Migraine symptoms how to treat. What causes a migraine. What is basilar migraine

Migraine is a chronic neurological disease that is accompanied by headaches and disorders in the digestive and nervous systems. As a rule, migraine attacks differ in different frequency.

Headache is considered a characteristic symptom of this neurological disease. Other associated symptoms include nausea, vomiting, sound and photophobia. So, people who are often bothered by such signs know what a migraine is.

Headaches most often develop in women (accounting for 18%). Less often such complaints are presented by men (6%).

It is believed that migraine, the signs of which can be observed in adolescents and children, manifests itself mainly by the age of 35. According to statistics, only 5% of older people suffer from such attacks.

Migraine is a hereditary disease. Thus, the presence of migraine attacks in both parents increases the likelihood of such attacks in a child by 60-90%; if the baby's mother suffers from pathology - 70%, and manifestations in the father increase the risk of morbidity by 20%. In this way, it can be concluded that the disease is transmitted through the maternal line.

Clinical picture

The symptoms of such a neurological pathology as migraine include the following manifestations:

Some cases of migraine attacks are accompanied by gastrostasis, which is explained by the stagnation of the contents of the stomach due to a decrease in peristalsis. Such facts become the reason that drugs taken during an attack cannot reach the small intestine, which means that they are practically not absorbed in the body.

With migraine headaches are often unilateral (although they can spread to both sides), and are often localized in the upper jaw and in the eye area. Moreover, the discomfort is pulsatile and can be exacerbated by the slightest stimulus, whether it be smells, light effects, or noise.

The main symptoms of a neurological disease are nausea and vomiting, which cannot bring relief. In addition, some cases may be accompanied by numbness, weakness and paresthesia of the limbs, as well as impaired speech. These signs precede the headache and form the so-called aura, foreshadowing the onset of a migraine attack.

A few tens of minutes or 2-3 hours - this is the duration of a standard seizure. In this case, a condition that lasts 2-3 days is called migraine status.

Migraine and its types

The following types of this neurological disease are distinguished in the classification:

• classic migraine, accompanied by an aura that occurs before an attack in 10-30 minutes);
• a seizure without an aura, which is called a regular migraine.

As a rule, changes in the sensory aura, as well as neurological status, occur shortly before the attack.

Among other varieties of the disease, the following are noted:

1. which is episodic and chronic. In this case, headaches appear from time to time at different intervals (once a year or several times a week). Some patients may experience migraines of a current or chronic nature (previously they were called transformed). Usually, the manifestation of such an ailment at the age of 20 or adolescence begins with episodic headaches, which become more frequent over time. Cephalgia, which occurs almost daily, is called chronic.
   
   The sale of over-the-counter pain medications sometimes leads to the abuse of analgesics and, as a result, to persistent migraines. Additional factors (such as being overweight or consuming large amounts of caffeine) may increase the likelihood of episodic seizures becoming chronic. Sometimes it is quite difficult to make a differential diagnosis between chronic migraine and intense pain in the head. After all, such options for unpleasant sensations can be combined with each other. In such cases, discomfort in one half of the head is accompanied by disturbances in the functioning of the gastrointestinal tract in the form of nausea and vomiting, which are characteristic of the chronic form of the disease. Most patients who suffer from persistent seizures are prone to depression.
2. Menstrual migraine. Most women report migraine attacks on the eve of menstruation or in the first days. Of no small importance are the quantitative fluctuations of progesterone and estrogen. If we compare this type of migraine with the standard one, it can be noted that the menstrual type of pathology is much longer, is not accompanied by an aura, and proceeds in a more severe form. Timely intake of triptans can bring relief, and sometimes prevent this type of pain.
3. Classic migraine. It is a subtype of neurological disease with aura. First, discomfort occurs in the back of the head, then spread to other areas of the head. The classic type of pathology affects mainly young people. Symptoms include speech disturbance, tinnitus, ataxia, dizziness, loss of consciousness, and severe cephalalgia.
4. Often this type of ailment affects children with a history of a family history of a similar neurological disease. Paroxysmal headaches are accompanied by discomfort in the abdomen, nausea and vomiting.
5. Eye migraine. This variant of migraine cephalgia may be accompanied by short-term blind spots or complete loss of vision in one eye for an hour or less. In addition, such a condition is accompanied by a headache, which may precede the aforementioned symptoms. However, some cases resolve without cephalalgia.
6. Ophthalmoplegic migraine. Adults often suffer from this type of disease. Attacks are characterized by the appearance of pain in the periorbital region of less intensity compared to standard migraine. In parallel with this symptom, double vision, paralysis of the eye muscles, and vomiting may occur. The duration of attacks ranges from several hours to 2-3 months. For differential diagnosis, CT (computed tomography) or MRI (magnetic resonance imaging) is used, during which the presence of hemorrhage from an aneurysm to the brain is excluded.
7. This is a disease that is characterized by recurrent dizziness, occurring as the only symptom, and in combination with headaches and signs inherent in migraine.
   
