Migraine - causes, symptoms and treatment methods. Causes and symptoms of migraine attacks, prevention and effective treatments What is migraine

1. With migraine, the resulting headache is pulsating in nature, while with tension pain it is stable.
2. Migraine affects only one side of the head.

1. Migraine pain worsens when you turn or otherwise move your head.
2. During a migraine, the patient becomes sensitive to sharp sounds and bright lights. Sometimes nausea and vomiting occur.

Types of migraine

In medicine, it is customary to distinguish between the following types of diseases:

• Episodic, chronic or tension migraine. Headaches are episodic attacks. They can happen once a year or occur several times in 1 week. The chronic form of the disease begins in adolescence and presents with periodic attacks of headaches. Over time, the frequency of their occurrence increases. Pain can be considered chronic if it bothers the patient for at least 10-15 days during the month. Most often, discomfort is caused by frequent use of various painkillers, obesity and a passion for drinks with a high caffeine content. Patients with a chronic disease are characterized by a depressive state.
• Menstrual migraine. This condition directly depends on a woman’s menstrual cycle. Most often, pain occurs before menstruation or on the first day of its onset. Hormonal fluctuations play a major role in this. Triptans help prevent migraines in this case.
• Classic migraine. It can usually begin with the main artery, which is located at the base of the skull and usually affects young people. Additional symptoms include dizziness, loss of balance, ringing in the ears, and even loss of consciousness.

• Abdominal migraine. This type occurs in children whose relatives suffer from this disease. Other symptoms include nausea, vomiting, abdominal pain.
• Ophthalmoplegic migraine. It is a rare species and differs from others in the concentration of pain in the eye area. This may cause vomiting, blurred vision, or paralysis of the eye muscles. Such attacks can last up to several months. To rule out rupture of weakened blood vessels, your doctor may recommend a CT scan.

• Retinal migraine. This type may be accompanied by a headache or pass without it. The main symptoms include: short-term vision loss or complete blindness in one eye. The duration of the attack is at least 1 hour. However, no changes are observed in the other eye.

The mechanism of cervical migraine. It is also called vertebral artery syndrome

• Vestibular migraine. This type is accompanied by dizziness and can develop without headache.
• Familial hemiplegic migraine is a rare genetic disorder. The disease causes dizziness, blurred vision and temporary paralysis of one half of the body. Such symptoms appear 10-90 minutes before the development of a headache and usually disappear with its appearance.
• Migrainosus status (migraine status). It is a rare, dangerous type of disease and requires immediate hospitalization of the patient.

Causes

Heredity is considered to be the main factor causing the disease. In 30% of cases it is transmitted through the paternal line and in 72% through the maternal line. If both parents have seizures, the likelihood of them occurring in the child increases to 80%. A person experiences the first manifestations of the disease at the age of 18-40 years. But there are cases when seizures can occur in five-year-old children. Children under 12 years of age, regardless of gender, are equally susceptible to such headaches. Periodic attacks will continue until approximately 45 years of age in men and menopause in women. This is due to fluctuations in the hormones estrogen and progesterone.

The following factors can trigger the onset of an attack:

1. Decreased arteriolar reactivity.
2. Poor blood circulation in the brain due to narrowing of the lumen of the alveoli.
3. Malfunctions of the nervous system, especially its central part.
4. Uneven narrowing or expansion of blood vessels in the head.
5. Serotonin metabolism disorder.
6. Change in blood pressure.

Attacks can be triggered by mental or physical stress, lack of sleep, and stress. Bad habits play an important role in the occurrence of headaches. Often complaints arise during weather changes. With the onset of an attack, the patient is advised to limit the consumption of chocolate, fish, cheese and citrus fruits. In this case, the patient needs to pay attention to the amount of fluid he drinks, since dehydration can also lead to migraines.

Signs of illness

The main symptoms of migraine include:

• Before the onset of an attack, patients often note precursors, which include general weakness, a feeling of fatigue, pale skin and difficulty concentrating.
• Throbbing pain on one side. As a rule, it begins in the temple area and after some time covers the rest of the head. In some cases, the first manifestations of headaches are more pronounced in the occipital region.

• Sometimes it is possible to change the side of manifestation.
• Migraine attacks are accompanied by nausea and vomiting, sensitivity to light and sound.
• Pain increases during movement.

These symptoms will always accompany an exacerbation of the disease. But there are also signs that may appear in some patients:

1. Increased fatigue.
2. Paleness or redness of the skin.
3. Anxiety.
4. Depressive state.
5. Increased irritability.

The frequency and intensity of attacks varies from person to person.

Consequences of the disease

Why is migraine dangerous? In some cases, this condition can cause the appearance and development of other diseases and lead to complications.

• A catastrophic form is considered to be a migraine stroke, which is characterized by neurological symptoms. In this case, the attacks are accompanied by flickering in the eyes. Tomography helps determine the disease.
• Migrainous status. The disease can be suspected if the headache does not stop for more than 3 days in a row. At the same time, it can be very strong and practically non-stop. Migraine status is accompanied by vomiting, which leads to dehydration. Convulsions are possible.

