Migraine is a chronic neurological disease usually characterized by recurrent excruciating, debilitating attacks of moderate/severe headache accompanied by light and sound phobia, as well as nausea and/or vomiting.
The prevalence of the disease in the population is 12% of the population, and it is 3-4 times more common in women.
It is most common at the age of 30-39 years, but is not uncommon in children and adolescents.
As a rule, one can trace a hereditary predisposition to the disease. The genetic basis of the most frequent forms of migraine is complex and mediated by more than one gene, so specific genetic tests are not performed and are not a criterion for diagnosis.
Migraine
Migraine provoking factors/triggers:
stress;
menstruation;
change in weather;
Alcohol, especially red wine;
certain foods;
Being in a stuffy room;
pungent smells;
sleep disturbances, overwork;
skipping meals;
pain in the neck.
Types of migraine and their symptoms
The most commonly identified forms of migraine are: migraine with aura and migraine without aura. Of these, the most common form is migraine without aura, occurring in 75% of cases of the disease.
A typical migraine attack develops in four stages:
The first stage - prodromal, occurs in 77% of migraine sufferers, includes a number of symptoms occurring 24-48 hours immediately before the onset of aura and headache, such as: increased yawning, irritability, stiffness in the cervical region;
The second stage - migraine aura, occurs in 25%, includes the gradual development of fully reversible, usually within an hour, neurological symptoms (visual phenomena, sensory and motor disturbances in the extremities and more)
The third stage is the headache itself. Most often it is unilateral pain, pressing or pulsating in nature, with a tendency to intensify from normal physical activity, such as walking quickly, climbing stairs. It is often accompanied by nausea or vomiting, and light and sound phobia. If the patient does not take analgesics, the headache attack lasts at least 4 hours;
stage four - postdromal period: after the end of the headache attack, patients may notice general weakness, and sudden head movements may cause temporary pain in the location of the preceding pain.
Visual abnormalities in migraine
Visual abnormalities in migraine
Diagnosis
Diagnosis does not usually require instrumental or laboratory tests. Diagnosis is based on collection of history, neurological examination, and compliance of complaints with diagnostic criteria for the disease.
However, in the case of an atypical course or the presence of so-called "red flags", your doctor may prescribe additional examinations.
Treatment
Migraine headaches are often not treated with standard painkillers, but only specific ones. They can only be prescribed by a neurologist, and pharmacies sell them with a prescription.
Generally, treatment includes two directions: relief of migraine attack and prophylactic treatment, i. e. aimed at reduction of attacks frequency. The latter in its turn includes non-medicinal methods and pharmacological ones.
Nonmedicamental methods imply avoidance of trigger factors, including optimization of work and rest schedule, sleep hygiene, walks outdoors and metered physical activity.
Drugs of different classes are used for drug prophylaxis, so the doctor selects the drug taking into account the individual characteristics of the patient.
Prophylactic therapy means daily intake of medication for 6-12 months.
The most modern group of drugs for migraine prophylaxis are monoclonal antibodies, which act on the so-called CGRP protein (calcitonin gene-related peptide) or its receptor. This protein is one of the pain mediators that is released in the trigeminal nerve system and is responsible for the headache of a migraine attack.
The drugs described block the pain pathway in which the CGRP protein is involved. The drug is administered as a subcutaneous injection once a month.
If you have detected the signs of migraine contact your doctor and he will determine the most effective individual tactics.
Our medical center employs doctors who are specially trained to diagnose and treat headaches. They will establish a diagnosis, select the necessary course of treatment and determine a headache prevention strategy.
Specialist selects medication and dosage personally. The therapeutic and prophylactic tactics for migraine differs at different stages of the condition, so self-treatment is inadmissible.
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Additional methods of treatment include physiotherapy and acupuncture. It is also necessary to work with a psychologist, aimed at overcoming chronic stress and depression.
The patient is recommended, both before the first visit and during treatment, to keep a so-called "headache diary", which is easily found freely available on the Internet. With its help, you can track the number of attacks per month, the individual triggering factors, the exact characteristics of each headache attack and subsequently track the effectiveness of the ongoing treatment.
Without qualified migraine treatment, complications can develop - neuroses, psychosomatic diseases, and depression. Background headache, which is difficult to treat, may also join.
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