8. Migrainos status. This form has a rather serious prognosis and a long course. The best option for treatment is a hospital.
9. Familial hemiplegic migraine. This type of disease is considered a rare hereditary disease. It is characterized by the appearance of episodic paralysis of one half of the body, visual impairment and dizziness. The occurrence of such signs manifests itself 10-90 minutes before the development of cephalalgia.

Symptoms

A typical migraine attack consists of four phases: prodrome, aura, direct seizure and postdrome.

Prodromal signs

The first stage is characterized by vague symptoms that precede the attack by several days or hours. Among them are the following:

aura signs

Only one patient out of five notes the appearance of a sensory aura that precedes a migraine attack. Visually, it is divided into positive and negative:

In addition, during a migraine attack, mixed auras can also be observed, described by patients in the form of an acute-angled fortress with a rather dark center.

The seizure may be accompanied by the simultaneous development of other neurological manifestations, expressed as:

• speech disorders;
• disorders of perception, namely distortions of dimensions and space;
• paresthesia of the limbs;
• confusion of consciousness.

Clinical manifestations of a migraine attack

In the absence of therapy, this condition can drag on for 4-72 hours.

The classic fit appearsthe following signs:

• nausea, vomiting;
• unilateral cephalgia of a pulsating nature, which can spread to the entire head;
• visual disturbances and various hallucinations;
• blanching and feeling cold;
• facial tingling or numbness;
• increased sensitivity to sound and light effects.

Rare symptoms of a migraine include redness of one eye, swelling of the eyelids, and rhinitis.

Postdromal features

As a rule, the migraine attack ends with the postdrome phase. Often during this period there is a blurred consciousness.

You should think about the severity of the disease when certain symptoms occur. At the same time, the absence of neurological manifestations in headache is not a characteristic sign of a volumetric process in the main organ of the CNS. In addition, episodic cephalgia does not always indicate malignant hypertension or cerebrovascular disorders.

The presence of chronic migraine headache can mask serious disturbances in the functioning of the body. The only right decision in this situation is to contact a specialist at the slightest change in the nature of cephalalgia or other signs.

In what cases it is necessary to visit a doctor

The presence of the following symptoms is the reason for the mandatory visit to a specialist:

Many people call migraine an ordinary headache, just a very severe one. This is a delusion, because migraine is an independent neurological disease, under which special attacks are hidden, accompanied by specific symptoms. We understand what is the difference between migraine and other types of pain, how to diagnose it and how to treat it.

What is a migraine?

From the ancient Greek language, the word "migraine" is translated as "half of the head." Such a translation is associated with the nature of the manifestations of the disease: most often migraine pain occurs in one half of the head and much less often in both. An attack occurs on its own or for some individual reason and can last from several hours to several days. The occurrence of pain, as well as the appearance of the disease itself, is not associated with either head injuries or other diseases. Excruciating headaches may be the result of the development of a pathology (for example, a brain tumor), but they are not related to the diagnosis of migraine.

Most often, the disease affects women and it is transmitted through the female line. The frequency of attacks can vary: from several times a year to daily. If migraine occurs more than 14 times a month, they speak of the chronic nature of the disease, but usually the frequency of attacks in patients is in the range of 2-8 times a month. When the attacks come one after another at short intervals, during which there is an improvement in well-being, or one attack stretches for several days, they talk about migraine status.

Causes of an attack

Migraine pain can occur unexpectedly, and reach the peak in two hours, or in a very short time. The reasons for its appearance are individual for each person: the body can react to certain foods or smells, to a sudden fright or strong emotions (both positive and negative), to hunger or physical stress. As a rule, patients themselves notice the factors that work as a trigger for seizures. Sometimes unobvious or prolonged conditions become catalysts - lack of sleep or excess sleep, emotional stress or exhaustion, overwork, weather and climatic conditions, taking medications, changes in hormonal levels.

