Contents
What is a migraine
Migraine is not just a headache, it is a chronic hereditary disease in which attacks of excruciating, throbbing headache regularly occur.1.
Migraine differs from a regular headache in that, as a rule, the head hurts only on one side, the pain lasts from 4 to 72 hours (if you do not take an anesthetic drug) and is often accompanied by nausea, vomiting, fear of bright lights and loud sounds, as well as requires rest.
Migraine attacks begin suddenly and can occur under a variety of provoking circumstances. Naturally, there can be no talk of any study or work during an attack. That is why migraine occupies a leading position among diseases that lead to social disadaptation and affect the quality of life.
Useful information about migraine
| Who suffers | more often women 25-45 years old |
| Types | episodic migraine (1-2 attacks in 1-3 months) chronic (more than 15 days a month for 3 months). |
| Causes | stress, lack of sleep, trauma, hormonal problems, etc. |
| Treatment | analgesics, anticonvulsants, antidepressants, beta blockers, acupuncture, surgery |
According to statistics, about 15 percent of the world’s population suffers from migraine, and women are 3 times more likely than men.2. Often migraine begins in childhood and can accompany the rest of life.
Doctors note that there is a genetic predisposition to the disease: if one of the close relatives suffered from migraine, the risk of headache attacks increases. More often migraine is transmitted through the maternal line.
Causes of migraine in adults
The causes of migraine are not yet fully understood. The main triggers (provocative factors) of migraine include:
- mental and psycho-emotional overstrain, stress;
- hunger, a big break in eating;
- lack of sleep, poor sleep, as well as excess sleep (the so-called “weekend migraine”);
- change of time zones;
- excessive exercise;
- head trauma;
- hormonal changes (puberty, menopause, menstruation, COC use)3;
- smoking and alcohol;
- weather changes (atmospheric pressure drops, sharp jumps in air temperature);
- long stay in a hot, stuffy room, pungent odors, bright light.
Sometimes a migraine attack can also be provoked by the use of certain foods – for example, hard cheeses, coffee, nuts, citrus fruits, fast food, etc. The amount of fluid consumed is important.
Symptoms of migraine in adults
Symptoms of migraine directly depend on its type: there is migraine without aura (simple) and migraine with aura (classic)4.
Migraine without aura is the most common and usually presents as attacks of unilateral intense headache that is accompanied by nausea, vomiting, fear of bright lights and loud noises, and requires rest.
In the case of classic migraine, the headache is preceded by an aura. In this case, several symptoms of the aura can replace each other. The important thing is that all manifestations of the aura are completely reversible and usually last about 30-60 minutes, but sometimes they can last for several hours. In the classic case, the aura can manifest itself in the following ways:
- sensory disturbances in the form of numbness or tingling on half of the face, arm and leg on one side, as well as impaired motor function in the arm and leg on one side;
- visual disturbances: flashes of light, glare, sparks and flickering before the eyes, in rare cases, vision in one eye may deteriorate or even temporarily disappear;
- speech disorders in the form of difficulty in pronouncing words, impaired understanding of addressed speech.
In some cases, there are variants of the so-called headless migraine or Fisher’s syndrome, when only aura symptoms occur without subsequent headache. These manifestations are more typical for patients older than 50 years. Sometimes, especially in children, a migraine attack is accompanied by abdominal pain, nausea, or vomiting.
Diagnostics
The diagnosis of migraine, first of all, is made on the basis of complaints and examination of the patient. The neurologist will ask you to describe the symptoms, specify how often attacks occur, how long they last, collect a complete history of the disease, and help identify triggers for headache attacks.
An additional examination, as a rule, is not required, but if necessary, the doctor may prescribe an MRI of the brain and cerebral vessels (to exclude vascular anomalies, brain pathology), EEG, duplex scanning of the neck vessels with an assessment of the venous bed, and also refer to an ophthalmologist who will assess the condition of the fundus.
Treatment of migraine in adults
For the treatment of migraine in adults, there are drug and non-drug therapies. Drug therapy includes direct treatment of a migraine attack to relieve pain and preventive treatment. If we are talking about analgesics, then it is preferable to use drugs that contain one active ingredient, such as aspirin, paracetamol, ibuprofen, naproxen.
Combined drugs should not be used (for example, citramon or pentalgin). If aspirin, paracetamol or ibuprofen do not help, then you need to take triptans (sumatriptan, eletriptan, etc.) – drugs created specifically for stopping a migraine attack.
It’s important: analgesics can be used no more than 8-10 doses per month. If the need is higher, then there is a risk of developing another type of headache – drug abuse.
Course prophylactic treatment of migraine is long: usually it lasts for one year. The drugs used for this purpose are from different groups, including anticonvulsants, antidepressants, beta-blockers, as well as botulinum toxin (prescribed for chronic migraine), and modern targeted drugs – monoclonal antibodies.
Monoclonal antibodies block one of the main migraine mediators, the CGRP protein (calciotonin gene-related peptide) or receptors sensitive to this peptide, thereby reducing the likelihood of an attack. This group of drugs has proven itself, showing the best efficacy in the preventive treatment of migraine. The drug is administered subcutaneously, as prescribed by the attending physician. Clinical studies have shown that the majority of patients responding to therapy, the effect occurs within three months.
– The choice of treatment and dose is determined by a headache specialist (cephalologist), – explains neurologist of the highest category, cephalgologist, butolinotherapist Ekaterina Samorukova.
