Update: December 2018
Migraine is a very ancient and common disease, about
The symptoms and treatment of migraine are mentioned in many historical
sources. This treacherous disease suffered very prominent people
such as Tchaikovsky, Julius Caesar, Charles Darwin, Isaac Newton,
Sigmund Freud, Chekhov et al.
Migraine is considered a hereditary, genetic disease,
occurring in people of working age (What is migraine).
Although the disease is not fatal, however, during attacks
a person becomes disabled, which negatively affects
the various factors of his life are reflected in his work, his family, and
on the attitude to yourself and to life. Как to treat мигрень человеку с
frequent attacks that worsen the quality of life?
Given that financial costs for the diagnosis and treatment of migraine
throughout life are really huge, they can be compared to
costs for diseases of the cardiovascular system. therefore
очень важно лечащему врачу найти Effectивные методы лечения мигрени
taking into account the individual characteristics of a particular patient,
implement an optimal selection of high-quality, modern and
safe medicines to relieve migraine attacks
in each case.
I would like to emphasize that the diagnosis and treatment of migraine
should only be done by a specialist, self-medication is dangerous:
- firstly possible misdiagnosis
- secondly the occurrence of complications from abnormal
To establish an accurate diagnosis, the physician should carefully
examine the patient’s history, the clinical picture of the seizures, their
frequency and duration. This is usually sufficient, but in rare
cases with neurological symptoms for differential
Diagnosis may require MRI of the brain, MRI of the cervical
spine, EEG, rheoencephalography.
With the differentiation of migraine with other headaches,
frequent pain that should be distinguished from migraine is
episodic tension headache.
Unlike migraine, tension headache:
- is bilateral
- not provoked and does not depend on physical activity
- she is not so intense
- has a constricting, pressing character, like a hoop or mask
- as well as with a migraine, photophobia is possible with it (the fear of a bright
light) as well as mild nausea
- провокаторами головной the pains от напряжения является вынужденное
uncomfortable position of the neck and head for a long time, and
stressful situation and prolonged emotional stress.
Doctors have found that women are more likely to suffer from migraine attacks
(7 раз в месяц, мужчины 6 раз), приступы more продолжительны (у
women 7, 5 hours, for men 6.5). In women, the most common cause
attack is weather changes – atmospheric pressure,
air temperature, in men – physical stress. With an attack
women are hypersensitive to odors and nausea, and men
more often note depression and photosensitivity.
- Sometimes precursors are observed before a migraine attack.
prodrome, they are expressed by weakness, inability to concentrate
attention, and also happens postdrom – general weakness, yawning and
pallor of the skin immediately after an attack.
- In migraine, a symptom that distinguishes it from other headaches,
is a throbbing, pressing pain, exciting only one
half of the head, and it begins most often with the temple,
spreading to the forehead and eyes.
- Sometimes migraine pain is localized in the occipital region,
then moving to the entire half of the head.
- Periodically there is a change of localization sides, once
seizure occurs in the left side, the other in the right.
- A distinctive feature of this disease is that,
at least one of the symptoms of migraine will necessarily accompany
seizure is nausea, with or without vomiting, and phantom or
- Усиление головной the pains вызывается резкими движениями, при
обычной ходьбе, при подъеме по the stairs.
- In children, migraine is quite rare, it
accompanied by drowsiness and usually goes away after sleep.
- Most often women suffer from migraine, since in the third part
of all migraine attacks in women, the migraine provocateur is
menstruation. Если мигрень длиться 2 суток с начала месячных —
This menstrual migraine, which happens in 10% of cases.
- Also, the use of hormone therapy (hormonal drugs for menopause,
non-hormonal drugs for menopause and the use of oral
means of pregnancy protection – hormonal
contraceptives, increases the frequency of attacks and the intensity of pain in
80% of cases.
Other migraine symptoms that may not manifest
can be attributed to – redness or vice versa pallor of the face, increased
fatigue, weakness, depression, irritability, or anxiety.
During an attack, the patient is in a heightened state.
sensitivity to everything – to noise, light, movement and everything
happening around him, most often he closes and tries
retire in a dark, calm place, especially strongly with it
desire to take a horizontal position.
The pain of a migraine is literally nothing to compare, so much so
painful, debilitating and often long lasting. Intensity and
the frequency of attacks is very individual, they are disturbed by someone 1 time
в полгода, кого-то 2-4 раза в месяц, the pains могут быть слабыми, а
may be very strong, with frequent vomiting. When moving the temporal
the artery tenses, pulses, and the headache intensifies.
Любые односторонние головные the pains, как постоянные, так и
arising periodically, but not characteristic of migraine, require
early inspection to exclude possible organic
Causes of migraine
Migraine is a neurological disease that has other
causes of occurrence rather than headache caused by the following
- Blood pressure drops
- Cervical osteochondrosis
- High intracranial pressure
- Muscular strain of the head or neck
До сих пор механизм возникновения мигренозной the pains до конца не
studied. Previously, this disease was considered solely as
vascular pathology, since an attack develops
vessels of the dura mater.
- The main cause of migraine pain is considered uneven.
dilation of the blood vessels of the brain that are expanding pressure on
nearest nerve cells.