The nature and localization of migraine pain

As with the causes leading to an attack, everything here is very individual - this makes it difficult both to diagnose a specific case and to study the disease in principle. Most often, pain occurs in one part of the head - on the right or left lobe, in the back of the head, in the frontal or temporal region, but it can affect several parts at once, and in rare cases it fetters the whole head.

The nature of sensations is also different. Most often, patients note throbbing pain, but there are other sensations, such as bursting. Often, a person, due to the high intensity of the attacks, cannot at all give a detailed description of his symptoms and is not even able to name the specific part of the head where the pain is localized. It is usually difficult to stop an attack with ordinary painkillers - stronger drugs or special anti-migraine medications are used for this. At the peak of an attack, pills may not help, as peristalsis is disturbed, the drugs do not reach the small intestine and are not absorbed.

Symptoms by which the disease is diagnosed

Despite the vastness of the manifestations, the disease still has specific signs. If the clinical picture does not meet the diagnostic criteria, then "migraine" is not set. In this case, a severe headache in a person is most likely caused by some other diseases or pathological processes in the body.

Mandatory symptoms for the diagnosis of "migraine":

• if the attack is not stopped, it lasts from 4 to 72 hours;
• the headache is concentrated in one part of the head (or at least its intensity is more in some specific area), is pulsating, moderate to severe, aggravated by ordinary physical or mental activity (walking, getting up from a place, counting in the mind);
• the attack is accompanied by nausea/vomiting, photophobia, or hypersensitivity to sounds.

Additionally, symptoms such as excessive susceptibility to odors, weakness and lethargy, irritability, dizziness, pain spreading to one or both eyes may appear. Rarely, such a type of migraine as hemiplegic occurs - with it, muscle weakness and paresis of the extremities develop.

migraine with aura

Aura is a complex of neurological disorders that appear at the time of the onset of an attack or some time before it. This type of disease is much less common - about 20% of the total number of migraine sufferers. The most common are visual disturbances. There may be fog in the eyes or hallucinations in the form of static or moving points and lines, geometric shapes, blind spots in the image. Also, a person may incorrectly assess the distance, shape, position or color of objects, there is a feeling that you have to look through a veil or cracked glass.

Along with visual distortions, the aura can manifest itself as follows: auditory hallucinations, impaired taste perception and smell, strange tactile sensations (goosebumps, tingling and numbness), impaired speech, confusion. The aura should not last more than an hour, and all its manifestations should disappear with the onset or end of the headache - this is mandatory for diagnosing migraine aura.

Mechanisms of the onset of the disease

The first mention of migraine-like symptoms dates back to the 3rd millennium BC. e., but until now this disease remains a mystery to the medical community around the world. There are many theories about how and why an attack occurs, but scientists have not yet agreed on the causes of the onset of the disease.

It has been scientifically proven that migraine is a vascular headache, not tension pain, and it is associated with impaired vasomotor regulation, which is responsible for vascular tone. But what leads to these violations is the question. According to one version, before an attack, a person has a powerful release of serotonin. Vessels dilate, blood flow increases. Then the level of serotonin drops, to which the body reacts in the opposite way - the vessels narrow, and their walls begin to experience strong pressure from the volumetric amount of blood, which leads to pain.

Another hypothesis links the disease with the pathology of the trigeminal nerve. This theory is supported by the practice of performing operations that led to an improvement in the condition of patients. In order to reduce the impact on the nerve, Botox is injected under the skin of the face or the smallest muscles are removed. After such surgical interventions, migraines in patients become rarer and less intense or disappear altogether. There are other theories, but none of them can explain? by what mechanisms the disease develops - because of this, there is no single system for the treatment of migraine patients.

Treatment to date

The main treatment for this disease comes down to two things: finding and eliminating the factors that provoke an attack, and identifying drugs that can stop the pain. Patients should monitor their condition and notice what leads to the development of migraine, and the task of the doctor is to direct the patient in the right direction (in case he does not know what triggers he has) and give recommendations on how to alleviate or eliminate symptoms. Additional examinations, diet, or drug therapy may be prescribed - all this in order to get a more detailed picture of a particular case of the disease.