In order not to lead to serious complications, we listen to the advice of neurologist Mikhail Moiseevich Shperling, who will talk about methods for diagnosing the disease and what to do during an attack:

• Risk of heart attack and stroke. Severe migraine headaches can lead to stroke and heart problems.
• Emotional disorders. Severe headaches have a negative impact on the patient's quality of life, including work productivity and family relationships. This is due to the relationship between migraines, depression and anxiety.

Whatever type of migraine is observed, it requires mandatory treatment, which consists of relieving pain and preventing its occurrence between attacks.

Treatment

A neurologist can tell you how to treat migraine attacks after a detailed examination and determine the causes of their occurrence. Treatment consists of using medications:

1. Non-steroidal painkillers, anti-inflammatory drugs (Ibuprofen, Paracetamol, Aspirin).
2. Combined products containing codeine, metamizole sodium and phenobarbital.

1. For intense and prolonged attacks, triptans are indicated. Such drugs reduce the level of serotonin, which affects the development of headaches. Their advantages include: high efficiency in stopping an attack, the absence of a sedative effect and rapid removal from the body.
2. Non-selective agonists such as Ergotamine. Such drugs relieve tension in smooth muscles. Side effects include: negative effects on the condition of blood vessels, toxicity, the possibility of scarring around the heart and lungs. They are contraindicated for use by pregnant, elderly patients and those who have problems with internal organs.
3. Psychotropic drugs as adjuvant therapy. These include Morphine, Demerol, OxyContin. Side effects that can result from their use include: drowsiness, loss of consciousness, constipation.

1. Anti-nausea medications. In combination with other medications, Reglan and other drugs are prescribed to improve the absorption of migraine medications.
2. Beta blockers. Their main purpose is to lower blood pressure. Some of these drugs have proven effective for headaches: Anaprilin, Lopressor, Tenormin, etc. Side effects of such drugs include: feeling tired, depression, dizziness.

1. Anticonvulsants. They are able to prevent bipolar disorders and epileptic seizures. These include: Valproic acid, Topamax. Side effects from such medications may include: diarrhea, hair loss, drowsiness, weight gain, dizziness, tingling in the extremities, blurred vision.
2. Antidepressants - Tricyclix, Effexor.

Only a doctor can determine which medications to use.

Prevention and non-drug treatment

Almost any disease can be prevented by using prevention methods. How to prevent migraines and what to do if a headache has already begun? Organize a healthy diet, start getting enough sleep, exercise and pay attention to non-drug methods:

• Behavioral therapy can address muscle contractions and uneven blood flow to the brain. Such prevention is especially useful for children, pregnant women and those for whom medications used to treat the disease are contraindicated.
• Full sleep. People who often don't get enough sleep experience debilitating headaches, including migraines.
• Adequate nutrition and restriction of certain foods. The occurrence of headaches is influenced by frequent consumption of: monosodium glutamate, sulfites, cheeses, caffeine, dried fruits, smoked meats, chocolate and alcohol. It is also important not to allow a long break between meals. This causes low blood sugar levels and can lead to dizziness and migraines.

• Relaxation. This method includes relaxation techniques and deep breathing. It has been noted that such techniques, in combination with a cold compress on the head, relieve headache attacks.
• Cognitive behavioral therapy allows you to identify and cope with a stressful situation.
• Alternative and traditional medicine.

There are herbal preparations and nutritional supplements that are also considered methods of preventing and relieving headaches. These include:

1. Magnesium and vitamin B2. These substances relax blood vessels and are safe for most patients.
2. Fish fat. The fatty acids it contains have anti-inflammatory and soothing effects. They are found in large quantities in fatty varieties of sea fish - salmon, sardines, etc.
3. Ginger. It can be used fresh or dry. Ginger is added to tea and various dishes. However, it may not be safe for children or pregnant women, so you should consult your doctor before using it.

It is impossible to completely cure migraine, but with the right approach to disease prevention and inter-attack therapy, you can successfully avoid its development and prevent further complications.

When a person is bothered by an intense headache in one part of the head, he asks the question: what is migraine, what are the symptoms, how to treat?

It is a neurological disease that affects about 15% of people. It is twice as common in women of working age (compared to men).

Cases of migraine are not always registered; many people do not seek medical help but treat themselves.

Migraine is a chronic disease; attacks do not have a specific frequency: for some they occur twice a week, for others - several times a year. The mechanism of development of the disease remains completely unknown; it is associated with disorders in the central nervous system.

Under the influence of external stimuli, biochemical and neurological reactions occur that affect the pressure in the blood vessels of the brain.

The disease can be provoked by:

• psycho-emotional overexcitation, stress;
• sudden change in climate or weather conditions;
• hormonal disbalance;
• overwork (nervous or physical);
• cerebrovascular accident;
• premenstrual syndrome;
• insufficient or prolonged sleep;
• alcohol consumption;
• inclusion in the diet of foods high in tyramine (smoked meats, chocolate, cheese, nuts);
• sharp sound, smell;
• disturbances in the activity of the central nervous system.

People who have been bothered by migraines for a long time take measures to eliminate factors that are relevant. The development of the disease is characterized by a hereditary predisposition (the pathology is transmitted through the female line).

The risk of developing the disease is higher:

• residents of large cities (they are more likely to be stressed);
• in children whose parents suffer from migraines;
• for ambitious individuals;
• in emotionally unstable people (prone to depression);
• in patients using hormonal drugs (especially those with high estrogen levels).

