What is migraine and how to treat it? Migraine. Causes, symptoms, diagnosis and treatment of the disease Focal migraine

The most common type of migraine paroxysms, the distinctive feature of which is the absence of an aura and any transient neurological disorders. Simple migraine is characterized by attacks of intense headache, often unilateral, accompanied by nausea, repeated vomiting, sound and photophobia. Diagnosis is based on clinical criteria. It is imperative to exclude other cerebral diseases, the symptom of which may be similar cephalalgia. Treatment of simple migraine is carried out with serotonin receptor agonists, NSAIDs, dihydroergotamines, non-narcotic and narcotic analgesics, antiemetics, sedatives and tranquilizers.

ICD-10

G43.0 Migraine without aura [simple migraine]

General information

Simple migraine accounts for up to 80% of all migraine attacks. Unlike migraine with aura and associated migraine, it does not have transient visual, motor or sensory disturbances preceding or accompanying the headache. The first attacks of simple migraine usually occur between the ages of 17 and 35. In old age, migraine attacks lose their duration and intensity. Women suffer from migraines 3-4 times more often than men; their attacks are often associated with periods of the menstrual cycle. Simple migraine occurs in the vast majority of migraine cases in children. In this case, the familial nature of the disease is often traced. In addition, some authors indicate that in 80% of men with migraine, their mothers also suffered from migraine paroxysms.

Causes of simple migraine

It is known that a simple migraine attack can be triggered by a stressful situation, physical fatigue, mental overload, lack of sleep, hypothermia, changes in weather, strong smell, noise, flickering light, drinking alcohol, eating disorders, eating certain foods (for example, nuts, citrus fruits). , chocolate, soy sauce, cheese, celery, Coca-Cola, etc.). In women, simple migraine can be caused by hormonal changes - ovulation and menstruation, taking hormonal contraceptives. Trigger factors for migraine are to a certain extent individual; over time, each patient knows his own set of similar triggers from experience.

Simple migraine, like other types of migraine paroxysms, is associated with such character traits as ambition and ambition, increased excitability. Patients are mostly strong-willed and strong people, but at the same time they are intolerant of the mistakes of others, which is why they are often irritated and dissatisfied.

The pathogenetic mechanisms of the development of migraine attacks are still the subject of study in clinical biochemistry and neurology. During an attack, changes are noted in the content of a number of substances - serotonin, histamine, catecholamines, prostaglandins, bradykinin. Today, the main role is played by serotonin. Studies have shown that at the onset of a migraine attack, there is a sharp release of serotonin from platelets, which is accompanied by constriction of cerebral vessels. Serotonin levels then decrease significantly. The effectiveness of serotonin metabolism regulators against migraine also emphasizes the importance of this neurotransmitter.

Other studies suggest a trigeminovascular mechanism for the development of simple migraine. The initial stimulation is the stimulation of the neurons of the trigeminal nerve nucleus located in the medulla oblongata, which provokes the release of neurotransmitters. The latter irritate trigeminal receptors and potentiate aseptic inflammation of the carotid artery wall. This explains the pain of the artery on palpation and swelling of the surrounding tissues.

Symptoms of simple migraine

Simple migraine is characterized by the sudden onset of cephalalgia without a preceding aura. In some cases, headaches are heralded by prodromal phenomena - decreased mood, drowsiness, decreased performance, nausea, yawning. Since cephalgia often extends to only half of the head, it is called hemicrania. Hemicrania is most often observed on the right side of the head. In some cases, cephalgia affects the second half of the head and is diffuse. The pain is accompanied by nausea of ​​varying intensity and repeated vomiting. Any movement increases the intensity of cephalgia. Increased sensitivity to sounds and light stimuli forces patients to isolate themselves from the outside world during a migraine attack (lock themselves in a room, curtain the windows, hide under a blanket, etc.).