At the peak of pain, a person's productivity drops until he completely disappears from life, so it is very important to find a way to stop the symptoms, and drugs are far from the only way out. Sleep helps someone, someone applies ice to the head or creates pressure on certain areas of the head - the ways to eliminate pain are varied and individual. The most effective way is to fight the attack in several ways at once - for example, take a pill, apply an ice pack and lie down in a quiet, dark and well-ventilated room.

Why You Shouldn't Postpone a Visit to the Doctor

Anyone who is familiar with migraine pain and has been diagnosed is unlikely to want to postpone the treatment of the disease on the back burner. You should not put up with this disease as a sentence, even though the causes of migraines have not yet been found. There are many innovative treatments that can significantly reduce the frequency and severity of seizures, and some are lucky enough to get rid of them altogether for good.

If you are tormented by severe headaches, but you still have not visited a doctor, then you should not delay a visit to a neurologist. Frequent and highly intense seizures can significantly reduce the quality of life and even lead to incapacity, which is considered disability. At the height of the attack, the risk of stroke increases significantly, and migraine is also on the list of frequent contraindications to taking many medications, such as hormonal contraceptives.

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Migraine is a disease of a neurological nature, in which a person has a severe headache that occurs without apparent organic causes. It most often occurs in women of childbearing age who are prone to stress or constantly experiencing excessive mental stress. Failure to maintain a healthy lifestyle also increases the risk of chronic cephalalgia. Often in women appear during the menstrual period or during pregnancy. To date, many effective approaches have been developed for the treatment and prevention of the condition. At the first suspicion of a disease, it is necessary to contact a neurologist who will select the optimal solution to the problem in a particular case.

In 70% of cases, migraine is a hereditary disease. At the same time, the mechanism of its flow is still not fully understood, there are only a few theories.

Experts associate the development of an attack with a change in the diameter of the blood channels of the brain. First, vasospasm occurs, which leads to a violation of blood flow in a particular area. Then their lumen pathologically expands, provoking stretching of the walls. This irritates the receptors and causes pain. In theory, such transitions occur due to metabolic disorders in tissues, in particular, an increase in serotonin levels. Normalization of indicators leads to the end of the attack.

Risk factors for migraine include:

• passive lifestyle;
• living in a big city with a polluted environment and an intense rhythm;
• the presence of hypertension, bronchial asthma, other diseases of blood vessels and internal organs;
• sleep disturbance, increased physical and mental stress;
• diets and poor nutrition;
• and the use of alcohol in any form;
• a diet based on caffeinated drinks, fast food, processed foods, products with flavor enhancers and chemical additives;
• the systematic use of medicines, not agreed with the doctor;
• unfavorable working conditions (permanent stay in a room with light and music, driving in transport, exceeding the permissible noise level).

By eliminating the listed potential in women, it is possible to significantly reduce the risks of developing the disease. If it has already manifested itself and is characterized as chronic, then this will at least reduce the frequency of occurrence of seizures. Additionally, you should pay attention to the indicators of your hormonal levels. It is the frequent change in its indicators that experts explain the fact that the disease is much more common in women than in men.

Migraine attacks often develop after exposure to triggers - provocateurs. Each patient may have their own irritants. The most common include exposure to loud noises, strong odors, bright or flickering lights. Sometimes an exacerbation provokes the intake of alcohol, the use of spicy or spicy foods, contact with cosmetics or household chemicals.

migraine symptoms

It grows gradually. It begins with discomfort, which is usually localized in the forehead, spreads to the eye and temple. Over time, the sensation turns into pain and covers the entire half of the skull. Symmetrical presentation of the symptom is uncommon, but alternation of sides is observed in some patients. By its type, the sign is pulsating, less often bursting or pressing. Any physical activity and even movement of the eyes lead to its intensification. The duration of the attack is individual - from 2-3 hours to 3 days.

Migraine in women is not limited to a headache, but may have additional manifestations:

• fear of light and / or sounds;
• violent reaction to odors;
• tinnitus, decreased quality of vision;
• temperature rise;
• increased sweating;
• pallor of the skin and mucous membranes;
• increased urination;
• nausea and vomiting - the latter brings relief;
• increased heart rate.

The clinical picture in each case is individual. Most often, signs characteristic of an exacerbation of the disease appear 1-2 times a month. Some women have attacks only a couple of times a year, while others have more than 15 days a month with a headache. In the latter case, the specialist diagnoses the chronic course of migraine.

