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Migraine and its treatment

MIGRENA WHAT ARE YOU FOR A DISEASE?

Symptoms of migraine

The essence of a migraine is an attack of a pounding headache that usually involves one part of the face. In some cases, the painful seizure is preceded by the prodromal symptoms of the so-called aura. The aura is, for example: transient visual impressions (glistening scythe, defect in the field of vision), sensory (semi-acute sensation or paresthesia, e.g. tingling or numbness), transient paralysis, speech disturbances. Often, companion attacks are nausea and vomiting, intestinal motility disorders, photophobia and hypersensitivity to sounds.

How does the migraine attack work?

A migraine attack usually lasts from a few to several dozen hours. The average duration of the attack is 18 hours, and every third person lasts 1-3 days. Migraine has a "capricious course". It can practically occur at any time of day or night because it is caused by emotions, weather changes or food. In some people, seizures appear only sporadically, other severe headaches exclude from normal life a few or even several times a year.

What is the threat to health?

Migraine is not a direct threat to life. However, due to the persistent pain and symptoms accompanying the migraine attack (nausea, vomiting, photophobia, hypersensitivity to sounds and smells) - often prevents normal work and proper rest and causes many difficulties in everyday life.

How chronic is this disease?

Unfortunately, migraine is usually life-threatening, albeit with variable severity. In 3/4 of cases, first migraine attacks occur before the age of 30. In women, migraine occurs most often during puberty, before and during menstruation, disappears in the second and third trimester of pregnancy, returns after childbirth, intensifies when taking contraceptive pills.

How often does migraine occur?

Migraine is relatively common - about 3-10% of people suffer from it. Statistically speaking - affects about 4% of children, 6% of men and 18% of women. Women suffer 4 times more often than men.

TREATMENT OF MIGRENE

In the treatment of migraine, let's talk about:

- preventive and mitigating treatment
- about the interruption of the existing attack of pain and other symptoms of migraine

Preventive treatment and alleviating migraine symptoms are:

- Tryptans
- Simple and complex analgesics and other non-steroidal anti-inflammatory drugs
- ergot alkaloids
- Supportive treatment: antiemetic, sedative, psychotherapy, etc.

Tryptans interrupt the onset of migraines

The basic drugs that suppress the onset of migraine and associated headache are triptans. These drugs treat migraine at any time during an attack. However, they are allowed to be used only for medical indications. They are so-called selective 5HT receptor antagonists, compounds that inhibit neurogenic inflammation - blocking extravasation of the plasma induced by stimulation of the trigeminal ganglion. The active substance does not affect the central pain centers, because it does not cross the blood-brain barrier. The first of the known and used triptans was sumatriptan. Currently, the triptychs of the next generations have appeared on the market. The most well-known of them are zolmitriptan and rizatrypan.

PREVENTION AND LIPING OF MIGREN'S RUNNING

Why does migraine hurt?

Migraine pain occurs due to irritation of the nerve endings of the brain. The mechanism of causing migraine pain is complicated, but in a simplified way it can be determined that it is caused by excessive expansion of the intracranial vessels. The phase of vasodilation triggers, among others, inflammatory mediators of inflammation. Through expanded arteries, the mediators get into the outside of the vessels and the peri-guillotine around the pericardium, in which there are many pain receptors. This process causes pain.

Prevention of migraine

When asked how to prevent a migraine attack, the answer is quite simple - block the production of inflammation mediators that irritate the pain receptors. Substances that inhibit the production of mediators are non-steroidal anti-inflammatory drugs (NSAIDs - also called analgesics). The simplest and most popular of them are aspirin, paracetamol, ibuprofen and naproxen. Simple analgesics can be combined with each other and with codeine and caffeine (complex analgesics), which increases the strength of their analgesic effect.

Condition - the patient's skills in anticipation of a migraine attack

The effectiveness of the above-mentioned drugs depends on the patient's ability to anticipate the onset of a migraine attack. It is important to detect early signs of a migraine attack and use these drugs with appropriate warning. Among other things, because the peristaltic disorder typical of a migraine head causes free absorption of drugs. Therefore, the rule is taking the medicine as soon as possible after the start of the attack (before the onset of nausea) along with the antiemetica.

How to choose a drug for a patient?

Because of their potency and different side effects, phenylpropionic acid derivatives are increasingly valued - eg ibuprofen, naproxen, ketoprofen, indole acetic acid derivatives - eg indometacin, aminophenylacetic acid derivatives, e.g. diclofenac. The choice of an appropriate non-steroidal anti-inflammatory drug should be individualized. It should be adapted to the health condition of the person treating the migraine and the side effects caused by the drug. The general rule is to avoid these drugs (except paracetamol) in people at risk for peptic ulcer disease.

Emergency treatment of migraines

For many years ergot alkaloids, namely ergotamine tartrate (recommended in the form of injections and currently still used as Ergotaminum tartaricum) were considered to be effective in the immediate treatment of migraine attacks. A positive response to ergotamine was considered a diagnostic factor for migraine. However, even a single administration of ergotamine may be dangerous to health due to its strong generalized vasodilating effect. Especially for people with cardiovascular disease. Less dangerous, but also less effective, are other derivatives of ergot alkaloids.

Supportive treatment

In addition to the typical medicines used in the prophylaxis of migraine, many doctors often make herbal preparations, mainly calming ones, such as extracts from: valerian, yarrow and primrose. In addition, magnesium preparations - 600 mg / day, riboflavin (Vitamin B2) - which increases the efficiency of energy conversion in the mitochondria and other beneficial effects.

Psychotherapy in the treatment of migraines

Psychological factors play a very important role in triggering a migraine attack. Often suffer from hyperactive patients with so-called neurotic personality. It is important to identify the triggering factors of headaches (which is not always possible) and to eliminate them. In practice, this involves changing lifestyle, eating habits, avoiding stress, re-adapting to the environment, applying relaxation techniques, and psychotherapy. In addition, the hydrotherapy endangered migraine, acupressure, and aromatherapy are beneficial. Particular attention should be paid to regulating the lifestyle - appropriate number of hours of sleep, outdoor activities, sports. It is very important to avoid factors that provoke migraine attacks, use a proper diet, avoid constipation, and keep a calendar of migraine attacks.