Migraine: Causes, Symptoms and Treatment

2 Symptoms and manifestations of

The dominant symptom of migraine is, of course, a strong, paroxysmal headache. However, the symptoms that precede pain may vary in different patients. There is a classification according to which the following types of disease are distinguished:

• migraine with aura( classical);
• without aura;
• is retinal migraine;
• is a migraine possible;
• migraine with complications( chronic, seizure, with seizures);

Classical migraine is accompanied by a so-called aura and consists mostly of several phases.

The phase of precursors occurs in about half the patients, mainly a few hours before the onset of the headache. It consists in the occurrence of mood changes: depression, fatigue, difficulty in concentrating attention and eating disorders( increased appetite).There may be a feeling of stiff neck.

The phase of the aura consists in the appearance of neurological symptoms such as scotoma, flares, image distortion, edge blur, limitation of the visual field, for example, visual impairment on the sides or in the middle. Changes in the proportions of objects( visual aura), tingling sensation usually in the face, one or two limbs on one side( sensory aura), paralysis, which is a rare symptom( aura motor), dizziness, imbalance, tinnitus, speech disturbanceslurred speech or problems with expressing thoughts) also refer to symptoms. The aura phase usually occurs 5-20 minutes before the onset of a headache.

The phase of the headache is manifested by the emerging pain, most often one-sided, has a "pulsating" character. If we are talking about its severity, then, as a rule, it is defined as strong. The duration of migraine is from 4 hours to 3 days with a frequency of 1-2 seizures per month. Often it is accompanied by nausea and vomiting, increased sensitivity to light and sounds. These symptoms refer to the criteria for recognizing migraine. In this case, there are visual disturbances, anxiety and irritability. There are symptoms in the form of abdominal pain, a feeling of heat or cold and sweating.

Factors that can cause migraines are:

• stress( eg, exam);
• weather change;
• alcohol,
• hunger;
• excessive physical exertion;
• menstruation or( rarely) ovulation;
• lack of sleep or too long sleep;
• specific products, for example, chocolate, citrus, products containing glutamate or sweeteners, such as aspartame;
• physical stimuli( eg, flashing light);
• smells;
• medications( birth control pills, nitrates used in ischemic heart disease, hormone therapy).

With retinal migraine, seizures are limited to one eye. Appear scotoma, visual impairment with concomitant headache.

It is necessary to pay attention to the painkillers that the patient takes, as abuse of them prevents to diagnose the disease. Chronic migraine is considered a complication of "regular" migraine - a migraine with an episodic character, because, as a rule, it develops precisely against its background.

Factors that can lead to such a transformation include:

• head or neck injury;
• influenza and other infections;
• meningitis;
• mental illness, for example, depression;
• stressful situations;
• operation;
• anesthesia;
• arterial hypertension;
• menopause.

The chronic state of migraine can be said when the pain lasts longer than 72 hours, without interruption or with interruptions of no more than 4 hours. The headache and discomfort accompanying the disease are usually quite severe, which is the reason for the patient's stay in the hospital. Sometimes, especially in the case of increased vomiting, signs of dehydration may appear, and in such situations it is necessary to saturate the patient with an intravenous route.

People with such a disease are wondering if a migraine is being treated. Unfortunately, most often the disease lasts a lifetime, although there are also periods of remission. After 50 years, the frequency of headache attacks may decrease. What is characteristic, the disease often passes during pregnancy. In women who have migraine attacks mostly on the period of menstruation, the frequency of seizures can be changed during the menopause, which is associated with a decrease in the concentration of estrogens in the blood. It rarely happens that migraine attacks can lead to a stroke.

It should be noted that migraine with aura in women taking oral contraceptives or hormone replacement therapy, and smokers may be associated with a higher risk of ischemic stroke of the brain.

1 Causes of the disease

Causes of migraine are not fully explained. Most doctors and scientists believe that the disease is caused by genetic factors. As already mentioned, migraine most often appears in women. This is most likely due to fluctuations in the level of estrogen, that is, the female sex hormone. It is proven that the frequency of migraine attacks increases during menstruation, when there is a natural decrease in the level of estrogen in the body of women.

The disease is associated with a number of processes occurring in the brain, the secretion of neurotransmitters such as norepinephrine, serotonin, dopamine, and endorphins. In the walls of the vessels, the release of various substances responsible for the transmission of pain occurs.

3 Diagnosis

The disease can be recognized, primarily on the basis of a characteristic history of the disease, that is, describing the patient specific symptoms that accompany the onset of headache and its provoking factors.

In case of severe sudden headache with concomitant symptoms, for example, vomiting, one should think about other diseases that can endanger the patient's life. This situation requires rapid diagnosis and medical intervention. Examples of such conditions are:

• subarachnoid hemorrhages;
• thrombosis of venous vessels of the brain;
• is an inflammation of the meninges.

The basis for diagnosis in such situations are neurological examination and computer or magnetic resonance imaging.

4 Methods of treatment

The procedure for dealing with a headache includes 3 elements:

• elimination of factors causing seizures;
• pharmacological treatment, which reduces the frequency of seizures and their severity;
• therapy in case of migraine attack.

In the case of temporary treatment, the following drugs are used:

1. Triptans. Causes weakening or elimination of pain, suppression of vomiting and nausea. It should be borne in mind that tryptans cause vasoconstriction, which is contraindicated in patients with cerebral ischemia.
2. Alkaloids. They are effective for some patients. Unfortunately, drugs of this group can aggravate nausea and vomiting.
3. Non-steroidal anti-inflammatory drugs, paracetamol and opioid analgesics. Often used in combination with caffeine or ergotamine.
4. Antiemetic drugs and antipsychotics.

In case of prevention of seizures apply:

• preparations that block beta receptors;
• antidepressants;
• anticonvulsant drugs - valproic acid;
• preparations from the group of serotonin receptor antagonists.

Treatment of chronic migraine usually focuses on eliminating situations that cause pain. In addition, adequate hydration of the patient's body and a properly formulated diet are necessary.

Migraine attacks that occurred in childhood can completely disappear in adulthood. In many cases, however, the disease is chronic and lasts a lifetime. In many patients, migraine attacks can be amplified up to 40 years. In some cases, migraine can completely disappear during pregnancy and manifest again after childbirth. After the menopause period, migraine attacks can be less painful and rare. This also applies to people of advanced age.

So what is a migraine?

Migraine is a disease with a very complex course, but it does not threaten life and does not cause in most cases persistent consequences.

Appropriate treatment and preventive measures should be taken.

5 Prevention of

Prophylactic treatment does not apply to all patients with migraine. In some patients, migraine attacks appear less often than once a month, while others may occur once a week or more often. The drugs used to prevent migraines differ from those used for temporary treatment. The main groups of drugs used in the prevention of migraine attacks include:

• drugs that block receptors with beta-blockers( so-called beta-blockers), for example, Propranolol;
• antidepressants are preparations of a new generation( Amitriptyline).

Other ways to get rid of a headache are changing your lifestyle, eating habits, avoiding stress, using relaxation techniques and psychotherapy. It is worth taking care of enough sleep and physical activity. Avoid factors that cause migraine attacks.