, the administration of antioxidants and metabolic drugs that improve cell energy processes and protect them from damage by free radicals is pathogenetically justified (combination of vitamins A, E, C, coenzyme Q10, antioxycaps, emoxipin).
For example, a study was recently published, which involved 1,550 children and adolescents suffering from frequent migraine attacks. In the course of it, it was shown that a low level of coenzyme Q10 in plasma was observed in a number of patients, and that a recommendation for the use of dietary supplements containing coenzyme Q10 may lead to an improvement in some clinical signs. The authors concluded that to confirm such observations requires an analysis with a more scientifically qualitative methodology.
In another study, in 42 patients, the authors compared the efficacy of coenzyme Q10 (300 mg / day) and placebo: coenzyme Q10 was significantly more effective than placebo to reduce the frequency of migraine attacks, the duration of headaches and the duration of nausea after 3 months of treatment. The authors evaluate coenzyme Q10 as an effective and well-tolerated means of preventing migraine manifestations.
A group of plastic surgeons from University Hospitals of Cleveland for about ten years worked on the hypothesis that in some cases the cause of recurrent headaches and migraines is trigeminal nerve irritation caused by spasm of the muscles around it. Published results of studies confirming the weakening or disappearance of headache with Botox injection and surgical removal of the corresponding muscles.
Alternative migraine treatment
Other ways to treat this disease:
- Biofeedback. This is a special kind of relaxation with the help of special equipment. During the procedure, the person learns to control the physiological responses to various effects, such as stress.
- Acupuncture. Studies have shown that this procedure helps to cope with headaches of various origins, including migraine. But acupuncture is effective and safe only if it is performed by a certified specialist with the help of special sterile needles.
- Cognitive behavioral therapy. Helps some migraine sufferers.
- Massage. An effective means of prevention, helps to make migraine attacks more rare.
- Herbs, vitamins, minerals, dietary supplements. Means such as butterbur herb, feverfew, high doses of riboflavin (vitamin B2), coenzyme Q10, and magnesium help prevent and make rarer migraine attacks. But before using them, you should always consult with your doctor.
Prevention of migraine attacks
By following these simple recommendations, you can avoid the provocation of an attack:
- Follow a diet and diet, do not rush during a meal and do not snack on the go.
- Do sleep hygiene, the duration of which should be 7-8 hours, where the daily quiet hour should be completely canceled. It is necessary to go to bed in a calm, non-irritated state at the same time (but not too early), and it would be good to get up at the same hour to get up.
- Reduce stressful situations to a minimum, always have on hand safe means of dealing with them (valerian tablets and
It is necessary to agree that it is difficult to fight migraine, but it is possible. Usually, disciplined patients know everything about their illness, and in most cases they cope, although, of course, they are not envied, you need to be on the alert all the time. “The road will be mastered by the one who walks!” Said the ancients.
With proper and complex therapy, the prognosis for this disease is encouraging. The presence of the disease can be evidence of the development of serious illnesses, including cancer, abscess, inflammation of the brain, encephalitis, vascular aneurysm, hydrocephalus and
The risk group of people who may have a migraine may include residents of large cities who lead a dynamic lifestyle and neglect leisure, girls and women over the age of 20 years (especially during menstruation), as well as people with a genetic predisposition to migraines.
For proper diagnosis and optimal treatment, you need to seek help from a neurologist. Only an experienced doctor will be able to distinguish signs of migraine from other syndromes with similar symptoms, and will also recommend step-by-step, effective therapy.