MIGRAINE

Migraine – General Information

Migraine is a neurological disease which is well known for the severe headaches that is the primary symptom. This medical condition causes headaches that can last from a few hours to three or even four days, which are accompanied by gastrointestinal problems like nausea, vomiting, sensibility to light (photophobia) and noise (phonophobia). A recent study shows that one third of the people who have headaches have a preceding aura. The aura is a perceptual incommodes experience before a headache (for example people who suffer from epilepsy have the same feeling before a seizure). This medical condition is spread world wide in the population and its characteristics are inconsistent. The exact reason which announces a headache varies widely. The simplest treatment, meaning the appliance of warmth or cold on the hurting area, does not have effect on everyone and it can make the symptoms worse, the same is with the drugs for this medical condition that can work for a patient but on the other hand may not work. Some types of headaches are not characterized by pain, or if they are, the pain is located in different parts of the body except the head. The pain is one of the several symptoms related to disorders of the serotonergic control system, which is a dual hormone-neurotransmitter with many receptors. The two types of headache: with aura and common Migraine (without aura) have a genetic factor, while other types are caused by hormone organ disease or injury. These conditions usually appear in females, however, the pre-pubertal Migraine affects in the same measure boys and girls, as it is correlated with the hormonal cycling.

Migraine - Symptoms

It is well known that the signs and symptoms of this medical condition vary a lot among patients. There are four common phases of an attack, but it is not necessarily for everyone who has a Migraine to experience them:

• The prodorm – occurs hours or even a few days before the headache. The probability to experience this phase is about 40% to 60%. In this phase you may confront yourself with: altered moods, excessive sleepiness, irritability, depression or euphoria, fatigue, yawning, stiff muscles (especially in the neck zone), constipation or diarrhea, a big quantity of eliminated urine, desire for certain types of food.
• The aura phase – is the phase that precedes the headaches. The attack begins after 60 minutes from the end of the aura. Patients may experience visual, sensory or motor symptoms, auditory or olfactory hallucinations, dysphasia (language disorder caused by the brain), tingling or numbness and vertigo (which is a type of dizziness).
• The pain phase – a common headache is moderate to severe, unilateral, throbbing, and can be aggravated by physical exercises. The pain is not necessary unilateral, it can also be bilateral, or can be become generalized. The pain lasts from four to seventy-two hours in an adult and one to forty-eight hours in children. The pain may be accompanied by nausea, hyperexcitability (meaning photophobia, phonophobia and osmophobia), blurred vision, diarrhea, polyuria, sweating.
• The postdrome phase – is the ultimate phase, when the headache washes out and the patient can feel tired, irritated can have a lack of concentration and mood changes.

Migraine – Treatment

The conventional treatment for Migraine is focused on three principal factors:

• Avoiding the factors that may lead to a Migraine.
• The symptomatic control
• Preventive drugs

 People who suffer from headaches usually have their own methods of making the pain go away like hot or cold showers directed on the hurting zone, taking a nap in a dark and quiet room and so on that prove to be more useful than medication in some patients. Minor vascular headaches are associated with bad sleep habits, irregular meals, unusually hard work and hormonal fluctuations of the menstrual periods. Patients can try to identify and avoid the factors which promote this medical condition, factors such as: alcohol, caffeine, irregular meals, and bad sleep habits. For patients who have headaches because of the changing weather, there is a treatment named “Valsalva maneuver”. All you have to do is to hold you nose and push the air in your mouth back to the ears; this popping of the air helps you to open your Eustachian tubes, which by regular opening and closing helps you maintain a normal equalize the barometric pressure. Many patients take drugs like paracetamol (also known as acetaminophen), ibuprofen, aspirin and many other analgesics that are nonsteroidal anti-inflammatory drugs for the headaches that can help them reduce their pain. Triptans are known to effectively relieve severe pain, and diminish the sensibility to light, sound and different smells.

Ergots have been on the market before triptans; the effects are the same as those of the triptans in treating Migraines but it is less expensive than the first mentioned drug.  Butalbital combinations are combinations of the sedative butalbital with paracetamol or aspirin that may result useful in different cases of headaches. Opiates, another category of drugs, are based on the combination of narcotics, especially codeine, but it used only when the patients are allergic or can not take ergots and triptans for different reasons. Another technique is the preventive medication that can prevent, reduce the frequency and duration of the headaches:

• Cardiovascular drugs such as beta blockers (which are used for the treatment of high blood pressure and coronary artery diseases) can also reduce the frequency and severity of the condition.
• Certain antidepressant drugs help preventing all types of headaches.
• Botulinum toxin type A also known as Botox is another helping hand in the fight with Migraines.
• Acupuncture may help a part of the patients, as they do not react in the same manner to the medication or different therapies.

Other drugs (triptans) that can be useful combating the Migraines are:

• Sumatriptan (Imitrax)
• Zolmitriptan (Zomig)
• Eletriptan (Relpax)
• Naratriptan (Amerge, Naramig)
• Rizatriptan (Maxalt)
• Frovatriptan (Frova)
• Almotriptan (Axert)

When triptans fail to help you reduce the pains caused by Migraine, some of these drugs may be useful:

• Ergotamine tartrate (Cafergot)
• Dihydroergotamine – nasal spray
• Acetaminophen-isometheptene-dichloralphenazone

There are also a few drugs that reduce the nausea and prevent the apparition of a Migraine:

• Prochlorperazine (Compazine)
• Promethazine (Phenergan)