Migraine: Complete healing is possible? We analyze myths and reality of the path to improvement
Chapter 1: Understanding Migraine – more than just a headache
Migraine is a complex neurological disease characterized by attacks of intense headache, often accompanied by other symptoms. It is important to understand that migraine is not just a “severe headache”, but a comprehensive condition that requires a careful approach to diagnosis and treatment.
1.1 Clinical manifestations of migraines: from headaches to neurological symptoms
- Headache: Usually one -sided, pulsating, intense pain. However, the pain can be bilateral, pressing, or even felt in the neck. The intensity varies from moderate to extremely strong, violating daily activities.
- Aura: Approximately 25% of patients with migraine have an aura preceding a headache or arising simultaneously with it. The aura is transient neurological symptoms, such as:
- Visual disorders: Flickering lights, zigzag lines (fortifications), loss of vision fields (scotoma).
- Sensory disorders: Numbness or tingling in hand, face, language.
- Speech disorders: Difficulty in the selection of words, slurred speech (rarely).
- Motor disorders: Weakness in the limbs (rarely, hemiplegic migraine).
- Related symptoms:
- Nausea and vomiting: Often accompanying headache, aggravating the patient’s condition.
- Photophobia: Increased sensitivity to light, causing discomfort and increased pain.
- Phonophobia: Increased sensitivity to sounds, irritating and enhancing pain.
- Osmophobia: Increased sensitivity to smells, causing nausea and increased pain.
- Fatigue and weakness: The feeling of exhaustion and weakness after an attack.
- Dizziness: A feeling of instability, rotation.
- Cognitive disorders: Difficulty concentration, forgetfulness.
- Mood changes: Irritability, depression, anxiety.
1.2 Classification of migraines: migraine with aura and migraine without aura
International classification of headaches (ICHD-3) distinguishes several types of migraines, but the main ones are:
- Migraine with aura: Headaches are accompanied by aura.
- Migraine without aura: Headache attacks are not accompanied by aura.
There are other, more rare forms of migraines, such as:
- Chronic migraine: A headache occurs 15 or more days a month for more than 3 months, while at least 8 days a month correspond to the criteria of migraine.
- Hemiplegic migraine: A rare form of migraine, characterized by weakness of one side of the body (hemiparesis) during the aura.
- Basial migraine (migraine with an aura of brain stem): The aura includes symptoms associated with the brain barrel, such as dizziness, ears in the ears, double -gathering, impaired coordination.
1.3 Pathophysiology of migraines: complex development mechanism
The migraine development mechanism is complicated and is not fully studied. However, modern studies indicate the role of several factors:
- Trigeminal-vascular system: Trigeminal nerv activation, which innervates the vessels of the brain, leads to the release of neuropeptides, such as CGRP (calcitonin-Gen Content peptide). CGRP causes the expansion of the vessels of the brain (vasodilation) and inflammation, which contributes to the development of pain.
- Crimely spreading depression (CSD): A slow wave of neurons depolarization spreading through the cerebral cortex. CSD can be the cause of the aura and activate the trigeminal-vascular system.
- Genetic predisposition: Migraine has a genetic component. The presence of relatives with migraine increases the risk of developing this disease. Genes associated with some forms of migraine, such as hemiplegic migraine, are determined.
- Dysfunction of the serotonin system: Serotonin plays an important role in the regulation of pain, mood and sleep. A decrease in the level of serotonin can contribute to the development of migraine.
- Inflammation: Inflammatory processes in the brain play a role in the development and chronic migraine.
Chapter 2: Factors provoking migraines: identification and elimination of triggers
Migraine is often provoked by certain factors called triggers. The identification and elimination of these triggers is an important step in managing migraine. Triggers are individual for each patient.
2.1 Food triggers: What should be avoided in the diet
- Sustained cheeses: Contain thyramin, an amino acid that can provoke migraine.
- Processed meat products: They contain nitrates and nitrites used as preservatives that can cause vasodilation.
- Chocolate: Contains phenylethylamine and caffeine, which can provoke migraine in some people.
- Alcohol: Especially red wine containing tiramin and sulfites.
- Artificial sweeteners: Aspartem can be a trigger in some patients.
- Glutamate sodium (MSG): The food supplement used to enhance the taste is often contained in Chinese food and processed products.
- Citrus fruit: May contain substances that provoke migraines.
- Fermented and pickled products: Contain tiramin.
