Migraine: What is it?
Migraine is a particular form of headache or headache. It differs notably headache “ordinary” by its duration, intensity and various other symptoms.
The headache often begins with a pain on one side of the head or located near an eye. The pain is often perceived as pulsations in the cranium. Migraine can also impair vision and cause nausea and vomiting.
Special surprisingly, some migraines are preceded by physiological events which are grouped under the name Aura. Auras are essentially visual effects which may take the form of flashing lights, rows of brightly colored or a temporary loss of sight. After 15 to 30 minutes, these symptoms disappear. Then comes the headache.
It is estimated that 10% to 20% of the population is affected by migraine in North America and worldwide.
Evolution
The frequency of migraine attacks varies greatly from one individual to another. Some people have a few per year, while others have 3 or 4 times per month. In some cases, seizures may occur several times a week, but rarely a day.
The first seizures appear during childhood or young adulthood. Beyond age 40, headaches are more rare and often disappear after 50 years.
Mechanisms of migraine
It is unclear why some people have headaches, tension headaches or migraines, and others have simply never, even if they are exposed to the same triggers.
Years 1960 to 1990, it was believed that migraines were caused mainly by vascular changes, a tightening of blood vessels surrounding the brain, followed by swelling. However, research carried out subsequently showed that the origin of migraine is much more complex. Indeed, a whole cascade of reactions in the nervous system that cause this intense headache. These chain reactions have effects not only on blood vessels, but also on inflammation, neurotransmitters and other elements.
Without a thorough understanding of the mechanisms of migraine, we know still better and better triggers (see Risk Factors) and ways to combat it.
Symptoms of migraine
A headache is preceded or without aura or a few warning signs. This varies from person to person. Migraine with aura is less common than migraine without aura.
The aura
This kind of neurological lasts 5 to 60 minutes before the headache appears. The patient knows in advance so that in a few minutes he will have very bad headache. However, it also happens that the aura is not followed by headache. The aura may manifest itself in different ways:
* Visual effects: flashes of light, rows of bright colors, a double vision;
* A temporary loss of vision in one eye or both eyes;
* A material weakness on one side of the body, akin to paralysis (called in this case hemiplegic migraine);
* Speech problems.
The current signs
They precede the headache a few hours to 2 days. The most common:
* Fatigue;
* Stiff neck;
* Food cravings;
* Emotions on edge;
* Increased sensitivity to noise, light and odors.
The main symptoms
The main symptoms of migraine. They generally are 4 to 72 hours.
* A headache more intense and more durable than ordinary headache.
* A localized pain, often concentrated on one side of the head.
* A dull ache, throbbing, pulsating.
* Nausea and vomiting (often).
* Changes in vision (blurred vision, black spots).
* A feeling cold or sweating.
Note: The headache is often followed by fatigue, difficulty concentrating and sometimes a feeling of euphoria.
People at risk
* Women. Migraines affect nearly 2 times more women than men. Two thirds of women with the syndrome suffer only during menstruation. These hormonal changes that trigger migraine, and particularly the fall of sex hormones at the end of the menstrual cycle.
Remarks
- The migraine attacks are more important from puberty and they tend to disappear with menopause.
- During pregnancy, migraines tend to decrease in intensity from the second quarter.
* People whose relatives are suffering or have suffered from migraines, especially in the case of migraine with aura.
* People with an inherited deficiency of a gene that predisposes to hemiplegic migraine. This familial form of inherited migraine is rare. It is characterized by prolonged paralysis of one body part.
Risk Factors
The following factors are known to trigger a migraine attack. They vary from person to person. Everyone should learn to recognize the elements that cause the migraine.
Various personal factors or environmental have been identified as triggers for people with migraine.
For example:
* Stress;
* Unwind after a stressful period;
* Hunger, fasting or skipping meals;
* Changes in sleep patterns;
* Changes in air pressure;
* Bright lights or loud noises;
* Make too much or not enough physical exercise;
* Perfume, cigarette smoke or unusual odors;
* Various drugs, including commonly used analgesics and oral contraceptives in some cases.
Triggers foodborne
Approximately 15% to 20% of people with migraine report that certain foods are the source of their attacks. The foods most often cited are:
* Alcohol, especially red wine and beer;
* Caffeine (or lack of caffeine);
* Aged cheeses;
* Chocolate;
* Yogurt;
* The fermented or pickled foods;
* Monosodium glutamate;
* Aspartame.
Obviously, the best known foods that trigger migraine is a natural and logical approach to the problem. By cons, this approach requires more effort and discipline, especially because he must find food problems. To do this, the fact of keeping a diary of headaches is certainly a good starting point (see Prevention section). It may also be useful to consult a nutrition specialist.
Prevention of Migraine
Basic preventive measures
The goal of preventive actions is:
* Reduce the intensity and frequency of migraine attacks, and sometimes even eliminate them;
* Improve the quality of life of people with migraines important;
* Reduce the need for medication.
Keep a diary of headaches
To prevent migraine naturally, the first step required is to find the element that triggered the crisis. To do this, it is recommended to keep a diary of headaches, “where we record the circumstances surrounding the arrival of each migraine. It will record all foods consumed, symptoms, their psychological status (stress, relaxation after stress, etc..) External conditions (bright light, noise, etc..). Record also any other information that seems relevant.
It can also be very useful to note the small symptoms, even if they seem harmless, preceding the migraine attack. Indeed, it is easier to combat migraines if we act at the onset of warning symptoms.
