Migraine: new approaches to riding forever

Migraine: new approaches to riding forever

I. Understanding migraines: more than just a headache

1. Definition and classification: Migraine is a neurological disease characterized by intense, pulsating headaches, often accompanied by nausea, vomiting, and increased sensitivity to light (photophobia) and sound (phonophobia). It is important to understand that migraine is not just a severe headache, but a comprehensive condition that affects various aspects of the functioning of the brain.

   • Migraine with aura: It precedes a headache and includes visual (flickering lights, zigzag lines, field loss), sensory (numbness, tingling), motor (weakness) or speech disorders. The aura usually lasts from 5 to 60 minutes.

   • Migraine without aura: The most common type of migraine, not accompanied by aura.

   • Chronic migraine: Headaches occur 15 or more days a month for more than 3 months, while at least 8 days correspond to migraine criteria.

   • Rare types of migraines: Migraine with hemiplegia (weakness of one side of the body), basic migraine (symptoms associated with impaired brain stem), ophthalmoplegic migraine (paralysis of the eye muscles).

2. Migraine neurobiology: key mechanisms: Modern studies indicate complex neurobiological mechanisms underlying migraines.

   • Trigeminal nervous system: This system plays a key role in the transmission of pain signals from the head and face to the brain. Activation of the trigeminal nerve leads to the release of vasoactive peptides, such as CGRP (calcitonin-Gen Content peptide), which causes inflammation and expansion of blood vessels in the brain.

   • CGRP (Calcitonin-Gen Contracted Peptide): Powerful vasodilator released by trigeminal nerve. CGRP plays a central role in the pathophysiology of migraine, and its inhibition is an effective treatment strategy.

   • Cortical spreading depression (CSD): A slow wave of depolarization of neurons, which spreads through the cerebral cortex. CSD can be the cause of the aura and activate the trigeminal nervous system.

   • The role of the barrel of the brain and hypothalamus: The brain trunk and hypothalamus play an important role in the regulation of pain, autonomic function and circadian rhythms, which can be impaired during migraine.

   • Genetic predisposition: Migraine often has a family character, which indicates a genetic predisposition. Genes associated with the risk of migraine development were identified, but specific genetic mechanisms are still studied.

3. Migraines triggers: an individual approach to identification: Many factors can provoke a migraine attack. It is important to identify individual triggers for effective prevention.

   • Food triggers: Red wine, aged cheeses, chocolate, processed meat products, products containing sodium glutamate (MSG), citrus fruits.

   • Environmental factors: Bright light, loud sounds, strong smells, weather changes, atmospheric pressure changes.

   • Stress: Both acute and chronic stress can provoke migraines.

   • Hormonal changes: Menstruation, pregnancy, menopause, taking hormonal contraceptives.

   • Sleep disorders: Lack of sleep, excess sleep, irregular sleep mode.

   • Passing of food intake: Hunger can cause a drop in blood sugar, which migraine can provoke.

   • Dehydration: Insufficient fluid consumption.

   • Physical strain: Intensive physical exercises.

   • Medicines: Some drugs can cause migraine as a side effect.

4. Migraine Diagnostics: Exclusion of other conditions: The diagnosis of migraine is based on an anamnesis, neurological examination and exclusion of other diseases that can cause headaches.

   • Anamnesis: A detailed questioning of the patient about the nature of headaches, frequency, duration, accompanying symptoms, triggers, family history.

   • Neurological inspection: Assessment of the function of cranial nerves, motor function, sensitivity, coordination.

   • Brain visualization (MRI, CT): It is necessary to exclude other causes of headache, such as tumors, aneurysms, hemorrhages. It is usually recommended for atypical symptoms, a sudden beginning of a headache or the presence of neurological disorders.

   • Laboratory research: It can be prescribed to exclude other diseases that can cause headaches (for example, infections, inflammatory diseases).

II. Traditional methods for treating migraines: relief symptoms

1. Analgesic drugs (analgesics): Effective for migrants of migraine.

   • Nonsteroidal anti -inflammatory drugs (NSAIDs): Ibuprofen, steady, diclofenac. Relieve pain and inflammation.

   • Paracetamol: Relieves pain, but does not have an anti -inflammatory effect.

   • Combined drugs: Contain an analgesic in combination with caffeine or other substances that enhance the analgesic effect.

2. TRIPTA: Specific preparations for the treatment of migraines, which affect serotonin receptors in the brain and narrow blood vessels.

   • Sumatiptan, Ratestandan, Zalkarpulty, Lubricant, ElterPatan, Frierytan, Available in various forms (tablets, sprays, injections). The most effective if you take them at the beginning of the migraine attack. Contraindicated to patients with cardiovascular diseases.