- Also after a sharp narrowing of the blood vessels occurs
impaired blood supply to the tissues, which is also accompanied
- Genetic predisposition – in 70 percent of cases
migraine is transmitted from parents suffering from migraine.
- Most often migraines are affected by persons with metabolic disorders.
substances or diseases of the central nervous system.
Today, the disease such as migraine, symptoms and
механизм возникновения the pains объясняет такая теория, как
serotonin. Serotonin is a substance that constricts blood vessels and
transmits nerve signals in the body, and before a migraine attack
the amount of this substance increases dramatically, creating
short spasm of cerebral vessels. In which area
A spasm of blood vessels occurred in the brain, symptoms develop in that place
Внутримозговые сосуды не могут быть источником the pains, поскольку у
there are no pain receptors. Why then does pain arise? Protective
body reaction to high serotonin levels
the release of other substances that break it down. After
serotonin has decreased dramatically, the tone of intracranial vessels is reduced,
and in the superficial temporal arteries the blood flow slows down and
their expansion occurs. Moreover, in these vessels there are receptors
generating pain impulses, so pain occurs. Once
serotonin returns to normal, a migraine attack is stopped.
Migraine pain is of secondary importance as its
appearance caused by the release of painful neuropeptide vasodilators
from the endings of trigeminovascular fibers. therefore, причиной
migraine is the activation of the trigeminovascular system. it
occurs only in people with increased excitability of the cerebral cortex
Connection with the hypothalamus
Recently, scientists have found a connection between the occurrence of such
paroxysmal pain with the hypothalamus (the brain region responsible for
endocrine function), which receives signals about
what is happening in the heart and respiratory systems. In the hypothalamus
is the center of vascular tone, thirst, hunger, control of emotions,
reaction to stimuli causing headache.
The most recent studies have found that with activity
гипотоламуса возникает приступ migraine. Perhaps this discovery will be
способствовать скорейшей разработке Effectивных препаратов от
Types of migraine
There are several clinical types of migraine:
- Migraine sleep – when an attack of the disease appears during sleep
or in the morning after waking up
- Panic migraine or vegetative – when an attack, except
головной the pains дополняется вегетативными симптомами мигрени —
heartbeat, choking, chills, tearing, swelling of the face
- Chronic migraine – if the attacks are 15 times a month in
for 3 months, and with each attack the intensity of pain
- Menstrual migraine – if the occurrence of seizures depends on
menstrual cycle because estrogen levels affect this
the disease, then his fall before menstruation causes
|Migraine with aura is considered if of the following 2-4
the symptom was with 2 attacks
|Migraine without aura is considered if of the following 2-4
Symptom were with 5 attacks
Aura does not lead to motor weakness, but only possible
- reversible speech impairment
- reversible visual impairment – flickering spots, stripes
- reversible disturbances of sensations, tingling in the limbs,
Without treatment, the attack lasts 4-72 hours. Headache
сопровождается хотя бы 2 из следующих symptoms:
- Visual disturbances or unilateral sensitive symptoms
– numbness, покалывание
- Если 1 симптом ауры имеет место в течении пяти и more
- Если каждый симптом длиться не менее 5 minutes, но не more
Headache is accompanied by at least 2 of the following.
- throbbing pain
- one-sided pain sensation
- medium or strong intensity
- increases with normal movement – walking, climbing
Headache meets the criteria for migraine without aura, and
occurs one hour after or during the aura. If pain
- nausea or vomiting
- photophobia or phonophobia
Most often the provocateurs of migraine are stress, hunger,
physical stress, as well as the use of food,
which contain tyramine and phenylethylamine – chocolate, citrus,
|Migraine provocateurs – факторы риска|
|Nutrition||Alcohol, including beer, champagne, wine, food containing
food supplements – monosodium glutomat, aspartame, vegetables and fruits with
nitrates, chocolate, nuts, cocoa, aged cheese. Big breaks
in food, diet.
|Environment||Irritant glare, noise, glittering lights, fluorescent
lighting, various odors, any fluctuations in temperature, humidity
air, wind, frost, heat.
|Hormonal||HRT, hormonal contraceptive use, menstruation,
|Medicines||Histamine, nitroglycerin, reserpine, estrogen, ranitidine,
|Psycho-emotional||Stress, and vice versa post-stress relaxation – vacation,
weekend, as well as depression, anxiety, nervous excitement
|Other||Exacerbation of chronic diseases, traumatic brain injury,
overwork, excessive physical activity, including
increased sexual activity
|Sleep||Sleeping or lack of sleep|
Migraine Treatment подразумевает 2 основных направления –
relief of an already developed attack, and prevention of appearance
seizures in the future.
Relief of attack. Only a neurologist can prescribe any.
remedies for pain during a migraine attack, it depends on
intensity and their duration. If the attack is moderate or weak
тяжести и длиться не more 2 дней, то врач назначает простые
analgesics, possibly combined.
