Migraine ( franz.migrain ) – a disease characterized by suddenly developing attacks of headache, usually covering one side of the head, may have a pulsating character. The duration of the attack varies from several hours to several days (from 4-72 hours). Clinic of migraine. Headache develops gradually, often accompanied by nausea and even vomiting, intolerance to noise, bright light, sharp odors. The pain may be moderate or severe in intensity.
The development of a Migraine attack is often preceded by lethargy, feelings of weakness, drowsiness, nausea, flashing flies in front of the eyes, impaired vision, smell, hearing, touch. All these symptoms that precede pain are called an aura. In the presence of these symptoms , a migraine with aura is diagnosed . And without all these previous symptoms, there is a “migraine without aura.” Migraine with aura accounts for up to 20% of all cases, and in 80% of cases of the disease constitutes “migraine without aura”.
Predisposing moments for the development of a Migraine attack are overfatigue, impaired gastrointestinal function ( duodenostasis , prolapse of the stomach , etc.), menstrual irregularities, hormonal disorders, traumatic brain injury, excitement, lack of sleep, overheating, increased smoking, some medications and etc. Many women suffering from migraine often have seizures before menstruation, in the first days of menstruation, in the days of ovulation. Overeating, some foods, alcohol can also trigger a migraine attack. The development of all the signs of Migraine is based on changes in the blood supply to the brain due to a short-term spasm (less often than expansion) of its vessels, which results in the formation of areas of blood stagnation in the brain. This, in turn, causes an increase in intracranial pressure, stretching of the meninges, which, in fact, is the cause of headaches.
Dizziness can be a leading symptom of basilar migraine. During the attack, visual and sensory disturbances, impaired consciousness, intense headache are also noted. Repeated attacks of vestibular dizziness (in the absence of other symptoms) may be a manifestation of dissociated migraine. The diagnosis of migraine in this case is possible only with the exclusion of all other causes.
Migraines usually begin during puberty and gradually disappear with age (by the age of 50-60).
Prevention consists in observing the regime of work and rest, proper nutrition, regular sleep, treatment of concomitant diseases.
To the extent possible, avoid stressful situations or learn to resist them and get out of them.
Treatment of migraine.
Every patient suffering from Migraine should be under the supervision of a doctor, as headache attacks can occur with serious brain diseases (e.g. brain tumors) requiring urgent treatment. If the pain does not subside for more than 24 hours, muscle stiffness appears, you need to urgently consult a neurologist.
Treatment of patients without an attack is to strengthen and harden the body, gymnastics, water and physiotherapy procedures carried out under the supervision of a doctor.
Hot foot baths help some, sometimes hot compresses on the head, tight pulling of the head, hot drink. It is advisable to cleanse the intestines. For strong, often recurring seizures, special medications are taken. The optimal drug and dose is selected by the doctor individually for each patient, depending on the condition of the patient and taking into account concomitant diseases. Usually, after the accepted procedures, the patient falls asleep and wakes up after the end of the attack.
MEDICINAL THERAPY OF MIGRAINE ACCESS.
- Analgesics and antispasmodics should be taken at the very beginning, before severe pain. For example, the following drugs are effective: Spazmonet , Nalgesin , Spazmoblok , Tempalgin , NSAIDs (Aspirin, Ibuprofen, Nimesil , Diclofenac sodium, etc.).
In severe migraine attacks ( migraine status), the patient should be hospitalized.
The following drugs are used to treat migraines:
- 5-HT1 agonists Sumatriptan , Imigran , Zolmitriptan , Ergotamine, Dihydroergotamine (DHE)
- Dopamine antagonists (can cause nausea, vomiting) and Prokinetic drugs (antiemetics, regulate motor-motor activity of the gastrointestinal tract). Aminazine , Prochlorperazine , Metoclopramide ( Reglan , Tserukal ), Domperidone ( Motilium ), Droperidol .
- Prostaglandin Inhibitors
NSAIDs ( Diclofenac Sodium, Ibuprofen, Aspirin, Nimesil , Ketorolac ).
Applied also combination preparations in the treatment of migraine:
NSAIDs + ergotamine and triptans , Prokinetic means + NSAIDs, triptans or DHE.
The optimal drug and dose is selected by the doctor individually for each patient.