2.2 Life lifestyle factors: sleep, stress, physical activity
- Disadvantage or excess sleep: Violation of the sleep regime can provoke migraines. It is important to maintain a regular sleep mode.
- Stress: Stress is one of the most common migraine triggers. Stress management using relaxation techniques, meditation, yoga can help reduce the frequency of attacks.
- Physical strain: Intensive physical activity can provoke migraines. It is important to maintain a moderate level of physical activity.
- Passing of food intake: A low blood sugar can cause migraine. Regular nutrition is important to maintain a stable blood sugar.
- Dehydration: Insufficient fluid consumption can provoke migraines. It is important to drink enough water during the day.
2.3 hormonal factors: the role of the menstrual cycle and menopause
- Menstrual migraine: Changes in estrogen levels during the menstrual cycle can provoke migraines.
- Menopause: Hormones level fluctuations during menopause can aggravate migraines.
- Hormonal contraceptives: They can affect the frequency and intensity of migraine attacks.
2.4 Ecological factors: weather, smells, light
- Weather changes: Swanks of atmospheric pressure, temperature, humidity can provoke migraines.
- Strong smells: Spirits, chemicals, smoke can be triggers.
- Bright or flickering light: It can provoke migraines in sensitive people.
- Noise: Loud sounds can cause headache.
2.5 keeping a headache diary: search for individual triggers
Keeping a headache diary is an effective way to identify individual triggers. In the diary, it should be noted:
- The date and time of the occurrence of a headache.
- The intensity of pain (on a scale from 1 to 10).
- Symptoms accompanying headache (aura, nausea, vomiting, photophobia, phonophobia).
- Possible triggers (food, stress, sleep, weather).
- Medicines taken to relieve pain.
- The effectiveness of drugs.
Analysis of the headache diary will help identify patterns and determine the factors provoking migraines.
Chapter 3: Treatment of Migraines: from stopping an attack to prevention
Migraine treatment includes stopping attacks and prevention. The purpose of treatment is to reduce the frequency, intensity and duration of seizures, as well as improve the quality of the patient’s life.
3.1 Treatment of migraine attacks: painkillers and specific drugs
- Analgesic drugs (analgesics):
- Nonsteroidal anti -inflammatory drugs (NSAIDs): Ibuprofen, Neproksen, Ketoprofen. Effective for migrants of migraine.
- Paracetamol: It can be effective for light migraine attacks.
- Combined drugs: Contain analgesic and caffeine, for example, citimon.
- Specific drugs for the treatment of migraines:
- TRIPTA: Constantin, risatriciptan, zolmitriptan, intrigripan, ethletriptan, frutitrippan, albripritan. Are selective agonists of serotonin receptors 5-HT1B/1D. Narrow the vessels of the brain, reduce the release of neuropeptides, such as CGRP, and suppress the activity of the trigeminal nerve. Effective with moderate and strong migraine attacks.
- Digidrérgotamine (DHE): The agonist of serotonin receptors and adrenergic receptors. It can be effective with prolonged and heavy migraine attacks. Available in the form of injections, nasal spray.
- Hypers (CGRP Antagonists): Rimegepant, parrypant. CGRP receptors are blocked, preventing its effect on the vessels of the brain and trigeminal nerve. Effective for stopping migraine attacks.
- Ditans (selective agonists 5-HT1F receptors): Lasmiditan. The mechanism of action differs from tripatans, does not cause narrowing of the vessels. It can be an alternative for patients with contraindications to tripatans (cardiovascular diseases).
- Anti -rate drugs: Metoklopramide, Domperidon. Used to reduce nausea and vomiting accompanying a migraine attack.
3.2 Preventive treatment of migraines: Prevention of seizures
Preventive treatment of migraines is prescribed to patients with frequent or severe attacks, which significantly affect the quality of life. The purpose of preventive treatment is to reduce the frequency, intensity and duration of attacks.
- Beta blockers: Propranolol, metoprolol. Reduce the frequency of migraine attacks.
- Antidepressants: Amitriptylin, Wenlafaxin. They have an analgesic effect and can improve sleep and mood.
- Anticonvulsants: Topiramate, valproic acid. Reduce the excitability of neurons and reduce the frequency of migraine attacks.
- CGRP monoclonal antibodies: Erenumab, Freanzumab, Galkanzumab, Eptynesumab. Block CGRP or its receptor, preventing its effect on the vessels of the brain and trigeminal nerve. Effective for migraine prevention.
