The concept of migraine, symptoms and treatment

1 Characteristics of the disease

Migraine is a noninfectious disease, the main symptom of which is paroxysmal headache. The prevalence of this pathology among the adult population is from 5 to 25%.Females suffer from this ailment more often than men. It is important that the first manifestations of migraine are observed at a young age. It is possible to develop an attack in adolescents. The highest incidence of migraine is observed at the age of 30-35 years. Often migraine occurs in children. This pathology is hereditary. If one of the parents of a child suffers from such a headache, then there is a high probability of migraine development in himself.

Headache may disturb patients at different intervals. Some people have seizures 1-2 times a year, others have a constant headache. In the latter case, the quality of life deteriorates significantly. What is a migraine, known for a long time. She was also studied by Claudius Galen. Migraine attacks are often found among people engaged in mental work, as well as people whose activities are associated with constant stress. Migraine in the absence of proper treatment can lead to loss of ability to work and even disability rights.

2 Why does an attack occur?

Why does an intense headache occur? The exact cause of migraine development is not established. There are several theories of the origin of this pathology. The basis is the change in the lumen of the cerebral vessels. The brain is powered by several large arteries. These include internal carotid and vertebral. The cerebellum and the brain stem feed the anterior and posterior cerebellar arteries. The posterior cerebral artery delivers blood to the structures of the occipital lobe of the brain. The frontal lobe feeds on the anterior cerebral artery. There is also an average cerebral artery. It feeds the frontal, temporal and occipital lobes. In most patients, the headache is felt in front of the head or in the region of the temples. This indicates a narrowing of the lumen of the anterior or middle cerebral artery.

The vascular theory of migraine development has become widespread. It is based on a sudden spasm of the cerebral arteries. Against the background of this brain tissue are experiencing oxygen starvation. Narrowing of the vessels contributes to the appearance of the aura. It means a set of symptoms that occur immediately before the headache. Soon the vessels expand, which causes a headache. There is another theory, which is based on the process of gluing together platelets. This contributes to the production of serotonin. So there is an aura. In parallel, the formation of histamine increases. Against the background of all this, the vessels become more sensitive to various changes. Over time, the mediator level decreases, and the vessels expand. Fabrics located near the arteries swell. All this causes pain syndrome. There is also a neurovascular theory and the theory of creeping depression.

3 Etiological factors

Headache can occur due to various factors. The exact cause of this pathology is not established. The following predisposing factors distinguish:

• emotional overload( frequent stress, depression);
• physical exhaustion;
• non-compliance with sleep and wakefulness;
• regular intake of alcohol;
• intellectual type of work;
• consumption in large quantities of certain foods and beverages;
• inhalation of various aerosols, tobacco smoke, strong odor;
• redundant lighting;
• change of weather conditions;
• power failure;
• taking certain medications;
• period of bearing a child;
• excessive insolation;
• exposure to noise;
• hormonal disorders.

Migraine most often appears in women due to the variability of the hormonal background. Oscillations are possible during child bearing, when using contraceptives, during menstruation. Symptoms of migraine may appear against the background of malnutrition. Excess in the diet of chocolate, coffee, cheese, canned foods, citrus, smoked products can become a trigger factor of this pathology. The greatest significance is emotional and physical overwork. Stress, lack of sleep, daytime sleep instead of night - all these are risk factors for migraine development. Night sleep should be 8-9 hours. At the same time, retirement should be at 10-11 pm. Symptoms of migraine may be due to alcohol abuse. Negative effects on the brain red wine, champagne, beer.

4 Clinical manifestations of

Symptoms of the disease depend on the type of migraine. There are 2 clinical forms of migraine: with and without an aura. Aura can be simple and time-consuming. In the first case, the aura lasts less than an hour, in the second case, from an hour to several days. Aura always precedes a headache. It does not occur in all patients. Migraine without aura is diagnosed more often. Aura is visual, speech, hemiparesthetic, hemiparetic and mixed.

Aura can be manifested by the following symptoms:

• by a sensitivity disorder;
• speech impediment;
• weakness in the arms and legs;
• vision impairment.

Most often, the aura is represented by visual disturbances. In this case, patients can feel black dots before their eyes, doubling in the eyes, the presence of fog. Often such patients can not concentrate on any object. Symptoms of migraine are few. The attack proceeds in several stages. In the beginning, precursors are observed. It can be drowsiness, mood changes, yawning, anorexia. Then the aura develops. Soon there is a headache. The pain with migraine has some peculiarities:

• is most often felt in the forehead, superciliary arches, temples;
• is gradually increasing;
• is felt from one side or from two;
• lasts from 4 hours to 3 days;
• may be accompanied by severe nausea, indomitable vomiting, phobia or intolerance to noise;
• is enhanced by sharp odors.