It has been noted that headaches are more common among people engaged primarily in mental work; migraine is called the “disease of aristocrats.”

Did you know that certain foods can trigger a migraine attack? In this topic, you will learn which foods are best to avoid if you have headache attacks.

Symptoms

Headache is just one symptom of a migraine. They differ depending on the form of the disease.

Migraine without aura - about 80% of cases are characterized by this form. Sometimes some patients may experience 2 types of attacks of the disease (alternating).

Migraine with aura

It comes in 2 options:

• normal aura (duration 5 - 60 minutes);
• long-lasting aura (from 60 minutes to several days).

Aura is a complex of neurological disorders that appear before the onset of an attack or simultaneously with it.

There are several types of it:

• Visual (accompanied by the appearance of a tiny dot, gradually enlarging, taking the form of bizarre flickering lines in the direction from the center to the edges. Patients sometimes note a feeling of loss of vision, double vision, the appearance of lines around objects, a change in the shape of objects).
• Paresthetic (manifests itself in a change in sensitivity, a feeling of numbness on one side of the body with a transition to the upper limb).
• Hemiparetic (accompanied by changes in movements: weakness in the limbs on one side, possible development of short-term paresis).
• Dysphasia (speech impairment, feeling of loss of ability to remember words, difficulty finding words).

A migraine attack is characterized by a change in one phase and the onset of another:

• Initial (accompanied by unclear symptoms that occur before the attack: thirst, fluctuations in appetite, feeling tired, drowsiness, anxiety or depression, irritability).
• Aura (replaces the initial phase, the appearance of headache is noted with the development of the aura or after it).
• Direct migraine (can last for several hours or several days, accompanied by pain on the side opposite the aura, localized in the occipital, frontal, and temporal regions. As the intensity of the pain increases, alternating sides is possible, increased pain is observed with movement).
• Resolution phase (the attack ends on its own or is stopped by taking medications).
• Recovery phase (increased urination is observed, appetite increases).

A migraine attack without aura occurs in a similar way, but there is no aura phase. When prescribing treatment, the form of migraine is important:

This migraine course is observed in typical cases. If a vegetative crisis develops, the heartbeat and urination become more frequent, there is a feeling of lack of air, surges in blood pressure, and anxiety.

Not every recurring headache is a migraine. There are clearly defined criteria for diagnosing this disease.

Migraine treatment

First of all, treatment is aimed at eliminating the migraine attack and preventing it.

This allows patients to control their migraines and live a full life. When prescribing treatment, they take into account how much the pain affects the patient’s life:

• performance, training;
• doing household chores, family life;
• social life, sports.

According to the MIDAS scale, attacks are divided into 4 degrees.

1. I degree is accompanied by a mild headache that does not interfere with normal life. Not all patients come to see a doctor. In this case, NSAIDs (Ibuprofen, Indomethacin, Naproxen), Analgin are used.
2. II degree is characterized by moderate to severe headache, slightly limiting normal life. NSAIDs or Solpadeine, Pentalgin, Tetralgin, Codeine are prescribed. For severe headaches, triptans are prescribed (Zomig, Naramig, Imigran, Sumamigren, Amigrenin).
3. III degree is accompanied by severe headache, restrictions in life are moderate.
4. IV degree characterized by pronounced restrictions in everyday life.

In the third and fourth degrees, triptans are immediately prescribed. Sometimes - Zaldiar, containing a powerful pain reliever Tramadol and Paracetamol (which has a weak analgesic and antipyretic effect). In more complex cases, hormonal drugs (Dexamethasone) are needed.

To eliminate nausea and vomiting, use Chlorpromazine, Domperidone, Metoclopramide. They should be taken 20 minutes before. before taking NSAIDs or triptans.

Triptan drugs are designed specifically to relieve migraine pain. They have a pronounced effect when taken in the right dosage at the beginning of an attack:

• when you feel an attack is approaching, take 1 tablet, if the pain goes away after 2 hours, the patient continues his normal life;
• if the pain intensity has decreased within 2 hours but has not gone away, take an additional 1 tablet. The next time you have an attack, you need to take 2 tablets.

A medicine that is taken on time and does not produce results needs to be replaced. Means have appeared in a convenient form that relieve a migraine attack: Dihydroergotamine and Sumatriptan in spray form.

Medicines work best at the very beginning of an attack. Patients need to carry the product with them and apply it when the first signs appear.

Most often, migraines do not cause complications, but in some cases complications can occur. and how to prevent the adverse consequences of the disease, read on our website.

Read about ways to relieve pain from migraines and headaches.

Video on the topic

This is the primary episodic form of headache, manifested by intense, paroxysmal headaches (usually unilateral) with a combination of neurological, autonomic and gastrointestinal manifestations. It usually first appears between the ages of 12 and 22. It ranks second in frequency after tension headache. Often, a migraine attack occurs after some aura and ends with a feeling of general weakness and weakness. When diagnosing migraine, it is necessary to exclude organic pathology of the brain and understand the possible causes of migraine. Treatment consists of drugs to relieve the existing attack and prevent the occurrence of a new migraine episode.