- Calcium channel blockers: Flunarizin. Reduce the excitability of neurons and reduce the frequency of migraine attacks.
- Botulinum toxin Type A (Botox): Used to treat chronic migraines. Botox injections in the muscles of the head and neck reduce the frequency of attacks.
3.3 Non -drug treatment methods: Alternative approaches
- Biological feedback (BOS): A method that allows the patient to learn how to control physiological processes, such as heart rate, muscle voltage. It can help reduce the frequency of migraine attacks.
- Cognitive-behavioral therapy (KPT): The psychotherapeutic method aimed at changing negative thoughts and behavior associated with migraine. It can help improve the adaptation to the disease and reduce the frequency of attacks.
- Acupuncture (Iglowerie): The method of traditional Chinese medicine, which consists in the introduction of thin needles into certain points on the body. It can be effective for the prevention of migraine.
- Massage: It can help relax the muscles of the neck and shoulders, reduce stress and reduce the frequency of migraine attacks.
- Yoga and meditation: They help reduce stress and improve relaxation.
- Regular physical exercises: Moderate physical activity can help reduce the frequency of migraine attacks.
Chapter 4: Migraine and related diseases: comorbidity and interconnection
Migraine is often combined with other diseases, which can complicate diagnosis and treatment.
4.1 Mental disorders: depression, anxiety, panic attacks
Migraine is often associated with depression, anxiety and panic attacks. The presence of mental disorders can aggravate the course of migraine and reduce the effectiveness of treatment. It is important to conduct comprehensive treatment of migraines and related mental disorders.
4.2 Cardiovascular diseases: stroke, coronary heart disease
Migraine, especially migraine with an aura, is associated with an increased risk of stroke and coronary heart disease. Patients with migraine and cardiovascular diseases should avoid triptans who can narrow the vessels.
4.3 Epilepsy:
There is a connection between migraine and epilepsy. Some antiepileptic drugs, such as topiramate and valproic acid, are used to prevent migraine.
4.4 Other diseases:
- Irritable intestine syndrome (SRK): Migraine and SRK are often combined.
- Fibromyalgia: Chronic muscle pain and connective tissue.
- Apnee syndrome in a dream: Breathing during sleep.
Chapter 5: Migraine in different periods of life: childhood, pregnancy, menopause
Migraine can manifest itself in different periods of life, having its own characteristics.
5.1 migraine in children and adolescents:
Migraine can begin in childhood and adolescence. Symptoms of migraines in children may differ from symptoms in adults. Children more often experience bilateral headache, vomiting, abdominal pain. Migraine treatment in children should be individual and include non-drug methods, such as a change in lifestyle, cognitive-behavioral therapy.
5.2 Migraine during pregnancy:
In some women, migraine improves during pregnancy, in others it worsens. Migraine treatment during pregnancy requires caution, as many drugs are contraindicated. Preference is given to non -drug methods.
5.3 Migraine in menopause:
Hormones level fluctuations during menopause can aggravate migraines. Hormonal therapy can help reduce the frequency of attacks.
Chapter 6: The prospects for healing migraines: modern research and hopes for the future
Complete healing from migraine is a complex, but not impossible task. Modern research is aimed at studying the pathophysiology of migraine and the development of new treatment methods.
6.1 New drugs and treatment methods:
- CGRP Antagonists and CGRP monoclonal antibodies: A revolutionary breakthrough in the treatment of migraines.
- Stimulation of the vagus nerve (VNS): The non -invasive method used for the treatment and prevention of migraine.
- Transcranial magnetic stimulation (TMS): A non -invasive method that stimulates the cerebral cortex.
- Gene therapy: It is aimed at correcting genetic defects that cause migraine (at the stage of research).
6.2 Individual approach to treatment:
Successful treatment of migraine requires an individual approach taking into account the patients of the patient, triggers, concomitant diseases. It is important to cooperate the patient and the doctor to achieve the best results.
6.3 The role of a change in lifestyle:
A change in lifestyle, including healthy diet, regular sleep, stress management, physical activity, plays an important role in managing migraine and can reduce the frequency of attacks.
6.4 Hope for complete healing:
Although complete healing from migraine is not always possible, modern treatment methods can significantly improve the quality of life of patients and reduce the frequency, intensity and duration of attacks. Constant research and development of new treatment methods inspire hope for the future, when complete healing from migraine will become a reality.
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