All these symptoms cause great anguish to a person. Such patients try to lie motionless. Often they cover their heads with a towel. The headache is pulsating and very intense. It increases when a person moves. Additional symptoms include dizziness, dysphoria, lethargy, dysfunction of the stomach. In the event that the symptoms do not disappear within a few days, a complication develops, such as migraine status. With it, the intervals between attacks of a headache are not more than 4 hours. There is severe vomiting. In most cases, after the headache, the resolution phase begins. Symptoms may disappear on their own or after taking medication. When the symptoms subsided, a person often falls asleep.

5 Diagnostic measures

Migraine is treated only after an accurate diagnosis. The diagnosis is established on the basis of clinical data and the results of a patient's interview. Instrumental studies can be conducted to exclude other pathologies( stroke, brain tumor).With migraine, there are no serious brain diseases. For the diagnosis is required neurological examination. It may be necessary to consult an ophthalmologist. To assess the state of the organ of vision, an ophthalmological examination is performed, visual acuity is determined, the eye fundus is examined. To assess the state of the brain, computer or magnetic resonance imaging, electroencephalography, angiography is carried out.

There are criteria on the basis of which the doctor makes a diagnosis. The criteria for migraine without an aura are as follows:

• history of 5 or more seizures;
• duration of an attack from 4 to 72 hours;
• the presence of 2 or more of the following symptoms: one-sided pain localization, pulsating nature of pain, high or medium pain intensity, increased pain during exercise;
• presence of nausea or fear of light and sound;
• absence of communication of a pain in a head with other diseases.

A doctor may suspect a migraine with an aura. In this situation, for a diagnosis, there must be at least 2 cases of aura in the history. Aura in this case should be manifested by ophthalmologic symptoms, difficulty with paresthesia. The next criterion for migraine with aura is the presence of a headache, characteristic of migraine without an aura. Headache with migraines occurs simultaneously with the aura or within 60 minutes after it. There must be no connection with other somatic and neurological diseases.

6 Treatment methods

If the symptoms are pronounced and meet all of the above criteria, a comprehensive treatment is organized. How to treat a migraine? Treatment involves the use of the following drugs: dihydroergotamine compounds, serotonin agonists, NSAIDs, antidepressants, anticonvulsants. Sometimes calcium channel blockers( "Verapamil") can be used. Selection of drugs is determined by the intensity of the headache. In case of a mild attack, NSAIDs may be used. This group includes "Ibuprofen", "Diclofenac".If there is severe nausea or vomiting, it is preferable to treat migraine with combined medications( Citramon, Excedrin, Solpadein, Pentalgin).

Serotonin agonists( "Sumatriptan", "Zolmitriptan") are used for severe headache. These drugs can prevent the development of an attack if taken with the appearance of the first symptoms. In severe seizures, the treatment of migraine may include the intake of glucocorticosteroids( "Dexamethasone").To eliminate vomiting and nausea, it is advisable to use "Metoclopramide", "Domperidone".These funds are taken shortly before NSAIDs and serotonin agonists. With the development of depression in a patient, the treatment of migraine includes the use of antidepressants( Venlafaxine, Duloxetine).When migraine with an aura characterized by visual impairment, Pagazal is often appointed. This is a combined drug that eliminates muscle spasm, dilates blood vessels and reduces blood pressure.

7 Advice on the prevention of

If you constantly suffer severe headaches, treatment must necessarily include normalizing the regimen of the day. Night sleep should be 8-9 hours. Do not need to engage in mental work in the evening. During the development of an attack, it is advisable to remain in silence. Lighting should be not bright. It is possible to carry out a head massage. Some patients are helped by the adoption of a cold or hot shower. A good effect is provided by acupuncture, meditation, whole body massage. It is required to lead an active life.

It is recommended to give up alcohol and smoking. Wellness has darsonvalization, hydrotherapy( taking baths).In addition, patients should follow a diet. It is necessary to limit the consumption of foods that can cause a migraine attack. Many drugs are contraindicated for women during the period of gestation. The use of certain drugs is allowed, but only during a migraine attack. Treatment in this situation is aimed at eliminating the main risk factors. Thus, migraine is most often caused by inadequate rest. To avoid migraine, you should exercise, move more, normalize your sleep and, if possible, spend free time outdoors.