A simple migraine can last from 4 hours to 2-3 days. Sometimes a migraine attack is accompanied by frequent urination, diarrhea, dizziness, nasal congestion, vegetative disorders (palpitations, sweating, a feeling of hot flashes, chills, a feeling of lack of air). The end of the paroxysm in half of the cases occurs with the patient's transition to a state of sleep. After a migraine attack, some fatigue and weakness may be observed; in some cases, on the contrary, increased physical and intellectual activity is noted.

Simple migraine in children is often diffuse or localized bitemporally and bifrontally. The attack usually does not last more than 1 day. The intensity of cephalalgia in children is often less than in adults. Nausea and repeated vomiting come to the fore. Cases have been described in which a migraine attack in a child was accompanied by fever and abdominal pain and was mistakenly interpreted as an intestinal infection.

Diagnosis of simple migraine

Simple migraine is diagnosed by a neurologist according to the following clinical criteria: a history of at least 5 migraine-like paroxysms, the duration of each of which is no shorter than 4 hours and no more than 3 days; cephalgia is characterized by at least 2 of the listed signs - it has medium and high intensity, pulsating, one-sided, becomes more intense with physical activity; there is at least 1 of the following accompanying symptoms - sound and photophobia, nausea and vomiting.

An important point is the differential diagnosis of migraine from serious cerebral diseases, such as meningitis, arachnoiditis, brain cyst, encephalitis, cerebral aneurysm, etc. Particular vigilance is required with the rapid development of a migraine attack, excessive intensity of cephalalgia or its unusual nature has not been observed before , the presence of rigidity of the muscles of the back of the head, an attack of loss of consciousness, convulsions, limitation of visual fields. To exclude organic cerebral pathology, a comprehensive neurological examination is carried out: electroencephalography, echoencephalography, REG, ultrasound of the vessels of the head, examination by an ophthalmologist with fundus examination and perimetry. According to indications, MRI of the brain and MRI of cerebral vessels are prescribed.

Treatment of simple migraine

Standard analgesics are ineffective in relieving migraine paroxysm. As a rule, dihydroergotamines (ergotamine, dihydroergotamine) or selective serotonin agonists - triptans (sumatriptan, rizatriptan, naratriptan, zolmitriptan, eletriptan) are used. With the gradual development of paroxysm, it is enough to take one of these drugs orally. However, due to reduced gastrointestinal motility, this method of administration may be ineffective. In such cases, the use of ergotamine in rectal suppositories, dihydroergotamine intramuscularly or intravenously, sumatriptan subcutaneously is recommended. The use of triptans is associated with frequent relapses of cephalalgia, since these drugs have a short half-life (only 2 hours). When cephalalgia recurs, it is often necessary to take the medication again, combining triptans with non-steroidal anti-inflammatory drugs (ibuprofen, nimesulide, diclofenac).

In some cases, simple migraine is relieved by endonasal administration of lidocaine, taking naproxen, and intramuscular administration of magnesium. Repeated vomiting is an indication for the use of antiemetics (metoclopramide, domperidone, ondansetron). With high intensity of cephalalgia and no improvement from the use of the above pharmaceuticals, they resort to the use of narcotic analgesics (tramadol, trimeperidine, codeine, fentanyl, nalbuphine). However, their use is possible no more than 2 times a week.

Unfortunately, at present, simple migraine does not have effective pharmacotherapy during the interictal period, which would significantly reduce the likelihood of a migraine attack. Neurologists use monoamine oxidase inhibitors, beta-blockers, tranquilizers, anticonvulsants, oxytriptan (a precursor to serotonin), etc. Some domestic studies have shown the effectiveness of long-term use of small doses of aspirin.

Since drug treatment is ineffective, great attention should be paid to the patient’s lifestyle and the exclusion of factors that provoke a migraine attack. This is a task that only the sickest person can solve. In addition to normalizing the daily routine and nutrition, this should include serious psychological work aimed at reducing demands on others and developing a more friendly attitude towards people. Psychological consultations, special trainings, and psychotherapy can play a supporting role in this.