ICD-10

G43

General information

The primary episodic form of headache, manifested by intense, paroxysmal headaches (usually unilateral) with a combination of neurological, autonomic and gastrointestinal manifestations. It usually first appears between the ages of 12 and 22. It ranks second in frequency after tension headache.

Etiology and pathogenesis

Previously, migraine was considered as a vascular pathology, since during a migraine attack, dilation of the vessels of the dura mater occurs, the innervation of which involves trigeminovascular fibers. However, pain during a migraine attack is secondary; it occurs as a result of the release of pain neuropeptides-vasodilators from the endings of trigeminovascular fibers, the most important of which are neurokinin A and peptide.

Thus, a migraine attack occurs due to activation of the trigeminovascular system. This activation occurs in patients with hypersensitization of trigeminovascular fibers and increased excitability of the cerebral cortex. The “provocateurs” of a migraine attack are most often emotional stress (a migraine attack occurs immediately after a stressful situation), menstruation, physical stress, hunger, as well as some foods containing phenylethylamine and tyramine (citrus fruits, chocolate, champagne, red wine).

Clinical picture

Migraines are characterized by pressing, throbbing headaches that occupy half of the head and are localized in the forehead/temple/eye area. In some cases, migraine pain occurs in the occipital region and then moves to one half of the head. From time to time, the location of the headache may change from one half of the head to the other. Moreover, persistent (or recurrent) unilateral headaches are not characteristic of migraine, but are considered an absolute indication for examination in order to exclude organic brain damage.

In some cases, a prodrome (precursors of a migraine attack) is observed, manifested by weakness, decreased concentration, and a postdrome (the state immediately after a migraine attack) in the form of general weakness, pallor and yawning. A migraine attack is usually accompanied by nausea, photo- and phonophobia, and loss of appetite. The headache gets worse when climbing stairs and walking. In childhood, a migraine attack is accompanied by drowsiness, and after sleep the pain usually goes away. Migraine is closely related to the female genital organs, therefore in 35% of cases a migraine attack is provoked by menstruation, and the so-called. menstrual migraine (a migraine attack occurs within two days from the start of menstruation) - in 8-10%. Taking hormonal contraceptives and hormone replacement therapy aggravates migraine in 70-80% of cases.

There are several clinical types of migraine:

• vegetative or panic migraine - the attack is accompanied by vegetative symptoms (chills, increased heart rate, lacrimation, feeling of suffocation, swelling of the face);
• migraine with aura - before an attack, transient, visual, speech, sensory, and motor disturbances appear; its variety is basilar migraine;
• associative migraine - headache paroxysm is accompanied by transient neurological deficit; its varieties are aphasic, cerebellar, hemiplegic and ophthalmoplegic migraine.
• sleep migraine - an attack occurs during sleep or in the morning upon awakening;
• catamenal (menstrual) migraine is a type of migraine associated with the menstrual cycle. It has been proven that the attack of such a migraine is caused by a decrease in estrogen levels in the late luteal phase of the normal menstrual cycle;
• chronic migraine - attacks occur more often than 15 days/month for three months or longer. The number of attacks increases every year until the appearance of daily headaches. The intensity of headaches in chronic migraine increases with each attack.

Diagnostics

As with other primary cephalgia, the basis for diagnosing migraine is the patient’s complaints and medical history. In most cases, there is no need for additional research methods (EEG, rheoencephalography, MRI of the brain). The manifestation of neurological symptoms was noted in only 2-3% of patients. However, in most cases, there is tension and soreness in one or more pericranial muscles, which becomes a constant source of discomfort and even pain in the neck and occipital region.

Migraine must be differentiated from episodic tension pain, for which, unlike migraine, bilateral, exercise-independent, less intense headaches of a pressing (squeezing) nature are typical.

Migraine treatment

Migraine therapy can be divided into two stages: relief of the developed attack and further preventive treatment to prevent new migraine attacks.

Stopping an attack. The neurologist's prescription of certain medications to relieve a migraine attack depends on its intensity. Attacks of weak or moderate intensity lasting less than two days are stopped with the help of simple or combined analgesics: ibuprofen (0.2-0.4 g), paracetamol (0.5 g), acetylsalicylic acid (0.5-1 g); as well as codeine-containing drugs (a combination of codeine, paracetamol, metamizole sodium and phenobarbital). For severe migraines (high intensity headaches, attacks lasting more than two days), specific therapy drugs are used - triptans (agonists of serotonin receptors of the 5HT type); for example, zolmitriptan, sumatriptan, eletriptan, as well as other forms of triptans (suppositories, solution for subcutaneous injection, nasal spray).

The prognosis for migraine is generally favorable, except for those rare cases when dangerous complications may develop (status migraine, migraine stroke).

Migraine prevention

To prevent chronicity of the disease and improve the quality of life, preventive treatment of migraine is carried out, the goals of which are: reducing the duration, frequency and severity of attacks; reducing the impact of migraine on the patient’s daily life.

The components of preventive treatment for migraine are selected individually for each patient, taking into account the pathogenetic mechanisms of the disease, provoking factors and emotional and personal disorders. The most widely used are beta-blockers (metoprolol, propranolol), antidepressants (amitriptyline, citalopram), calcium channel blockers (nimodipine), and NSAIDs (naproxen, acetylsalicylic acid). In modern medicine, non-drug methods (progressive muscle relaxation, psychotherapy, acupuncture) are increasingly used to prevent migraines.

