Migraines : Causes, Symptoms , Diagnosis, Treatment
Neurology / / April 28, 2016
What is a migraine?
Differences between migraine and other types of headaches
migraine occurrence of risk factors
Diseases associated with migraine
Symptoms of migraine
diagnosis of migraine and headaches
treatment of migraine and headache
Botox injections in the treatment of headaches and migraines
non-drug treatment of migraine
herbs and supplements used for headache and migraine prevention migraine
migraine in children
Disclaimer migraine medicines
Complications of migraine prevention and migraine headaches
migraine - pain is the type of neurovascular headaches.Doctors believe that the neuro-vascular headaches are caused by the interaction between the blood vessels and nerve disorders.Migraine is the second most common type of primary headache after tension headache.The primary is a headache which is not caused by another disease or condition, in other words, is not a consequence of any disease.
Migraine is characte
Differences between migraine and other types of headaches
Differences between migraine and headaches from the stress
Migraine and type of stress "headache" have some similar characteristics, but also some important differences:
- headache, migraine - throbbing, while the pain of stress - usually stable;
- migraine may affect only one side of the head and a headache from stress pain usually affects both sides of the head;
- headache, migraine progresses from head movement;
- headache, migraine may be accompanied by nausea or vomiting, it is sensitive to light and sound.
Differences between migraine and sinus headache
Many primary headaches, including migraine, often misdiagnosed as sinus headaches, forcing patients to inappropriate treatment with antibiotics.Patients who think they have sinus headaches may actually have a migraine.Also, patients with migraine may sinus symptoms - such as facial and pressure overload.
sinus headaches occur in front of the face, pain or pressure around the eyes, cheeks, or forehead.They are usually accompanied by a fever, runny nose and fatigue.When sinus headaches (ie, a sense of deep, throbbing pain and pressure in the face
Sinuses -. It is air cavities, which are located inside the head and around the nose, also known as paranasal cavities or paranasal sinuses inflammation of sinuses usually occurs in allergic reactions.malignancy or infection, stops the mucus outflow, and causes headaches. Sinus headaches are associated with a deep and constant pain in the maxillary, paranasal and paranasal area. The pain usually intensifies with sudden movement or straining and is accompanied by nasal discharge, feeling of stuffiness in the ears, fever and swellingface. Only a doctor can determine whether the headaches disease sinuses. If the headache is really caused by the blockage of the sinuses, for example, as a result of infection, make sure the temperature is displayed. the doctor assigns a diagnosis along with a physical examination to determine the exact diagnosis), discharge from the nose greenor yellow.A nasal migraines - clear and watery.
This sinus headache sinus is a sign of an acute sinus infection, it responds to treatment, and decongestants can sometimes require antibiotics.If a sinus headache is repeated, then the patient is likely to experience pain from migraine.
migraine Migraines are classified as:
- with aura (aura - an optical phenomenon, the pathology of perception for 10-30 minutes prior to an attack.), Formerly known as "classic migraine";
- without aura, formerly known as "common migraine";Aura
sensory disturbances occur before a migraine attack, which may cause changes in vision, with other neurological symptoms or without them.
- episodic and chronic migraine, or migraine voltage. Migraines usually occur as single episodic attacks that may occur once a year, or several times in one week.In some cases, patients experience ultimately the current and chronic migraine (earlier they were called transformed migraines).Chronic Migraine usually begins as episodic headaches, when patients are in their teens or 20 years of age, and then, with their rate increases over time.Chronic headache is considered, when it occurs, at least half of the days in the month, and often - almost daily.
Most chronic migraines are caused by the abuse of analgesics as a prescription pain medication.Obesity and excessive caffeine - are other factors that can increase the risk of episodic migraine in the transition to chronic.Chronic migraines may resemble intense headache, and it is sometimes difficult to distinguish between them.Both types of headaches can coexist.In addition to the throbbing pain on one side of the head, observed in chronic migraine gastrointestinal symptoms - such as nausea and vomiting.Many patients suffering from chronic migraine and also depression.