Attacks that follow one after another, and do not pass within 3 days, are characterized as migraine status. This pathology is treated in a hospital, the patient is under constant medical supervision.

Types of migraine

80% of migraine cases are simple attacks that occur without aura. The rest of the patients suffer from a disease with aura, i.e. some time before the onset of headaches, a woman develops specific symptoms of a neurological type.

The duration of the period between attacks and aura can be from 5 minutes to an hour. Usually, specific manifestations end against the background of cephalalgia, but sometimes they can persist during it.

Experts distinguish several types of aura:

• ophthalmic - manifests itself in the form of flashes, dots, flickering of light before the eyes;
• retinal - characterized by temporary complete or partial blindness;
• ophthalmoplegic - problems with eye movement appear, the eyelid drops, double vision;
• sensitive - muscle strength decreases;
• speech - problems with speech perception and pronunciation;
• vestibular - severe dizziness, problems with coordination;
• panic - increased heart rate, panic attacks, anxiety.

The development of the aura helps a woman to understand that she is developing a migraine attack. This allows you to take a medicine in time that reduces the intensity of pain or slows down the duration of an exacerbation. Sometimes the appearance of such precursors does not lead to cephalalgia.

It happens that ladies suffering from migraines note a decrease in the frequency or severity of attacks after conception. Sometimes in women, on the contrary, they appear only with the onset of pregnancy. Problems that arose in the first trimester provoke hormonal changes in the body. As soon as the background normalizes, the symptoms disappear.

In the last weeks of pregnancy, headaches can occur due to stress and against the background of increased stress on the spine. The main thing that migraine is dangerous during pregnancy is the need to take medications to combat the symptom. Their list is strictly limited, drugs are prescribed by a doctor and are used strictly according to the scheme.

Menstrual migraine

Signs of a migraine in a woman before the onset of menstruation are not considered a pathological condition, but indicate the presence of certain malfunctions in the body at the level of hormone synthesis. They are observed in 50% of the fair sex of different ages.

Most often, young girls suffer from this, in whom the cycle has just begun and has not yet been established. The development of symptoms at a later age occurs against the background of fluctuating levels of estrogen and progesterone. Headaches in most cases appear two days before menstruation and persist in the first 2-3 days of the cycle. The condition is characterized by an increased intensity of the symptom, a deterioration in the general well-being of a woman. The syndrome is subject to diagnosis and complex therapy aimed at preventing cephalalgia.

The approach to the fight against cephalgia in a neurological disease is individual. In some cases, to stop the attack, it is enough for the patient to take a warm bath or put a cold compress on her head. most women still can not do without drugs. They are prescribed by a neurologist or a general practitioner, the list of medicines is selected privately, often this is done empirically.

Typically, such treatment is based on the use of NSAIDs, triptans, ergotamines, analgesics. Additionally, symptomatic therapy can be carried out, which includes antiemetic and sedative drugs.

How to prevent seizures

If migraine pains torment 2 times a month and more often, the prevention of exacerbations is additionally carried out. For this, the same tablets are often used that are used to stop cephalalgia.

Their dosages can be reduced, the reception is carried out for several weeks or months. These should also be selected by a doctor. It is strictly forbidden to independently try drugs that bring relief to someone else. Additionally, the effect on the body of triggers that provoke the appearance of a headache should be minimized.

Treatment of migraine folk remedies

It's also good for migraines. The use of natural remedies helps to reduce tension and general strengthening of the body, which provides a pronounced therapeutic and preventive effect. For these purposes, it is recommended to take homeopathic preparations "Arnica", "Veratrum", "Hamomilla". You can make your own blackcurrant tincture. To do this, you need to grind a few branches of the plant, pour them with a glass of boiling water and insist in a thermos for 4 hours. Strained broth is divided into three parts and drunk during the day. Inhalation of aromatic oils allows you to quickly stop the symptom. The main thing is to pre-coordinate the use of all these approaches with your doctor.

Migraine Prevention

According to statistics, migraine-related discomfort disappears as you get older. human, but this process can stretch for years. So that excruciating headaches do not pursue during this period, it is necessary to pay attention to the prevention of exacerbations. At a minimum, triggers for seizures should be identified and their effect on the body should be excluded.

Additionally, do the following:

• normalize the mode of operation, provide the body with a full night's 8-9 hour sleep;
• take medications only in consultation with the doctor;
• engage in general healing and hardening of the body;
• enter into a regimen of regular normalized physical activity.