Migraine is a chronic neurological disease characterized by recurrent severe headaches. A distinctive feature is that most often the pain spreads only to 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 fair half of humanity often suffers from attacks of severe headaches. But many men also face this problem. Another name for migraine is the disease of aristocrats. It is believed that headaches occur more often in people who engage in mental work.

What it is?

Migraine is a neurological disease, the most common and characteristic symptom of which is episodic or regular severe and painful attacks of headache in one (rarely in both) half of the head.

In this case, there are no serious head injuries, stroke, or brain tumors, and the intensity and pulsating nature of the 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 migraines were described by ancient healers from the time of the Sumerian civilization even before the birth of Christ in 3000 BC. A little later (around 400 AD), Hippocrates identified migraine as a disease and described its symptoms. However, migraine owes its name to the ancient Roman physician Claudius Galen. In addition, he was the first to identify a feature of migraine - the localization of pain in one half of the head.

It is noteworthy that migraines often become the companion of geniuses. This disease, like no other, “loves” active and emotional people who give preference to mental work. For example, such outstanding personalities as Pontius Pilate, Pyotr Tchaikovsky, Edgar Allan Poe, Karl Marx, Anton Pavlovich Chekhov, Julius Caesar, Sigmund Freud, Darwin, Newton suffered from it. Modern celebrities have not escaped migraines either. Suffering from headache attacks, such famous personalities as Whoopi Goldberg, Janet Jackson, Ben Affleck and others live and work.

Another interesting fact (though it has not been scientifically proven): migraines are more likely to affect people who strive for perfection. Such individuals are ambitious and ambitious, their brains are constantly working. It’s not enough for them to do everything perfectly, they have to be the best. Therefore, they are very responsible and conscientious about everything, they work “for themselves and for that guy.” Essentially, they are workaholics.

The mechanism of development of migraine headaches

As you know, migraine is a special type of headache, the mechanism of development of which is unique and unlike any other. Therefore, most headache medications are ineffective for migraines.

A migraine attack occurs in several successive phases:

1. Spasm of the arterial vessels of the brain and the development of short-term hypoxia of the brain. It is with this phase that the development of migraine aura is associated.
2. Then comes dilatation, or expansion, of all types of brain vessels (arteries, veins, venules, arterioles and capillaries). At this stage, a typical throbbing headache develops.
3. Swelling of the walls of blood vessels and the perivascular space develops, which makes them rigid to signals for reverse narrowing. This phenomenon determines the duration of migraine headaches.
4. The last stage is characterized by the reverse development of migraine and is also called post-migraine syndrome. For some time after the pain stops, 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 headaches, new information appears every day, as this problem is actively studied by scientists around the world. For example, according to recent 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 is the causes of migraines. Based on many years of observations, it was possible to establish some patterns of the occurrence of attacks.

Migraines affect both men and women, but they occur twice as often in women as in men. There is a dependence of the incidence of the disease on lifestyle, so it has been established that people who are most susceptible to migraines are socially active and ambitious people, people in professions that require high mental activity, as well as housewives. Cases of migraine are extremely rare among people in working professions whose activities involve constant physical activity.

People suffering from it attribute many factors to the causes of migraine, but in fact, their direct influence on the development of the attack could not be established, so such factors can only be considered predisposing, or a “trigger moment” that is triggered when the true cause of the disease appears. Causes of migraine include:

• Some types of products: hard aged cheeses, red wine, chocolate, fish of the mackerel family, smoked meats, coffee;
• Stress or experienced psycho-emotional arousal.;
• Certain types of medications, such as oral contraceptives;
• Sudden changes in weather (weather-dependent form of migraine);
• Strong physical activity;
• Premenstrual syndrome.

Typically, experienced patients know what exactly provokes a migraine attack in them, and they try to exclude the influence of this factor, thus they manage to reduce the frequency of attacks, but not get rid of them completely.

Classification

Depending on the symptoms of migraine, the disease is divided into the following types:

• hemiplegic (the ability to perform an action with a hand or foot is lost);
• migraine status (lasts more than one day).
• retinal (affects half of the head and the eye area, a sharp decrease in vision is possible);
• basilar (occurs in young women, fraught with cerebral infarction in the absence of adequate treatment);
• ophthalmological (affects the visual organs, drooping of the eyelid occurs, loss of visual function);
• abdominal (often found in children and young men, accompanied by cramps and abdominal pain);

In medical practice, there are also concepts of migraine with and without aura.

Without an aura, the patient experiences frequent headache attacks that can last from four hours to three days in a row. Pain sensations are fixed in a specific part of the head (at a point). The pain intensifies with physical activity, as well as intense mental activity.

Aura is accompanied by a large number of complex, sometimes mixed symptoms that occur long before the attack or immediately with its onset.

Migraine symptoms

The most basic symptoms of migraine in women and men are throbbing, paroxysmal pain in half the head, lasting from 4 to 72 hours. When bending over, the pain intensifies - this is due to excessive expansion of the blood vessels.