- Menstrual migraine. Migraines often (in about half of the women with migraines) associated with a woman's menstrual cycle and usually are in the days before beginning of menstruation or her.Fluctuations in the ratio of estrogen and progesterone may play a role here.Compared with migraines that occur at other times of the month, menstrual migraine usually heavier they are longer and they have no aura.The drug Triptane can give relief and can help to prevent this kind of migraine.
- classic migraine. is considered a subtype of migraine with aura, begins in the main artery, formed at the base of the skull.It occurs mainly in young people.Symptoms may include feeling dizzy, tinnitus, slurred speech, unsteadiness, possible loss of consciousness, and severe headaches.
- Abdominal migraine. usually observed in children with a family history of migraine.Recurrent seizures are accompanied by abdominal pain, often - nausea and vomiting.
- Oftalmoplegicheskaya migraine. This is a very rare headache commonly seen in young adults.The pain focuses around one eye and is usually less intense than the standard migraine.It may be accompanied by vomiting, double vision, fallen eyelids and paralysis of the eye muscles.Attacks can last from a few hours to months.Computed tomography (CT) or magnetic resonance imaging (MRI) may be needed to prevent bleeding from the aneurysm (weakened blood vessel) in the brain.
- retinal migraine. retinal migraine symptoms - short blind spots or complete blindness in one eye, which lasts less than an hour.Headache may precede eye symptoms or run concurrently with them.Sometimes a retinal migraine without headache develops.The other eye and neurological disorders should be excluded.
- Vestibular migraines. These pains produce episodic vertigo, which can develop on your own or with a headache and other common symptoms of migraine.
- Familial hemiplegic migraine. This is a very rare inherited genetic disorder of migraine, can cause temporary paralysis of one side of the body, vision problems and dizziness.These symptoms occur in about 10-90 minutes before the headache.
- status Migrainosus . This is a serious and rare type of migraine.It is so dangerous, and lasts so long that requires hospitalization.
The exact causes of migraines are unknown.Physicians believe that migraine can begin with the underlying disorder of the central nervous system.When triggered by various stimuli, can cause the disorder and neurological chain of biochemical events, some of which subsequently affect the blood pressure of the brain vessels.There is certainly a strong genetic component of migraine.Probably, in its occurrence involving several different genes.Many
brain chemicals (neurotransmitters) and disrupters nerve pathways appear to play a role in the onset of migraine.
Many types of events and conditions can change the conditions in the brain and cause a migraine.They include:
- severe emotional stress;
- physical stress (intense exercise, lifting, or even bowel movements or sexual activity);
- sudden changes in weather;
- bright or flickering lights;
- pungent smells;
- high altitude;
- travel, enhanced motion;
- lack of sleep;
- skipping meals;
- some foods, as well as chemical substances contained in them.More than 100 foods and beverages may potentially trigger a migraine.Caffeine is one of these triggers (trigger - in a general sense, "something which leads to action element"), it can also trigger migraines in people who are accustomed to caffeine.Red wine and beer - are also common triggers.Preservatives and additives (nitrates, nitrites, etc.) can also cause painful attacks on the head.Doctors recommend patients to keep a headache diary to keep track of foods that cause migraines;
- fluctuation of female hormones can trigger migraines in women.
Risk Factors of migraine
- Paul. About 75% of all migraine sufferers - women.After puberty, migraine is more common in girls.Migraines most commonly affects women between 20 and 45 years old.Fluctuations of female hormones (estrogen and progesterone) appears to increase the risk of migraine and its severity in some women.In about 50% of women with migraines connected their menstrual cycle.For some migraine Women also tend to be heavier during the first trimester of pregnancy, but it is easier during the last trimester.