By discovering the products or situations that trigger migraines, many people are able to reduce or substantially eliminate crises.
Adapting your lifestyle
The newspaper will make the necessary changes. For many, that living under stress, to have regular hours of sleep (getting up and going to bed at the same time, as the week that the weekend) and sufficient (at least 6 to 8 hours per night), do not skip meals and do physical exercise is very beneficial.
Preventing seizures with medication
Drugs called “prophylactic” are intended to prevent a migraine attack to occur and diminish the intensity. They must generally be taken each day. The preventive effect may take 2 to 3 months before they occur.
They are usually prescribed to people who suffer from migraines repeatedly (3 or more seizures per month) and whose activities are disturbed enough to warrant medication. Note that certain medications have side effects and their long-term effectiveness is not guaranteed. However, for persons suffering from severe migraines and frequent, prophylactic medications can be a blessing.
The drugs most commonly prescribed are:
* Beta-blockers, commonly used to treat hypertension and cardiovascular disorders (eg, propranolol (Inderal ®) and timolol (Timol ®);
* Anticonvulsants (eg gabapentin), may nevertheless cause significant adverse effects at high doses (nausea, vomiting, diarrhea …).
* Tricyclic antidepressants in low doses;
* Vitamin B2 (riboflavin) to address certain deficiencies of brain cells in people suffering from frequent headaches;
* Hormone replacement therapy (estrogen and progesterone) for women of childbearing age whose migraines are linked to hormonal fluctuations during the menstrual cycle;
Note: Botox, including the bacterial toxin used to reduce the effects of aging skin, can also help to loosen tight muscles of the head and neck. Botox injections repeated every 3 months were used to try to prevent migraines. This practice is declining due to mixed results. Moreover, according to studies, it is not effective, except perhaps in those rare cases where the headache is chronic and occurs every day.
Medical treatment of migraine
All treatments whatsoever, will be more effective in relieving pain when applied at the onset of signs of migraine.
People who undergo only a few migraine attacks per year can probably use drugs occasionally without too much worry. The situation is different for those who suffer from frequent migraines. Indeed, many studies indicate that, first, the drugs can lose their effectiveness if they consume a large amount each year (more than 10 to 15 days per month) and, secondly, they can even cause increased frequency of migraines. People who have frequent migraine attacks have an interest in favor a precautionary approach to reduce their symptoms.
Nonprescription
Acetylsalicylic acid (aspirin), acetaminophen (Tylenol ®) and anti-inflammatory prescription drugs (ibuprofen (Advil ®, Motrin ®, etc..)) Will often be sufficient to break a crisis slight headache if taken at the onset of symptoms. Some preparations have been specifically designed to relieve migraines: the case of Advil Liqui-Gels ® (and Liqui-Gels Advil Extra Strength ®), which contains a solubilized form of ibuprofen, to the effect.
Attention. Eaten regularly, anti-inflammatory drugs can cause stomach irritation and ulcers. Ask the pharmacist or your doctor.
Some medicines contain a combination of molecules to effect pain. This is where the medicine Excedrin ®, each tablet consists of acetaminophen (250 mg), aspirin (250 mg) and caffeine (65 mg). It is approved by the Food and Drug Administration since 1998 to relieve mild to moderate migraines. The Ultra-Efficient Tylenol ® for its part contains a mixture of acetaminophen (500 mg per tablet) and caffeine (65 mg).
Prescription Drugs
If prescription drugs are not enough, doctors can offer a wide range of products more powerful, as appropriate and personal tolerance.
* Anti-inflammatory drugs. The doctor may prescribe anti-inflammatory powerful as naproxen or ketorolac. However, it is unclear whether these drugs are more effective than ibuprofen at the same dose.
* Triptans. Sumatriptan (Imitrex ®) was the first drug in this class. Since then, other triptans have appeared on the market: almotriptan (Axert ®), eletriptan (Relpax ®), frovatriptan (Frova ®), naratriptan (Amerge ®), rizatriptan (Maxalt ®) and zolmitriptan (Zomig ®). These synthetic molecules mimic the action of serotonin and cause constriction of blood vessels. Some form of nasal sprays, some form of tablets.
They have the disadvantage of causing some people nausea, dizziness, muscle weakness and sometimes cardiovascular problems.
* Ergotamine. Ergotamine or not combined with caffeine (Ergomar ®, Cafergot ®) tablets, is also prescribed to help reduce pain. It is less effective than the triptans and may cause nausea and vomiting. There are also dihydroergotamine (Migranal ®), a derivative of ergotamine, which causes fewer side effects and is administered by nasal spray.
* Antinauseants. For headaches that are accompanied by severe nausea, metoclopramide or prochlorperazine can help relieve this symptom. It is sometimes used in hospitals, intravenously to treat migraines resistant.
* Butalbital and other pain relievers. For an analgesic effect stronger than those found for sale there including the Fiorinal ®, which contains butalbital (a sedative), acetylsalicylic acid and caffeine. They tend to be neglected in favor of other more effective drugs.
* Opiates. For severe cases, it is sometimes necessary to receive a medication containing narcotics like codeine. They are used as a last resort because they may be addictive. Moreover, they are generally less effective as triptans for migraine relief.
Tags: Mechanisms of migraine, Medical treatment of migraine, Prevention of Migraine, Symptoms of migraine, The current signs