- NSAIDs (ibuprofen), paracetamol (contraindicated in pathologies
kidney and liver), acetylsalicylic acid (should not be taken when
tendency to bleeding and with gastrointestinal diseases)
- Combination preparations containing codeine, paracetamol,
phenobarbetal and metamizole sodium
- If the intensity of the pain is high, the duration of the attacks is over 2
days, Triptans are prescribed for migraine (a list of all modern
triptans, prices, how to take them correctly). They are issued in
candles, solutions, sprays, infections.
- Non-selective agonists – Ergotamine, etc.
- Auxiliary psychotropic drugs – domperidone,
Triptans are drugs developed 20 years ago and are
serotonin derivatives. They act in several
- Have a pronounced analgesic effect, reducing
- Triptans affect blood vessels selectively, reducing painful
pulsation only in the brain, without affecting the rest of the vascular
- Effects only on specific producing substances.
(receptors), which provoke the appearance of pain, reduced their
the amount goes away and the pain.
With the classic version of migraine with aura, Papazol can help
taken in the first minutes. Someone helps a hot bath, someone
exposure to cold, the third facilitates the state of the pressure chamber.
Treatment of an acute migraine attack
|NSAIDs + conventional painkillers + protivovorotnye||in 60% of cases, attacks can not be stopped|
|Naratriptan 2.5 mg||Few side effects, less frequent relapses|
|Zolmitriptan 2.5 mg||High-speed triptan|
|Sumatriptan 50 or 100 mg||The effect manifests itself in 70-80% of patients, after 4 hours gives
|Sumatriptan, spray, 20 mg||It has a very fast action.|
|Ergotamine||Basically it was replaced by triptans.|
|Sumatriptan subcutaneous, 6 mg||Очень Effectивен при сильных приступах с рвотой|
||b-blockers могут вызывать чувство усталости, их нельзя
use for persons with bronchial asthma and cardiac
|Valproate sodium 200 mg||Weight gain and increased sleepiness in 15% of patients
limit their use
|Metislergid 1-2 mg||A frequent side effect is abdominal pain, rarely –
|Amitriptyline or dotiepin at night 25 mg||They have an analgesic effect if the attack is provoked.
|Aspirin||The effect and dose are not approved or established, therefore
|Pisothiphene 1.5-3.0 mg||Also increases the weight that many patients are contraindicated,
drowsiness is stopped by increasing the dose, gradually over
of the month.
General rules for migraine
To reduce the intensity of pain should follow
Some simple rules:
- Denial of bad habits – alcohol and nicotine are destructive
affect the entire body, including the vascular
- Refusal from artificial stimulants – such stimulants as
energy drinks (can lead to teenage death), coffee,
intense workouts lead to a lot of energy that with
tendency to migraine provokes seizures.
- Normalize sleep and rest, precisely during sleep
energy reserves are replenished, especially until 3 in the morning. By scientists
it is determined that after 3 o’clock in the night energy consumption is renewed, and
prolonged staying up late can lead to exhaustion.
- Diet – it is known that convenience foods, fast food, pickled,
smoked, spicy dishes, food additives, flavors and
preservatives clog up the vessels so much that it not only leads to
circulatory disorders, and provokes migraine attacks, but also
increases the risk of atherosclerosis, stroke, heart attack.
- Weak dim lighting, mental decline,
frequent outdoor living, easy physical work
the street, silence – all this reduces the risk of developing an attack.
How to treat a migraine – tips from a single woman who suffers
migraine how does she manage to soften her attacks
Patients own experiences and their ways of dealing with sometimes
incurable diseases is a new concept of perception
some nervous or mental illness that helps
reveal yourself and achieve great success in fighting your
For a long time, one woman observed when and how
there are her migraine attacks. At the same time, she realized that it was
her migraine appears:
- after bright sunshine
- after inhaling heavily polluted air
- strong odors of perfume, chemicals
- and also change of weather and the use of purchased semi-finished products with
chemical additives and products with dyes
- thunderstorm, temperature changes necessarily caused her head
It is impossible to avoid so many migraine provocateurs, they
everywhere, especially in summer. Very well, if a person can advance
anticipate the onset of attack, it is peculiar
sensitive natures with good intuition and those
listens to your body. When a woman starts aura
– spots appear before eyes, and in the left hand it is felt
tingling She immediately begins to take action.
The most important thing is to quickly be home, where you should open
all the windows, shut them down, turn on the fan (if it’s summer), sit down
in the chair and intensely massage the head with your fingers. Then this
the woman lies down and puts a cold heating pad under her head, but maybe
this is not suitable for everyone, and someone needs, on the contrary, a hot
warmer. In addition, she rubs whiskey with lavender oil or mint (on
which may be allergic), then tries to get some sleep,
head tying a handkerchief. After sleep, take a cool bath with
lemon balm, chamomile, oregano and valerian root to soothe
нервную the system.
If such measures are taken as quickly as possible, then usually
the pain is insignificant and passes quickly. For the prevention of this woman
in the summer drinking primrose infusion – 1 tablespoon of dried leaves for 1
a glass of boiling water, a quarter cup 4 times a day, also tries
do not use public transport in summer to avoid odors
deodorants and wears dark glasses.
Perhaps someone will help these ways to mitigate attacks.
migraine in the summer.