Forecast

A simple migraine in itself is not a disease threatening the life or health of the patient. However, migraine attacks reduce the performance of patients, making it impossible for them to perform their work duties during the attack. In addition, some patients (for example, rescuers, doctors, workers in noisy workshops, cooks, etc.) are forced to change their profession because it is associated with migraine triggers. Unfortunately, according to statistics, only in 10% of cases doctors manage to achieve cessation of migraine paroxysms. On the other hand, there are numerous cases where patients themselves, by changing their lives, achieved recovery.

MIGRAINE- a disease whose dominant manifestation is repeated attacks of intense headaches. Hereditary predisposition plays an important role in the pathogenesis of migraine. For a long time, a migraine attack was associated with changes in vascular tone: narrowing of the intracerebral arteries and dilation of the arteries of the dura mater. It has now been established that these changes are secondary and may not be directly related to the symptoms of the disease. The leading role in the genesis of pain is played by the activation of neurons of the trigeminal nerve nucleus, and as a result, biologically active substances are released at their endings in the vascular wall, causing focal neurogenic inflammation and swelling of the vessels and the adjacent area of ​​the dura mater. And the activation of serotonergic neurons in the raphe nuclei plays an important role in the initiation of the attack and the genesis of the aura. Migraine is more common in women aged 25 - 55 years.

Clinically, there are 2 main forms: migraine without aura (simple migraine) and migraine with aura (classical migraine). In more than half of patients, a migraine attack is preceded by prodromal phenomena that begin several hours or days before the onset of the headache (depressed mood or euphoria, irritability or lethargy, drowsiness, sometimes sensitivity to light and sound, thirst, frequent urination, constipation, diarrhea). In a typical case, it is unilateral (hence the name - migraine, which comes from the term “hemicrania”), but in at least 40% of cases it is bilateral. The pain is usually very intense, pulsating in nature, localized in the frontotemporal region, and intensifies with physical activity. The attack most often begins in the morning. The pain gradually increases (over 30 minutes - 2 hours), after which it stabilizes and then slowly passes. The total duration of the attack averages about a day (with fluctuations from 4 to 72 hours). Almost always accompanied by other symptoms: anorexia, nausea, and less often vomiting. During an attack, there is increased sensitivity to light and sounds, so patients tend to find a dark, quiet room. In many patients, the cessation of an attack is facilitated by sleep or. After an attack, you often feel tired, irritable, and depressed, but some, on the contrary, note unusual freshness and euphoria.

Aura is the hallmark of classic migraine, accounting for about 20% of migraine cases. It is characterized by focal neurological symptoms that precede or accompany the headache. The aura usually develops within 5-20 minutes and lasts 10-30 (no more than 60) minutes. usually occurs no later than 60 minutes after the end of the aura. A typical aura is distinguished (visual, sensory, motor or aphasic). Most often, a visual aura is observed, manifested by flashes of light, moving flickering dots and luminous zigzags, sometimes reminiscent of the outlines of the bastions of a fortress, in the place of which a scotoma remains - a blind spot. Visual phenomena most often begin in the central region and gradually spread outward. An aura can be paresthesia and numbness in the hand, perioral area and half of the tongue, hemiparesis,.

Provoking factors include menstruation, stress (or, rather, its resolution), fatigue, sleep disturbance, weather changes, prolonged exposure to the sun, noise, and exposure to perfume. In some patients, the provoking factor is the ingestion of certain foods: chocolate, nuts, creams, yogurt, chicken liver, avocado, citrus fruits, bananas, canned (especially pickled) foods, pork, tea, coffee, sausages, alcohol (especially red wine) , pizza, cheese.

If focal symptoms persist after the headache ends, they speak of complicated migraine. Currently, two separate conditions are distinguished: migraine with a prolonged aura lasting from 1 hour to 1 week, and migraine infarction, in which focal symptoms persist for more than 1 week. In middle and old age, migraine attacks may manifest themselves only as an aura without headache (migraine equivalents).

