Migraine - Causes, symptoms and treatment. MF.

Migraine is an attack( paroxysm) of intense headache in the half of the head( hemicrania), more often in the orbital - frontal - temporal region, which is accompanied by nausea, and even vomiting, increased sensitivity to light and sound stimuli.

Migraine attack .

The prevalence of migraine is 5 - 25%.Young women are more often ill - the onset of the disease is up to 20 years, the peak is 25-35 years.

Migraine is a hereditary disease. If both parents suffer from migraine, the child's chance to get sick increases to 60 - 90%, if only mom - 70%, only the father - 20%.Thus, it is clear that the migraine is transmitted through the maternal line.

The mechanism of migraine development is complex, not fully understood. Provoking factors can be emotional and physical overload, eating disorders, alcohol( beer, red wine, champagne), smoking, sleep disturbances, changes in weather conditions, overheating in the sun, noise, strong smells, hormonal changes in the body of a woman, menstruation, hormonal contraceptive use. Eating foods rich in tyramine - chocolate, coffee, cocoa, cheese, nuts, smoked foods, citrus fruits, disrupt the metabolism of serotonin in the central nervous system, which is considered one of the factors in the development of a migraine attack. The leading role in the development of migraine paroxysm is played by activation of the trigeminal nerve nucleus. People with high social activity, with increased anxiety, with high ambitions suffer more often.

Migraine doubles the risk of Bell's paralysis( the most common form of paralysis of the facial nerve).Probably, these diseases have a common cause. Experts consider infections, inflammation and problems with the cardiovascular system as possible causes of migraine and Bell's paralysis.

Symptoms of migraine

The main symptoms of migraine: paroxysmal, pulsating, moderate intensity or severe pain in the half of the head, which lasts from 4 to 72 hours. This pain is aggravated by physical activity, the inclination of the head, accompanied by nausea, vomiting. Bright light, sharp sound, strong smell intensify the pain. I want to wrap my head around my hands and hide in a quiet, dark place. Patients often bandage their head with a towel, cover the sore side and eyes. If you have experienced such a condition at least 5 times - you have a migraine. Sometimes there is a bilateral migraine.

A migraine attack can be preceded by an aura( in about 20% of cases).Aura are neurological symptoms - visual, auditory, sensitive, motor, aphasic, vestibular, preceding an attack. The aura develops within 5 to 20 minutes and lasts no more than an hour. Often there is a visual aura - a person sees flashing of bright flashes( photopsy) in the right or left field of view, lightning, snake, falling out of the field of view or its fragments with distortion of objects.

Numbness of limbs( right, left, hand only) is possible. There is a hemiplegic aura, in which the right or left limbs do not move. The basilar form of migraine with an aura is characterized by noise in the ears, dizziness, paresthesias in the extremities, photopsy in binazal or in the bitemporal fields of vision, sometimes there are faints. With a vegetative form, there is panic, fear, palpitations, tremors, rapid breathing, weakness, polyuria.

All the symptoms of the aura are completely reversible.

Migraine status is a serious complication of migraine. This is a series of severe, with repeated vomiting, following one after one migraine attacks. Intervals between attacks are no more than 4 hours. This condition needs inpatient treatment.

Migraine examination

A recurring headache should necessarily lead you to a neurologist. The diagnosis is put clinically - a survey, an examination. But: migraine paroxysms may be the first symptoms of a brain tumor, vascular malformation. Therefore, a thorough neurological examination is necessary to exclude the organic process. I'll have to visit an ophthalmologist, check the fields of vision, visual acuity, the fundus, do electroencephalography, computer or magnetic resonance imaging, magnetic resonance imaging in angiography. Preparations for stopping the attack and preventive treatment will be prescribed to you by a neurologist.

Treatment of migraine

Medication for migraine headache

To stop a migraine attack, use:

- non-steroidal anti-inflammatory drugs - paracetamol, ibuprofen, diclobber, or in combination with caffeine, selagin, pentalgin, solpadine;

- preparations of dihydroergotamine( available in the form of nasal sprays);

- selective serotonin agonists - sumatriptan( antimigren), zolmitriptan( zolomigren, rapimig), naratriptan, rizatriptan, almotriptan. The drug should be taken at the beginning of the attack, rather than waiting for several hours in the hope that the attack can pass itself. In case of ineffective drug, repeated administration is possible after 2 hours.

Non-medicamentous treatment of migraine

During an attack, you need to rest in a quiet, warm, darkened room with a sufficient influx of fresh air. It is allowed to lightly massage the head and collar zone, massage the points of the auricle, acupuncture, warm or cold bandages on the head.

Migraine patients themselves already know the circumstances triggering a migraine attack. We must try to eliminate them as much as possible.

For preventive treatment and prevention of migraine attacks, use medicines and non-drug therapies in the complex. As non-drug methods, acupuncture, collar zone massage, darsonvalization of the head and collar zone, water procedures - pearl, coniferous baths, physiotherapy exercises with an emphasis on the cervical spine, diet are used.

Cognitive-behavioral therapy provides good results in treating migraine.

Prevention of migraine

Medication prophylaxis of migraine is prescribed taking into account provoking factors, emotional-personal characteristics, concomitant diseases. Used β-blockers( metoprolol, propranolol), calcium channel blockers( flunarizine), antidepressants, serotonin antagonists, anticonvulsants( topiramate).

Profimig - at a dosage of 1.5 mg in the evening or topiramate - 25 mg in the evening for a long time. These drugs are prescribed by a neurologist and are taken only with the established diagnosis of migraine.

Preventive treatment is prescribed if migraine headaches occur more than 2 times a month, if the seizures last more than 48 hours, if the seizures are very severe, with complications.

Treatment of migraines is not only medication therapy, but also a modification of the way of life. Normalization of sleep, nutrition, physical and emotional loads. Eliminate or at least reduce the consumption of cocoa, chocolate, alcohol, nicotine, spices. The intervals between meals should not be more than 5 hours, breakfast is mandatory. It is necessary to use products that are maximally useful, rich in vitamins, trace elements and energy - fresh vegetables and fruits, meat, fish, sour-milk products, eggs. Very useful water procedures - contrast shower, swimming, bath with sea salt.

It's easy to say: "do not worry", it's hard not to worry. But if possible try to avoid stressful conflict situations, less emotionally react to the circumstances, revise the circle of communication. Taking sedatives - valerian, persen, dormiplant will help relieve emotional tension. Effectively use free time and vacation period - tourist trips, outdoor activities with little physical exertion( for example, walking, swimming).

Consultation of a neurologist on migraine:

Question: Why do I have a drug against epilepsy for migraines?
Answer: anticonvulsants, in particular valproate and topiramate are used to prevent migraineous paroxysms. Topiramate reliably reduces the frequency of migraine attacks and is the first line drug for the prevention of migraine.

Question: Which points are massaged to relieve a migraine attack?
Answer: points located on the eyebrow, between the eyebrows, in the upper corner of the forehead at the border of the hair growth, from the center of the eyebrow up, the auricle, the fingertips, the point in the corner formed by the first and second metacarpals( point G4), over the ray head(P7), in the center of the shoulders, another magic point can be found by placing the brush on the bent knee, placing the middle finger on the tibia - then E36 will be located under the ring finger. You need to massage to strong pain. Possible easy massage of the collar zone.

Question: Do I need to take "dropper" courses every six months?
Answer: no. Migraine is prophylactically treated with a long( up to 4 - 6 months) intake of tablets - anticonvulsants.

Doctor neurologist Kobzeva S.V.

* Magnetic impulses can put an end to migraine attacks

Using a magnetic device in size and shape resembling a hair dryer, patients experiencing migraine with an aura will be able to forget about the pain, the researchers said.

After conducting a double-blind study, Dr. Mohammad and his colleagues showed high efficiency of the device. The device that generates magnetic impulses is used at the stage of origin of aura in patients, Dr. Mohammed said at the meeting of the American Headache Society meeting.

Dr. Mohammed said that the device is absolutely safe, the principle of its operation is simple: the device sends magnetic pulses in one Tesla to the occipital part of the head. In this case, the patient feels a slight pressure on the back of the head. Magnetic impulses interrupt the process of spreading the so-called depression of the cerebral cortex( cortical depression).Currently, this process is usually considered the cause of migraine with aura.

Similar devices are also used to help patients who are depressed.