For people prone to migraines, it is important to relieve emotional stress in time. A visit to a massage parlor, a spa or a hobby will help you get rid of stress and negative emotions. In difficult cases, you may need to visit a psychologist or psychotherapist. Reflexology sessions give a good effect.

The appearance of migraine symptoms can seriously complicate a woman's life. With a hereditary predisposition to the disease, it is worth visiting a doctor in advance and taking care of the prevention of the disease. The very first symptoms of the disease are also an indication for specialist advice, diagnosis and immediate initiation of therapy.

This is the primary episodic form of headache, manifested by intense, paroxysmal headaches (usually unilateral) with a combination of neurological, autonomic and gastrointestinal manifestations. It usually first appears between the ages of 12 and 22. It ranks second in frequency after tension headache. Often a migraine attack occurs after some aura and ends with a feeling of general weakness and weakness. During the diagnosis of migraine, it is necessary to exclude organic pathology of the brain and deal with the possible causes of migraine. Treatment consists of means for stopping the attack that has arisen and preventing the onset of a new episode of migraine.

ICD-10

G43

General information

The primary episodic form of headache, manifested by intense, paroxysmal headaches (usually unilateral) with a combination of neurological, autonomic and gastrointestinal manifestations. It usually first appears between the ages of 12 and 22. It ranks second in frequency after tension headache.

Etiology and pathogenesis

Previously, migraine was considered as a vascular pathology, since during a migraine attack there is an expansion of the vessels of the dura mater, in the innervation of which trigeminovascular fibers are involved. However, pain sensations during a migraine attack are secondary, they arise as a result of the release of painful vasodilator neuropeptides from the ends of trigeminovascular fibers, the most important of which are neurokinin A and peptide.

Thus, a migraine attack occurs due to the activation of the trigeminovascular system. Such activation occurs in patients with hypersensitization of trigeminovascular fibers and hyperexcitability of the cerebral cortex. “Provocateurs” of a migraine attack are most often emotional stress (a migraine attack occurs immediately after a stressful situation), menstruation, physical stress, hunger, as well as some foods containing phenylethylamine and tyramine (citrus fruits, chocolate, champagne, red wine).

Clinical picture

Migraine is characterized by pressing, throbbing headaches that affect half of the head with localization in the forehead / temple / eye area. In some cases, migraine pain occurs in the occipital region with a subsequent transition to one half of the head. From time to time, the location of the headache can change from one side of the head to the other. Moreover, persistent (or recurrent) unilateral headaches are not typical for migraine, but are considered an absolute indication for examination in order to exclude organic brain damage.

In some cases, there is a prodrome (harbingers of a migraine attack), manifested by weakness, a decrease in concentration, and a postdrome (a condition immediately after a migraine attack) in the form of general weakness, pallor and yawning. A migraine attack is usually accompanied by nausea, photo- and phonophobia, and loss of appetite. Headache worse when climbing stairs and walking. In childhood, a migraine attack is accompanied by drowsiness, and after sleep, the pain usually disappears. Migraine is closely related to the female genital organs, so in 35% of cases a migraine attack is provoked by menstruation, and the so-called. menstrual migraine (a migraine attack occurs within two days from the onset of menstruation) - in 8-10%. Taking hormonal contraceptives and hormone replacement therapy aggravates the course of migraine in 70-80% of cases.

There are several clinical varieties of migraine:

• vegetative or panic migraine - an attack is accompanied by vegetative symptoms (chills, increased heart rate, lacrimation, feeling of suffocation, swelling of the face);
• migraine with aura - transient, visual, speech, sensory, motor disorders appear before an attack; its variety is basilar migraine;
• associative migraine - a headache paroxysm is accompanied by a transient neurological deficit; its varieties are aphatic, cerebellar, hemiplegic and ophthalmoplegic migraine.
• sleep migraine - an attack occurs during sleep or in the morning, during awakening;
• catemenial (menstrual) migraine is a type of migraine associated with the menstrual cycle. It has been proven that an attack of such a migraine is due to a decrease in estrogen levels in the late luteal phase of a normal menstrual cycle;
• chronic migraine - attacks occur more often than 15 days/month for three months or longer. The number of attacks increases every year until the appearance of daily headaches. The intensity of the headache in chronic migraine increases with each attack.

