Migraine: Symptoms, Causes and Treatment

There are external and internal causes that trigger migraine headache. The most important are:

• hunger, rare food intake and lack of fluids;
• consumption of cheese, nuts, red wine, chocolate, coffee, smoked and citrus;
• acute and chronic traumatic situations, fatigue;
• physical overload;
• insufficient, excess sleep or falling asleep at an inopportune time;
• women - cyclical hormonal changes, as well as oral contraceptives and other therapy sex hormones;
• changes in atmospheric pressure;
• pungent smells, flickering light, loud noise, stuffy, air travel and other unusual effects.

Migraine without aura

This is the most common variant, found in four cases out of five. Manifested typical right or left, rarely - double-sided, throbbing headache, during which patients require light, sound and physical rest. Often accompanied by nausea and vomiting.

Migraine with aura

This type of migraine is characterized by symptoms that occur most often for half an hour before the headache, at least at the same time with it. They arise gradually and consistently, have consequences and can not be extended more than an hour. Aura can be:

• typical with the development of visual disorders, sensory disturbances or speech, but without muscle weakness;
• stem with symptoms from the brain stem (dizziness, coordination disorders, double vision, violation of pronunciation);
• hemiplegic with transient muscle weakness of the limbs on the one hand;
• retinal disorder with unilateral short-term view (brilliant lightning flashes, loss of patches or complete blindness). It may be a combination or alternation of these features. For example, the aura begins with flashes of lightning, and then drops out of the field of view.

chronic migraine

Attacks occur at least 15 times a month and continues for at least 3 months. It begins with a typical rare attacks.

If the headache is characterized by the following features, you should look for the cause of migraines is not. Such patients should be evaluated, and sometimes an emergency:

• headache emerged as a hit, reaching maximum intensity within a few seconds;
• headache progressively grows, while in migraine between attacks head does not hurt;
• pain arose suddenly and character different from the usual;
• unusual, or lasts longer than an hour migraine aura;
• the pain is accompanied by signs of focal lesions of the nervous system (limited defeat any portion thereof, e.g., motor pathway) or general symptoms of fever, depression or change consciousness;
• headache accompanied by symptoms of increased intracranial pressure - the maximum intensity in the morning, swelling of the optic nerve, revealed by an ophthalmologist;
• there are indications of a head injury, cancer, HIV;
• treatment failure, which was usually effective.

The basis of the diagnosis of migraine is a thorough survey of the patient, assessment of the nature of headache and neurological examination data. There are diagnostic criteria for migraine:

• At least five (migraine with aura at least two) headaches similar course lasting from 4 hours to 3 days, other than:
  • one-sided;
  • pulsating character;
  • intensity, driving the patient to cease regular classes;
  • Depending on the physical load.
• For migraine with aura - its symptoms are completely reversible, developed consistently, lasted no more than hour, at least one of them is one-sided, on the background of the aura or headache occurs shortly after the pain.
• The presence of associated symptoms of nausea (vomiting), photophobia, intolerance to loud sounds.
• No signs of other diseases, too, accompanied by headache. These are numerous infectious, autoimmune, psychiatric, cancer, endocrine, cardiovascular and many other diseases. Headache - one of the most common symptoms, so its exclusion of other sources - the most important stage of diagnosis of migraine.

Migraine Treatment consists of:

• cupping of an attack;
• interictal treatment aimed at reducing the frequency of attacks and ease their severity.

For cupping prescribed:

• nonsteroidal antiinflammatory drugs (ibuprofen, diclofenac, lornoxicam (Ksefokam)), paracetamol, atsetilsalitsillovuyu acid (aspirin). Analgin is not recommended because of the high risk of side effects, especially in the blood;
• triptans: sumatriptan (Imigran, trimigren, Amigrenin), eletriptan. They change the state of the serotonin receptors involved in the formation of pain, and it allows you to stop an attack. Drugs in this group are effective even in patients with severe disease and resistance to painkillers. Some of them come in the form of candles or sprays, which ensures complete digestion even with repeated vomiting;
• controls motor activity of the digestive system to reduce nausea and vomiting stops: metoclopramide (Reglan).

These drugs are taken at the start of a migraine attack without aura or at the end of the aura, if it is.

Interictal treatment is necessary not for everyone. It is prescribed in cases of:

• frequent and prolonged attacks;
• of complicated migraine;
• chronic migraine.

The most frequently used:

• beta-blockers metoprolol, propranolol;
• angiotensin II receptor antagonists: candesartan;
• anticonvulsants (anticonvulsants): valproic acid, topiromat;
• antidepressants: amitriptyline.

The treatment is considered effective when 3 months frequency of attacks was reduced by half.

Drug-free treatment of migraine complementary receiving drugs. These include:

• psychotherapy;
• biofeedback - a method of treatment using hardware images, sounds, temperature effects reflecting the function of organs and systems, including the vascular tone. During the sessions, patients learn to manage pain through the relationship feelings and physiological reactions;
• manual therapy;
• massage of the head and neck area;
• acupuncture.