3. Ergotamines: Old drugs for the treatment of migraine, which also narrow the blood vessels. They have more side effects than triptans, and are used less often.

4. Anti -rate drugs: Metoklopramide, Domperidon. They are used to facilitate nausea and vomiting, which often accompany migraine. They can also improve the absorption of painkillers.

5. Preventive treatment: It is prescribed to patients with frequent or severe migraine attacks to reduce the frequency, intensity and duration of headaches.

   • Beta blockers: Propranolol, metoprolol. Reduce blood pressure and can reduce the frequency of migraines.

   • Antidepressants: Amitriptylin, Wenlafaxin. Increase the level of serotonin and norepinephrine in the brain, which can reduce pain and improve mood.

   • Anticonvulsants: Valproic acid, topiramate. Reduce the excitability of neurons in the brain and can reduce the frequency of migraine. Have side effects that should be taken into account.

   • Calcium channel blockers: Flunarizin. Prevent calcium into cells, which can reduce the migraine frequency.

   • Botox injections (botulinum toxin type a): Effective for the treatment of chronic migraines. Botox is introduced into the muscles of the head and neck and blocks the release of neurotransmitters involved in the transmission of pain signals.

III. New approaches to the treatment of migraines: Hope for deliverance forever

1. Monoclonal antibodies to CGRP (Calcitonin-Gen Related Peptide) and its receptor: A revolutionary breakthrough in the treatment of migraines.

   • Erenumab, Fremanesezumab, Galkaneesezumab, Eptiyzumab: These drugs block CGRP or its receptor, preventing the activation of the trigeminal nervous system and the development of migraine. They are introduced subcutaneously or intravenously. They have less side effects than traditional preventive drugs.

   • Advantages: High efficiency, good tolerance, ease of use (injections once a month or quarter).

   • Flaws: The relatively high cost, long -term effects are still being studied.

2. Hypers (CGRP receptor antagonists): Preparations for stopping migraine attacks, which also block the CGRP receptor.

   • Romegepant, Urogepant: Available in the form of tablets. Effective to relieve pain and concomitant symptoms of migraine. They have less side effects than triptans and ergotamins.

   • Advantages: The rapid relief of pain, good tolerance, the possibility of use in patients with cardiovascular diseases.

   • Flaws: It can be less effective than triptans, with very strong migraine attacks.

3. Nerves stimulation: Non -invasive and invasive methods of stimulation of nerves to relieve pain in migraine.

   • Transcranial magnetic stimulation (TMS): Uses magnetic impulses to stimulate or suppress the activity of certain areas of the brain. It can be used to stop migraine attacks or for prevention.

   • Transcular stimulation of the supraorbital nerve (TSNS): Stimulation of the nerve in the forehead using electrodes. It can reduce the frequency and intensity of migraine.

   • Stimulation of the vagus nerve (VNS): Stimulation of the vagus nerve in the neck using a non -invasive device or implantable stimulant. It can reduce the frequency and intensity of migraine.

   • Personal nerve stimulation (ONS): Implantation of electrodes in the nape area to stimulate the occipital nerves. It can facilitate a chronic migraine resistant to other types of treatment.

4. Biological feedback (BOS) and neurofidbek: Methods that allow patients to learn how to control physiological processes, such as heart rate, muscle tension and brain waves.

   • Empty: The patient receives feedback about his physiological state (for example, using sensors measuring muscle voltage) and learns to consciously change these parameters. It can reduce the frequency and intensity of migraine.

   • Neurofedibek: The specialized form of BOS, which allows patients to learn to control their brain activity. It can improve the regulation of brain processes associated with migraine.

5. Alternative and complementary treatment methods: They can be used in addition to traditional treatment methods to alleviate the symptoms of migraine and improve the quality of life.

   • Acupuncture: The introduction of thin needles into certain points on the body. It can reduce the frequency and intensity of migraine.

   • Massage: It can help relieve muscle stress and reduce stress, which can facilitate migraine.

   • Yoga and meditation: They can help reduce stress and improve the regulation of the nervous system.

   • Plant remedies and additives: Some plant agents and additives, such as magnesium, coenzyme Q10, riboflavin, can help reduce the frequency of migraine. Consultation with a doctor is needed before use.

IV. Life and self -help: active participation in the treatment of migraines

1. Keeping a headache diary: It helps to identify migraine triggers, evaluate treatment effectiveness and track progress.

   • Write down: The date and time of the beginning of the headache, the intensity of pain (on a scale of 1 to 10), accompanying symptoms, possible triggers (food, drinks, stress, weather changes), accepted drugs and their effectiveness.

2. Healthy nutrition: Regular nutrition, avoiding passes of food intake, restriction of food triggers.

   • Observe the diet: Eat regularly to maintain a stable blood sugar.