Diagnostics

As with other primary cephalalgias, the basis for diagnosing migraine is the patient's complaints and anamnesis data. In most cases, the need for additional research methods (EEG, rheoencephalography, MRI of the brain) does not arise. The manifestation of neurological symptoms was noted only in 2-3% of patients. At the same time, in most cases, there is tension and soreness of one or more pericranial muscles, which becomes a constant source of discomfort and even pain in the neck and occipital region.

Migraine must be differentiated from episodic tension pain, which, unlike migraine, is characterized by bilateral, exercise-independent, less intense headaches of a pressing (squeezing) nature.

Migraine treatment

Migraine therapy can be divided into two stages: the relief of an attack that has developed and further prophylactic treatment in order to prevent new migraine attacks.

Relief of an attack. The appointment by a neurologist of certain drugs for the relief of a migraine attack depends on its intensity. Attacks of mild or moderate intensity lasting less than two days are stopped with simple or combined analgesics: ibuprofen (0.2-0.4 g), paracetamol (0.5 g), acetylsalicylic acid (0.5-1 g); as well as codeine-containing drugs (a combination of codeine, paracetamol, metamizole sodium and phenobarbital). In severe migraine (high intensity of headache, duration of attacks for more than two days), specific therapy drugs are used - triptans (agonists of serotonin receptors of the 5HT type); for example, zolmitriptan, sumatriptan, eletriptan, and other forms of triptans (suppositories, hypodermic solution, nasal spray).

The prognosis of migraine is generally favorable, with the exception of those rare cases when the development of dangerous complications is possible (status migraine, migraine stroke).

Migraine Prevention

To prevent the chronicity of the disease and improve the quality of life, preventive treatment of migraine is carried out, the purpose of which is: to reduce the duration, frequency and severity of attacks; reducing the impact of migraine on the daily life of the patient.

The components of preventive treatment of migraine are selected individually for each patient, taking into account the pathogenetic mechanisms of the disease, provoking factors and emotional and personality disorders. The most widespread are beta-blockers (metoprolol, propranolol), antidepressants (amitriptyline, citalopram), calcium channel blockers (nimodipine), and NSAIDs (naproxen, acetylsalicylic acid). In modern medicine, non-drug methods (progressive muscle relaxation, psychotherapy, acupuncture) are increasingly being used to prevent migraine.

This pathology is neurological in nature. It is characterized by paroxysmal throbbing pain in the temple or frontal lobe. Most often, these symptoms appear only on one side. Migraines usually affect both men and middle-aged women.

The mechanism of the development of the disease has no connection with other diseases, since it appears for completely different reasons.

Read about the difference between migraine and headache in our material, and in this article you will learn about the classification of migraine according to the ICD 10 code.

Kinds

Depending on the cause and nature of pain, migraine is divided into the following types:

This pathology is characterized by a short-term speech disorder, confusion, blurred vision, impaired tactile function. By type, migraine is also divided into the following types:

1. migraine with aura. The aura in this disease is a complex of clinical manifestations that precede pain in the head. It is they who indicate the imminent onset of an attack.
2. Migraine without aura. This is a fairly common type of disease that develops as a result of excessive fatigue, severe overwork, emotional overstrain.

Migraine without aura is not a systemic disease. Subject to the normal regimen of the day, the development of this pathology can be avoided.

Read about how migraine occurs in adolescents, and in this article we talked about whether they take the army with this disease.

Pathogenesis: the mechanism of the onset of the disease and what happens in the head and brain

Regardless of the cause of the appearance of this disease, it can be divided into the following stages of development:

Passing through these stages, the headache intensifies, which can last for a long period of time. With each new attack, these sensations become more and more unbearable..

Read about how long a migraine attack lasts.

Description of the etiology of the disease

Symptoms of pathology: how it manifests itself in the early and late stages

As for the previous symptoms that indicate the imminent onset of a migraine attack, they include:

• general weakness of the body;
• rapid overwork;
• poor concentration of attention;
• constant sleepiness.