A migraine attack may be preceded by an aura - various neurological symptoms: vestibular, motor, sensory, auditory, visual. Visual aura occurs more often than others when a person sees many bright flashes in the left or right field of vision, fragments of the visual field fall out or objects are distorted.

So, the main signs of migraine are as follows:

1. Precursors of migraine are weakness, a feeling of unmotivated fatigue, inability to concentrate, and attention problems. After attacks, a postdrome is sometimes observed - drowsiness, weakness, pallor of the skin.
2. Nausea is an important symptom that helps differentiate migraine pain from other types of pain. This symptom always accompanies attacks and is sometimes so severe that it leads to vomiting. At the same time, the patient’s condition is subjectively alleviated; he feels better for a few minutes. If vomiting does not bring relief, and the pain does not subside within several days, then this may be a sign of migraine status and requires hospital treatment.
3. The nature of pain during migraine differs from other headaches - starting from the temple, throbbing and pressing pain gradually covers half of the head, spreading to the forehead and eyes.
4. In 10% of cases of migraine in women, it occurs during menstruation and lasts a day or two from its onset. Menstrual migraine affects one third of all women who have this disease.
5. With migraine, there is always one or more accompanying symptoms - photophobia, nausea, vomiting, fear of sound, disturbances in smell, vision or attention.
6. Oral contraceptives and other drugs that affect hormonal balance, including hormone replacement therapy, can significantly increase the risk of an attack, in 80% of cases increasing its intensity.
7. The arteries in the temple area are tense and pulsating, pain and tension increase with movement, so patients endure the principle in bed, in a quiet and dark room, to minimize the amount of external irritants.
8. Irritability, anxiety, fatigue, drowsiness, pale or red skin, anxiety and depression are symptoms associated with migraine that may or may not appear in each individual case.
9. One-sided pain can alternate from attack to attack, covering either the left or right side of the head or the occipital region.

According to medical research, women are more likely to suffer from migraines, experiencing an average of 7 attacks per month versus 6 attacks in men, and the duration of attacks is 7.5 hours in women and 6.5 hours in men. The causes of an attack in women are changes in atmospheric pressure, air temperature and other climate changes, and in men - intense physical activity. The symptoms accompanying migraines also differ: women are more likely to experience nausea and impaired sense of smell, and men are more likely to experience photophobia and depression.

How to relieve pain at home?

With minor manifestations of migraine, pain from an attack can be relieved without medication, for which you need to:

• allowing yourself to “sleep”;
• cold and hot shower;
• facial gymnastics;
• washing head;
• head and neck massage;
• acupuncture;
• yoga classes;
• homeopathy.

The simplest home remedy for migraine relief is over-the-counter analgesic tablets containing Ibuprofen, Nurofen, Aspirin, Paracetamol (the latter is the least effective), acting faster and stronger in the form of “effervescent” forms.

To reduce the symptoms 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 effect.

How to treat migraine?

At home, migraine treatment involves 2 main directions - stopping an attack that has already developed, and preventing the occurrence of attacks in the future.

Stopping an attack. Only a neurologist can prescribe any pain relief during a migraine attack; it depends on the intensity and duration. If the attack is of moderate or mild severity and lasts no more than 2 days, then the doctor prescribes simple analgesics, possibly combined.

1. Combination drugs containing codeine, paracetamol, phenobarbetal and metamizole sodium.
2. NSAIDs (ibuprofen), paracetamol (contraindicated in kidney and liver pathologies), acetylsalicylic acid (cannot be taken if you are prone to bleeding or have gastrointestinal diseases).
3. If the intensity of the pain is high, the duration of attacks is more than 2 days, then Triptans for migraine are prescribed (list of all modern triptans, prices, how to take them correctly). They are available in suppositories, solutions, sprays, and infections.
4. Non-selective agonists - Ergotamine, etc.
5. Auxiliary psychotropic drugs - domperidone, metoclopramide, chlorpromazine.

Triptans are drugs developed 20 years ago and are derivatives of serotonin. They act in several directions at once:

1. Triptans act selectively on blood vessels, reducing painful pulsation only in the brain, without affecting the rest of the body's vascular system.
2. They act only on special producing substances (receptors) that provoke the appearance of pain, their number is reduced and the pain goes away.
3. They have a pronounced analgesic effect, reducing the sensitivity of the trigeminal nerve.

For the classic version of migraine with aura, Papazol taken in the first minutes can help. For some, a hot bath helps, for others, exposure to cold, for others, a pressure chamber alleviates the condition.

Experimental treatments for migraine

Experimental methods include treatment using hypnosis, electronic devices, and a special adhesive plaster. However, there is no evidence of their effectiveness and more research is needed.

Due to the disruption of cellular metabolism and activation of lipid peroxidation that occurs in the pathogenesis of migraine, along with conventional drug treatment, the prescription of antioxidants and metabolic drugs that improve energy processes in cells and protect them from damage by free radicals (a combination of vitamins A, E, C, coenzyme Q10, antioxycaps, emoxypin).

For example, a study was recently published that involved 1,550 children and adolescents suffering from frequent migraine attacks. It showed that a number of patients had low plasma levels of coenzyme Q10, and that the recommendation of dietary supplements containing coenzyme Q10 may lead to an improvement in some clinical signs. The authors concluded that to confirm such observations, analyzes with more scientifically sound methodology are required.