At the same time, non-drug therapy, including changing the patient’s lifestyle, is also of great importance. For example, a relationship between the development of migraine and certain lifestyle factors can be established by a clinician based on a headache diary that patients with migraine should keep. Very often, patients with migraine combine smoking, endocrinological diseases and depression, or increased anxiety. Insufficiently active lifestyle, malnutrition, sleep disturbance, and stress affect the risk of developing a migraine attack, so you need to put your daily routine in order.
– Non-drug methods are to prevent triggers of migraine attacks. First of all, these are corrective recommendations regarding the patient’s lifestyle: reducing stress, switching to a healthy diet, giving up bad habits, etc. Another effective non-drug method of combating migraine is acupuncture. If migraine is accompanied by depression, anxiety is additionally prescribed psychotherapy, cognitive-behavioral therapy – adds Ekaterina Samorukova.
The method of non-invasive neurostimulation of the first branch of the trigeminal nerve using portable devices and transcranial magnetic stimulation (TMS) also show high efficiency. In severe cases, migraine surgery is considered.
Pills
– It is worth distinguishing between simple anesthesia and prophylactic course treatment for complicated migraine. If we are talking about analgesics, then it is preferable to use drugs that contain one active ingredient, for example, aspirin, paracetamol, ibuprofen. Combined drugs should not be used (for example, “Citramon” or “Pentalgin” is a bad idea).
If aspirin, paracetamol or ibuprofen do not help, then you need to take triptans (sumatriptan, eletriptan, etc.) – drugs created specifically for stopping a migraine attack. Important: analgesics can be used no more than 8-10 doses per month. If the need is higher, then it is the turn of prophylactic migraine therapy.
Course prophylactic treatment of migraine is long: usually it lasts for one year. The drugs used for this purpose are from different groups, including anticonvulsants, botulinum toxin, and modern monoclonal antibodies. The choice of treatment and dose is determined by a headache specialist (cephalologist), explains neurologist of the highest category, reflexologist Olga Lisenkova.
Traditional methods of treatment
All our experts agree: traditional medicine methods can be used in the treatment of migraine and quite effectively. It is important not to self-medicate and be sure to follow the doctor’s recommendations. Therefore, no advice from the Internet, but make an appointment with a neurologist.
What are the methods of alternative treatment of migraine?
– There are quite effective methods of non-traditional treatment – Bach drops, licorice root. Visceral massage of the abdomen, osteopathy, acupuncture, as well as standing on nails of the Sadhu help well, lists Doctor of Medical Sciences, Honorary Professor of the Mongolian University, member of the Union of Pediatricians of Russia, member of the Association of Reflexologists Yong Joon Choi.
Prevention of migraine in adults at home
Migraine prevention is primarily aimed at reducing the risk of new attacks.5. To do this, you need to pay attention to your lifestyle: avoid stress and anxiety, have enough sleep and rest during the day. An effective diet with the restriction or complete exclusion of certain foods (nuts, hard cheeses, alcohol, citrus fruits, canned food, fast food, etc.).
Preventive drug prophylaxis of migraine is also possible, including the use of antidepressants and anticonvulsants, monoclonal antibodies. Important: any medications are prescribed strictly in consultation with the doctor!
Popular questions and answers
Our expert neurologists explain what dangerous complications a migraine can have, what to do if a migraine is accompanied by a high temperature, and what kind of “anti-migraine” diet exists.
Why is a migraine dangerous?
Like any disease characterized by a long-term pain syndrome, migraine is often accompanied by depression or anxiety disorders, which, in turn, aggravate the general condition of the patient and the course of the disease. It turns out a kind of vicious circle. Therefore, it is so important to contact a specialist as soon as possible.
According to recent Western studies, migraine can significantly affect the quality of sleep. This is especially true for chronic migraine. In addition to reduced sleep quality, migraines are associated with insomnia, somnambulism, bruxism, and other neurological complications.
The complicated relationship between migraine and pregnancy. On the one hand, during pregnancy in the second and third trimesters, headaches are noticeably less disturbing, but in the first trimester of pregnancy, as well as during lactation, an increase in pain is possible. The management of patients with migraine during pregnancy is a separate story, because during this period the possibilities of drug treatment are very limited and non-drug methods of therapy come to the fore.
What to do if migraine is accompanied by fever?
What diet should be followed for migraine in adults?
With migraines, it is recommended to eat fractionally in small portions, there should not be a big break between meals. When eating in small portions, the number of meals can be up to five per day. Do not allow starvation and overeating, – advises Doctor of Medical Sciences, Honorary Professor of the Mongolian University, member of the Union of Pediatricians of Russia, member of the Association of Reflexologists Yong Joon Choi.
Sources:
- Migraine. Ilatova E.G., Wayne A.M. MMA them. THEM. Sechenov. Volume 1, No. 2, 1999. – 60-65 p.
- Chronic migraine / A.R. Artemenko, A.L. Kurenkov – M .: Publishing House “ABV-press”, 2012. – 488 p.
- Menstrual migraine. Tabeeva G.R. MMA them. Sechenov. Volume 16, No. 4, 2008. – 195-199 p.
- Migraine and its therapy. Levin Ya. I. MMA them. Sechenov, Volume 17, No. 7, 2009 – 441-445 p.
- Topical issues of migraine prevention. Rybalko A.N. “Science and education today”, 2019.