   • Limit consumption: Red wine, aged cheeses, chocolate, processed meat products, products containing sodium glutamate (MSG), citrus fruits.

   • Drink enough water: Dehydration can provoke migraines.

3. Regular sleep: Maintaining a constant sleep and wakefulness regime, avoiding a lack and excess of sleep.

   • Go to bed and wake up at the same time every day: Even on weekends.

   • Create comfortable sleeping conditions: Dark, quiet, cool room.

   • Avoid the use of caffeine and alcohol before bedtime.

4. Stress management: The use of relaxation methods such as meditation, yoga, breathing exercises.

   • Meditation of awareness: Helps reduce stress and improve concentration.

   • Respiratory exercises: Deep breathing with the stomach can help relax and relieve tension.

   • Yoga: Combines physical exercises, breathing techniques and meditation.

5. Regular physical exercises: Moderate physical activity can help reduce the migraine frequency.

   • Aerobic exercises: Walking, running, swimming, cycling.

   • Power exercises: Lift weights, exercises with your own weight.

   • Start gradually: And increase the intensity and duration of training as physical form improves.

6. Ergonomics of the workplace: Optimization of the workplace to reduce tension in the neck and shoulders.

   • Correct posture: Sit straight, with even shoulders and neck.

   • Monitor at eye level: In order not to tilt your head.

   • Support for wrists: When working with a keyboard and a mouse.

7. Restriction of the exposure of triggers: Avoiding famous triggers, such as bright light, loud sounds, strong smells.

   • Sunglasses: To protect against bright light.

   • Noise reduction headphones: To protect against loud sounds.

   • Avoid strong perfumes and air fresheners.

8. Psychotherapy: Cognitive-behavioral therapy (KPT) can help patients learn to cope with pain, stress and anxiety associated with migraine.

   • KPT: Helps patients to identify and change negative thoughts and behavior that can aggravate migraines.

   • Training in self -regulation skills: Relaxation methods, stress management, development of coping strategies.

V. Prospects for the future: new research and development in the treatment of migraines

1. Development of new drugs: Studies on the development of new drugs for the treatment and prevention of migraine are ongoing, which affect other mechanisms involved in migraine pathophysiology.

   • Preparations affecting other neurotransmitters: Serotonin, dopamine, glutamate.

   • Preparations affecting inflammation in the brain.

   • Preparations affecting ion channels in neurons.

2. Personalized medicine: Development of individual treatment plans based on genetic, clinical and other factors.

   • Genetic testing: To identify genes associated with the risk of migraine development and sensitivity to various drugs.

   • Analysis Biomarkerov: To determine the level of certain substances in the blood or spinal fluid, which may indicate the activity of migraine.

   • Individual selection of drugs and dosages: Based on the characteristics of the patient and test results.

3. Artificial intelligence (AI) and machine learning: The use of AI for the analysis of large volumes of data and identifying factors affecting migraine, as well as for the development of new treatment methods.

   • Prediction of migraine attacks: Based on the analysis of weather, dream, stress and other factors.

   • Development of applications for monitoring and managing migraine.

   • Automated migraine diagnosis.

4. Studying the role of intestinal microbioma: Studies show that intestinal microbia can play a role in the development of migraine. Methods of treatment are developed aimed at improving the composition of intestinal microbioma.

   • Probiotics and prebiotics: To improve the balance of intestinal microflora.

   • Microbiotic transplantation: In severe cases, migraines resistant to other types of treatment.

   • A diet contributing to the health of the intestine.

5. Development of new nerves stimulation methods: Studies are ongoing to develop more effective and less invasive methods of stimulation of nerves to treat migraine.

   • Stimulation of deep brain structures: For influence on pain centers and regulatory areas of the brain.

   • Using new technologies: Ultrasound, optogenetics.

   • Personalized nerves stimulation: Based on the individual characteristics of the patient.

VI. The role of the doctor and the multidisciplinary approach

1. The choice of a doctor: It is important to find a doctor specializing in the treatment of a headache who has experience and knowledge in the field of migraine. A neurologist is the best choice.

2. Communication with a doctor: An open and honest discussion of symptoms, triggers, treatment and any problems that occur during treatment.

3. Multidisciplinary approach: Attracting various specialists, such as a neurologist, physiotherapist, psychologist, nutritionist, to develop a comprehensive treatment plan.

4. Active participation of the patient: Following the doctor’s recommendations, keeping a headache diary, making changes to the lifestyle, regular visits to the doctor.

5. Patience and perseverance: Migraine treatment can be a long and complex process. It is important not to give up and continue to look for effective treatment methods.

Migraine is a complex disease, but new approaches to treatment discover hope of getting rid of pain forever. Active participation of the patient, cooperation with a doctor and the use of modern treatment methods can significantly improve the quality of life and return the joy of life without a headache.