In another study of 42 patients, the authors compared the effectiveness of CoQ10 (300 mg/day) and placebo: CoQ10 was significantly more effective than placebo in reducing the frequency of migraine attacks, the duration of headache attacks, and the duration of nausea attacks after 3 months of treatment. The authors evaluate CoQ10 as an effective and well-tolerated means of preventing migraine manifestations.

A team of plastic surgeons at University Hospitals of Cleveland has been working for about a decade on the hypothesis that in some cases, the cause of recurrent headaches and migraines is irritation of the trigeminal nerve caused by spasm of the muscles around it. Studies have been published confirming that headaches are reduced or eliminated by Botox injections and surgical removal of the associated muscles.

Alternative Migraine Treatments

Other ways to treat this disease:

1. Biofeedback. This is a special type of relaxation using special equipment. During the procedure, a person learns to control physiological responses to various influences, for example, stress.
2. Acupuncture. Studies have shown that this procedure helps cope with headaches of various origins, including migraine. But acupuncture is effective and safe only if it is performed by a certified specialist using special sterile needles.
3. Cognitive behavioral therapy. Helps some people with migraines.
4. Massage. An effective preventive measure that helps make migraine attacks less frequent.
5. Herbs, vitamins, minerals, dietary supplements. Such remedies as butterbur herb, feverfew, high doses of riboflavin (vitamin B2), coenzyme Q10, and magnesium help prevent and make migraine attacks less frequent. But before using them, you should definitely consult your doctor.

Preventing migraine attacks

1. Follow your diet and nutrition regimen, do not rush during meals and do not snack on the go.
2. Practice sleep hygiene, the duration of which should be 7-8 hours, where the daytime “quiet hour” should be completely abolished. You need to go to bed in a calm, non-irritable state at the same time (but not too early); it would also be good to get up at the same time.
3. Reduce stressful situations to a minimum, always have harmless means of dealing with them at hand (valerian tablets, etc.), and also do not forget that in other cases it is advisable to seek the help of a psychotherapist who will help you learn to control your behavior.
4. Do not get carried away with alcohol, nicotine and coffee, but if you can afford no more than two cups of your favorite coffee drink a day (in the first half of the day), then you should avoid alcohol and tobacco products altogether.
5. Under no circumstances should you ignore the use of preventive anti-migraine medications prescribed by your doctor. They should also always be at hand.
6. It is a good idea to periodically undergo sanatorium-resort treatment or treatment at a local dispensary, where you can receive non-drug preventive measures (physiotherapy, neck massage, acupuncture).

We must agree that fighting migraines is difficult, but possible. Usually disciplined patients know everything about their illness and in most cases cope, although, of course, you cannot envy them; you need to be on guard all the time. “The one who walks will master the road!” - said the ancients.

Forecast

With competent and comprehensive therapy, the prognosis for this disease is encouraging. The presence of the disease can be evidence of the development of serious ailments, including cancer, abscess, inflammation of the brain, encephalitis, vascular aneurysms, hydrocephalus, etc.

The risk group of people who may experience migraines includes residents of large cities who lead a dynamic lifestyle and neglect rest, girls and women over the age of 20 (especially during menstruation), as well as people with a genetic predisposition to migraines.

For correct diagnosis and optimal treatment, you need to seek help from a neurologist. Only an experienced doctor will be able to distinguish the signs of migraine from other syndromes with similar symptoms, and also recommend step-by-step, effective therapy.

Migraine is a chronic neurological disease that is accompanied by headaches and disturbances in the digestive and nervous systems. As a rule, migraine attacks vary in frequency.

Headache is considered a characteristic symptom of this neurological disease. Other associated symptoms include nausea, vomiting, sound and photophobia. So, people who are often bothered by such symptoms know what migraine is.

Headaches most often develop in women (they account for 18%). Men make such complaints less often (6%).

It is believed that migraines, the symptoms of which can be observed in adolescents and children, mainly appear by the age of 35. According to statistics, only 5% of older people suffer from such attacks.

Migraine is a hereditary disease. Thus, the presence of migraine attacks in both parents increases the likelihood of developing such attacks in a child by 60-90%; if the baby’s mother suffers from the pathology – 70%, and manifestations in the father increase the risk of morbidity by 20%. Thus, we can conclude that the disease is transmitted through the maternal line.

Clinical picture

Symptoms of a neurological pathology such as migraine include the following:

Some cases of migraine attacks are accompanied by gastrostasis, which is explained by stagnation of stomach contents due to decreased peristalsis. Such facts cause the fact that drugs taken during an attack cannot reach the small intestine, and therefore are practically not absorbed into the body.

With migraine, headaches are often unilateral (although they can spread to both sides), and are often localized in the upper jaw and eye area. Moreover, the unpleasant sensations are pulsating in nature and can intensify with the slightest irritation, be it odors, light effects or noise.

The main symptoms of a neurological disease are nausea and vomiting, which cannot bring relief. In addition, some cases may be accompanied by numbness, weakness and paresthesia of the limbs, as well as speech impairment. These signs precede a headache and form the so-called aura, which heralds the onset of a migraine attack.