After these signs there is a migraine attack with characteristic symptoms:

1. Pressing and throbbing pain, which is localized in one temple. Gradually, it spreads over the entire half of the head.
2. Localization of headaches can alternate from different sides. Not necessarily the attack covers only one part of the head.
3. The attack is accompanied by such additional symptoms as fear of bright light, loud sounds, nausea with vomiting, distortion of smells, decreased visual acuity and attention.
4. In childhood, drowsiness is observed during an attack. Usually after sleep, the pain in the child recedes.
5. In men, an attack is manifested as a result of excessive physical exertion. There is excessive fatigue. The man is unable to move.
6. In some cases, the following symptoms may be observed: causeless irritability, severe fatigue, discoloration of the skin on the face, anxiety, depression. But these signs may not always appear. They are not the primary symptoms of a migraine.

In order to alleviate the patient's condition, he tries to take a horizontal position as soon as possible in a quiet, dark place. This helps to minimize the amount of irritants that make the headache worse.

Complications and consequences of severe, frequent and persistent headache attacks

Why is a daily migraine dangerous, that is, one that occurs almost every day? This pathology can lead to such dangerous consequences:

1. Chronic hemicrania. This disease is diagnosed as a result of uncontrolled use of painkillers during attacks. They disturb the patient almost every day. You can get rid of this disease only by regular preventive measures.
2. Persistent Aura. It is characterized by prolonged ailments, which are the symptoms preceding the attack. A long stay in this state can lead to loss of tone, memory impairment and nervous disorders.
3. Epilepsy attack. if you do not pay due attention to the correct treatment of migraine, then this is fraught with an attack of epilepsy. Therefore, if the prescribed medications do not give the desired result, you need to contact a specialist. He will prescribe therapy in a hospital under the strict supervision of doctors. This will help alleviate the condition, as well as avoid possible convulsive seizures.
4. migraine status. It is characterized by constant attacks that replace each other after a short period of time. In this case, throbbing pain in one half spreads throughout the head. This leads to constant vomiting, which causes dehydration. This condition requires immediate hospitalization and treatment in a hospital.
5. migraine stroke. It is also called a catastrophic form of migraine. During attacks, in addition to pain in the head, disturbances in the functioning of the nervous system are observed.

During prolonged attacks of headache, a person needs to seek help from a specialist urgently and continue intensive therapy in a hospital under the supervision of doctors.

Is migraine dangerous in early pregnancy? This ailment is a common occurrence during the period of bearing a child. But it should be avoided by observing the daily regimen and diet. Since migraine during pregnancy can adversely affect the development of the fetus. This pathology can lead to such consequences during pregnancy:

• darkening in the eyes;
• severe dizziness;
• nausea;
• increase or decrease in blood pressure.

Violation of the functioning of blood vessels is the main cause of migraines during early pregnancy. This factor negatively affects the growth and development of the unborn baby, he may experience a lack of oxygen.

Therefore, if a pregnant woman suffers from headaches on a regular basis, you need to consult a specialist. The attending physician will prescribe the most effective and safe treatment.

How to treat and which doctor to contact?

Which doctor treats migraine? In order to find out the exact cause of pain, first of all, you need to contact a local therapist. People with various ailments of unknown origin come to him for a consultation.

After a detailed examination and questioning of the patient for complaints, the therapist refers the patient to a neurologist. It is this doctor who is a specialist in the field of pathologies of the brain and nervous system.

When examining and conducting certain studies, a neurologist excludes possible serious diseases associated with severe headaches. After that, he diagnoses migraine and prescribes the necessary treatment. Therapy for the development of this disease has two directions.:

• elimination of an attack with the help of painkillers;
• systemic treatment to prevent recurrence.

Symptomatic treatment involves the use of such drugs of the analgesic group:

• Ibuprofen.
• Analgin.
• Paracetamol.
• Phenobarbetal.
• Codeine.

Before using them, it is imperative to study the instructions for use for contraindications. Indeed, for example, Analgin can worsen the condition of a patient who has a violation of blood clotting or diseases of the digestive system.

In order not to harm your health, you should use only medications prescribed by the doctor in appropriate dosages.

With severe headaches, such medications will help to relieve well-being:

• Zolmitriptan.
• Sumatriptan.
• Ergotamine.
• Naratriptan, as well as their analogues.

To prevent seizures, the patient is also prescribed medications of the following groups:

1. beta blockers;
2. calcium channel blockers;
3. antidepressants.

In order to get rid of regular migraine attacks, one should also not forget about preventive measures. Their essence lies in the complete rejection of addictions, caffeine-containing products, adherence to the daily routine and nutrition.

Also do not forget about regular walks in the fresh air, which help to saturate the body with oxygen, and not overload yourself with excessive physical exertion.

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