- Age. Migraine usually happens in people aged 15-55 years.However, it also affects about 5-10% of all children.Most children migraine eventually stops when they reach adulthood or moving to a less serious tension headache.Children with a family history of migraines may have a greater likelihood of the continuation of this disease.
- Family history.Migraine usually "works" in families.Approximately 70-80% of migraine patients have a family history of the disease.
Diseases associated with migraine
People with migraines may have a history of depression, anxiety, stroke, high blood pressure, epilepsy, irritable bowel syndrome, etc.These terms do not necessarily increase the risk of migraine, but they are associated with it.
Symptoms of migraine
migraine attack may include up to four symptoms phases: prodromal phase, aura, attack and postdromalnaya phase.These phases can not occur simultaneously in each patient.
- prodromal symptoms. Phase "prodrome" - a group of vague symptoms that may precede migraine attacks for a few hours or even a day or two.Prodromal symptoms may include:
- sensitivity to light or sound;
- change in appetite, including its reduction or food craving;
- fatigue and sleepiness;
- mood changes, including depression, irritability or anxiety.
- The symptoms of aura. Sensory disturbances of the aura before a migraine attack occurs in 1 out of 5 patients.Visual aura can be positive or negative:
- positive aura, includes a bright or flashing lights or shapes on the edge of the field of vision (scintillating scotoma).They can grow and fill the field of view.Another positive experience aura - zigzag lines or stars;
- negative aura - black holes, blind spots, or tunnel vision (inability to see to the side).
Patients may have a mixed positive and negative auras.It is a visual experience that is sometimes described as a fortress with sharp corners and dark center around.
Other neurological symptoms may occur at the same time as the aura, although they are less common.These may include:
- speech disorder;
- tingling, numbness or weakness in an arm or leg;
- perception disorders - such as distortion of space or size;
- symptoms of a migraine attack. If migraine is left untreated, the attacks usually last from 4 to 72 hours.A typical migraine attack produces the following symptoms:
- throbbing pain on one side of the head (pain sometimes extends to the whole head);
- pain is aggravated by physical activity;
- nausea, sometimes with vomiting;
- visual symptoms and hallucinations;
- tingling or numbness of the face;
- increased sensitivity to light and noise;
- paleness and feeling cold.
Less common symptoms include redness and tearing in one eye, eyelid edema, nasal congestion, rhinitis including (these symptoms are more common in some other headaches).
- Postdromalnye symptoms.After migraine attack usually occurs phase "postdrome", during which the patient for some time may feel a clouded psyche.
- Symptoms that can indicate the severity of the underlying disease. Headaches, indicating the seriousness of the underlying problem - such as cerebrovascular disorder, or malignant hypertension, are a rarity (headache without other neurological symptoms is not a common symptom of a brain tumor).People with chronic headaches, however, may miss a more serious condition, believing that it is their usual regular headache.Such patients should consult a doctor immediately, if the quality of a headache or have accompanying symptoms changed.
Each person should consult a doctor if any of the following symptoms:
- sudden severe headache, which is maintained or increased in intensity over the next hour, sometimes accompanied by nausea, vomiting, or changes in mental status (possible hemorrhagic stroke);
- sudden, extremely severe headache, worse than you have ever experienced (possible hemorrhage or aneurysm rupture);
- chronic or severe headaches after 50 years;
- the headache is accompanied by other symptoms - such as loss of memory, confusion, loss of balance, changes in speech or vision, loss of strength, numbness or tingling in the hands or feet (subject to a stroke or a brain tumor);
- headache after head injury, especially if there are drowsiness and nausea (possible bleeding);
- the headache is accompanied by fever, rigidity (stiffness, hardness, elasticity, inelasticity, a sharp and sustained increase in the tone of anatomical structures and their resistance to deformation, uniform resistance to the muscles in all phases of passive movement, is equally expressed in the flexors and extensors) neck, nauseaand vomiting (possible meningitis);
- headaches that increased cough or voltage (possible swelling of the brain);