Several tens of minutes or 2-3 hours - this is the duration of a standard seizure. In this case, a condition that lasts 2-3 days is called status migraine.

Migraine and its types

The classification identifies the following types of this neurological disease:

• classic migraine, accompanied by an aura that occurs 10-30 minutes before the attack);
• a seizure without an aura, which is called a common migraine.

Typically, changes in the sensory aura as well as neurological status occur shortly before the attack.

Other types of the disease include the following:

1. which is episodic and chronic. In this case, headaches appear from time to time with varying frequency (once a year or several times a week). Some patients may experience current or chronic migraines (previously called transformed). Typically, the manifestation of such an illness at the age of 20 or in adolescence begins with episodic headaches, which become more frequent over time. Cephalgia that occurs almost daily is called chronic.
   
   The sale of painkillers without a prescription sometimes leads to the abuse of analgesics and, as a result, to persistent migraines. Additional factors (for example, being overweight or consuming large amounts of caffeine) can also increase the likelihood of episodic attacks becoming chronic. Sometimes it is quite difficult to make a differential diagnosis between a chronic form of migraine and intense pain in the head. After all, such variants of unpleasant sensations can be combined with each other. In such cases, discomfort in one half of the head is accompanied by disturbances in the functioning of the gastrointestinal tract in the form of nausea and vomiting, characteristic of the chronic form of the disease. Most patients suffering from constant seizures are prone to depression.
2. Menstrual migraine. Most women experience migraine attacks on the eve of menstruation or in the first days. Quantitative fluctuations in progesterone and estrogen are of no small importance. If we compare this type of migraine with the standard one, it can be noted that the menstrual type of pathology is much longer, is not accompanied by an aura and occurs in a more severe form. Timely use of triptans can bring relief and sometimes prevent this type of pain.
3. Classic migraine. It is a subtype of neurological disease with aura. First, unpleasant sensations arise in the back of the head, then spread to other areas of the head. The classic type of pathology mainly affects young people. Symptoms may include speech impairment, tinnitus, ataxia, dizziness, loss of consciousness and severe cephalalgia.
4. Often, this type of illness affects children who have a family history of a similar neurological disease. Paroxysmal headaches are accompanied by discomfort in the abdominal area, nausea and vomiting.
5. Ocular migraine. This variant of migraine cephalalgia can be accompanied by short-term blind spots or complete loss of vision in one eye for an hour or less. In addition, this condition is accompanied by headache, which may precede the above-mentioned symptoms. However, some cases resolve without cephalalgia.
6. Ophthalmoplegic migraine. Adults often suffer from this type of illness. Attacks are characterized by pain in the periorbital region of less intensity compared to standard migraine. In parallel with this symptom, double vision, paralysis of the eye muscles, and vomiting may occur. The duration of attacks ranges from several hours to 2-3 months. For differential diagnosis, CT (computed tomography) or MRI (magnetic resonance imaging) is used, during which the presence of hemorrhage from the aneurysm into the brain is excluded.
7. This is a disease that is characterized by periodic dizziness, occurring as the only symptom or in combination with headaches and symptoms inherent in migraines.
   
8. Migrainosus status. This form has a rather serious prognosis and a long course. The optimal treatment option is a hospital.
9. Familial hemiplegic migraine. This type of disease is considered a rare hereditary disease. It is characterized by the appearance of episodic paralysis of one half of the body, blurred vision and dizziness. The appearance of such signs appears 10-90 minutes before the development of cephalgia.

Symptoms

A standard migraine attack consists of four phases: prodrome, aura, seizure itself and postdrome.

Prodromal signs

The first stage is characterized by vague symptoms that precede the attack by several days or hours. Among them the following are noted:

Aura Signs

Only one patient out of five notes the appearance of a sensory aura preceding a migraine attack. Visually it is divided into positive And negative:

In addition, during a migraine attack, mixed auras can be observed, which patients describe as an acute-angled fortress with a rather dark center.

A seizure may be accompanied by the simultaneous development of other neurological manifestations, expressed as:

• speech disorders;
• perception disorders, namely distortions of size and space;
• paresthesia of the limbs;
• confusion.

Clinical manifestations of a migraine attack

Without treatment, this condition can last for 4-72 hours.

A classic seizure occursthe following signs:

• nausea, vomiting;
• unilateral cephalalgia of a pulsating nature, which can spread to the entire head;
• visual disturbances and various hallucinations;
• paleness and feeling of coldness;
• facial tingling or numbness;
• increased sensitivity to sound and light effects.

Rare symptoms of migraine include redness of one eye, swelling of the eyelids and rhinitis.

Postdromal signs

As a rule, a migraine attack ends with the postdrome phase. Often during this period there is a clouded consciousness.

You should think about the seriousness of the disease when certain symptoms occur. At the same time, the absence of neurological manifestations during headache is not a characteristic sign of a space-occupying process in the main organ of the central nervous system. In addition, episodic cephalalgia does not always indicate malignant hypertension or cerebrovascular disorders.

The presence of chronic migraine headaches can mask serious disturbances in the functioning of the body. The only correct solution in this situation is to contact a specialist at the slightest change in the nature of cephalalgia or other signs.

In what cases is it necessary to visit a doctor?

The presence of the following symptoms is a reason to contact a specialist: