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What is Migraine Headache? Definition, symptoms, causes, treatments, prevention, and complications

Migraine_Headache
Source: www.clinicalpainadvisor.com
Definition
Severe "pulsing" pain - a feeling of beating - is usually on one side of the head, often accompanied by nausea, vomiting, and severe sensitivity to light and sound.

Migraine often begins in childhood or adolescence.
Migraine usually lasts 4 to 72 hours if untreated.
Women are 3 times more likely to develop migraine than men.

Causes
It is not yet clear, and genetic and environmental factors are likely to play a role.
The imbalance of chemicals in the brain, especially serotonin, which helps to regulate pain in the nervous system, may play a role in the cause. Serotonin levels decrease during migraine attacks. This may push the trigeminal nerve to release substances called neurotransmitters To the meninges, resulting in migraine pain, and other neurotransmitters also play a role in migraine pain, including the peptide (calcitonin) associated with the gene.

Symptoms
Migraine attacks may develop in four stages: warning phase or Premonitory, Aura, headache and postdrome, but the patient may not suffer from all these stages.

Warning phase or Premonitory
Changes are observed before the start of Migraine warning of its arrival, including:

  • Constipation
  • Mood swings
  • Desire to eat
  • Neck stiffness
  • Increase thirst and urination
  • Repeating yawning

Aura
May occur before or during the migraine attack (some people may suffer Migraine attacks without Aura), neurological symptoms that begin gradually, increase over several minutes, and last for 20 to 60 minutes. These include:

  • Visual phenomena such as seeing various shapes, bright patches or light flashes
  • Loss of vision
  • Feeling needles and pins in the arm or leg
  • weakness or numbness in the face or on one side of the body
  • Difficult to speak
  • Hearing noise or music
  • convulsion or other uncontrollable movements

Headache

  • Pain on one side of the head - or on both sides - (like pulse or beat)
  • Sensitivity to light and noise, and sometimes sensitivity to smells and touch
  • nausea and vomiting
  • Blurred vision
  • dizziness(followed by syncope at times)

Postdrome
Follow the migraine attack, interspersed with mental confusion, mood swings, weakness, and dizziness.

Migraine triggers

  • Hormonal changes in women: Increased incidence of episodes immediately before or during menstruation (decreased estrogen level), during pregnancy, or in menopause
  • Foods: as additives to food and alcoholic beverages and rich in caffeine
  • Psychological and physical stress (including sexual activity)
  • Sensory stimuli: bright lights, high sounds, strong smells
  • Changes in the pattern of waking and sleeping
  • Environmental changes: weather changes and atmospheric pressure

Complications

  • Chronic migraine
  • A prolonged and debilitating Migraine attack
  • Continuous Aura without infarction
  • Prolonged migraine attack with infarction: Aura symptoms that last for more than one hour can indicate a loss of blood perfusion to an area of the brain (stroke)

Treatment
Drugs used to combat migraine attacks are located in two broad categories:

Pain relievers
These types of drugs, also known as acute or abortive treatments during migraine attacks, are designed to stop symptoms:

  • Pain-relieving medications: aspirin or ibuprofen or acetaminophen to relieve moderately severe Migraine attacks, Indomethacin suppositories may be helpful in relieving migraine if the patient is suffering from nausea (these drugs are not effective alone in the treatment of severe migraine attacks)
  • Triptans: to relieve pain and other symptoms through the contraction of blood vessels and block the pathways of pain in the brain, including Sumatriptan, Rizatriptan, and others .. (not recommended for people who suffer from the risk of stroke and heart attacks)
  • Ergot drugs: Dihydroergotamine, which is less effective than Triptans in general (but more effective in treating people who continue to have pain for more than 48 hours and are more effective when taken immediately after migraine attacks)
  • Anti-nausea medications: Chlorpromazine or Metoclopramide
  • Opioid drugs: Codeine (for the treatment of migraine pain in people who can not take drugs Triptans or Ergot)

Preventive drugs
These types of drugs are taken on a regular basis daily in most cases to reduce the severity or frequency of migraine attacks, including:

  • Cardiovascular drugs: beta blockers (propranolol, Metoprolol Tartrate, and Timolol), which have been shown to be effective in the prevention of migraine attacks in addition to calcium channel blockers (verapamil)
  • Tricyclic antidepressants: (especially Amitriptyline) reduce the frequency of migraine attacks by affecting the level of serotonin and other chemicals in the brain
  • Anticonvulsants (valproate and topiramate) reduce the frequency of migraine attacks
  • Onabotulinumtoxina (Botox): given by the doctor through injection into the muscle of the muscles of the front and neck - every 12 weeks - and has been proved useful in the treatment of chronic migraine attacks in adults
  • Erenumab-aooe (Aimovig): taken once a month by self-injection, a new class of drugs inhibiting the activity of a molecule that has a role in migraine attacks

Note 1: Migraine "accompanied by Aura" may be associated in some cases with Limb weakness.

Note 2: The US Food and Drug Administration has recently approved the use of a Cefaly device (External Trigeminal Nerve Stimulation device (e-TNS)), which is similar to a headband attached to an electrode to stimulate the Supraorbital nerve through the skin, as a preventive treatment of Migraine. Research has shown that migraine attacks have decreased in people who used the device.

Cefaly-dual-model-close
Source: www.cefaly.us

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