Diagnosis is based solely on the history, revealing the characteristic features of headache and associated symptoms, prodromal symptoms, positive family history, pain relief after sleep, exacerbation due to menstruation, typical precipitating factors. The recurrence of attacks is a characteristic feature of migraine, so after the first attacks you should be careful - migraine-like pain may be a manifestation of the brain, sinusitis or glaucoma.

Treatment. During an attack, the patient should be placed in a quiet, darkened room, and a warm or cold compress should be applied, slightly squeezing the head. Some patients are helped by simple analgesics: 2 tablets of aspirin or paracetamol, taken when the first signs of an attack appear. Additionally, antiemetics are used to improve the absorption of analgesics - metoclopramide (Cerucal) 5-10 mg orally, domperidone (Motilium) 5-10 mg orally, pipolfen 25-50 mg, meterazine 5-10 mg. In case of vomiting, these drugs are administered rectally (in the form of suppositories) or parenterally.

If simple analgesics are ineffective, they resort to non-steroidal anti-inflammatory drugs (NSAIDs) or combination drugs containing barbiturates. enhances the effect of analgesics, improving their absorption, but with frequent attacks, when the daily dose of caffeine at least several times a week exceeds 300 - 500 mg (3 - 4 cups of coffee), it can worsen the condition, causing rebound or withdrawal headaches. The addition of codeine and barbiturates (drugs, pentalgin, solpadeine) increases effectiveness, but also increases side effects and creates the possibility of abuse. For migraine, various NSAIDs are effective, but ibuprofen (200 mg), (250 mg), (75 mg), (10 mg) is most often prescribed (usually take 2 tablets with the same dose repeated after 1 hour). NSAIDs can also be administered parenterally: aspirin (aspizol) 1000 mg intravenously, diclofenac (Voltaren) 75 mg and (toradol) 30 - 60 mg intramuscularly. In cases where these drugs are ineffective, ergotamine tartrate is used, usually in combination with caffeine, which improves its absorption (drugs caffeamine, cofergot, etc.). Usually start with 2 tablets (1 tablet contains 1 mg of ergotamine and 100 mg of caffeine), if necessary, the same dose is repeated after 1 hour. When using rectal suppositories, smaller doses are needed, since absorption occurs more completely. Start with 1/4 of a suppository (1 suppository contains 2 mg of ergotamine and 100 mg of caffeine); if ineffective, 1/2 of a suppository is administered after 1 hour. The maximum daily dose of ergotamine is 4 mg (it can be used no more than 1-2 times a week). Since it provokes nausea and vomiting, before taking it it is often necessary to administer an antiemetic (metoclopramide, aminazine or pipolfen). also causes abdominal pain, paresthesia in the distal extremities, and cramps. The drug is contraindicated in pregnancy, uncontrolled arterial hypertension, stenotic lesions of coronary, cerebral or peripheral vessels, sepsis, liver and kidney diseases. Effectively relieves migraine attacks and, which is administered parenterally (0.25-0.5 mg). The drug is also available in the form of an aerosol for nasal administration (dihydroergot). Sumatriptan (imigran), which is administered subcutaneously in a dose of 6 mg (the drug is available as an autoinjector) or 100 mg orally, is highly effective. If the effect is partial, the drug can be re-administered after 1 hour. The drug is contraindicated in coronary heart disease, basimirtic and hemiplegic migraine, and uncontrolled arterial hypertension. After administration, pain at the injection site, paresthesia in the distal extremities, hot flashes, and chest discomfort are possible. To relieve attacks, opioid drugs (Tramal), butorphanol (Stadol), 10-20 mg intramuscularly, must also be used in combination with antiemetics. For migraine status, in addition to the above medications, parenteral fluid administration is mandatory (especially with persistent vomiting), and the use of corticosteroids (dexamethasone 8-12 mg intravenously or intramuscularly, if necessary, again after 3 hours).

Preventive treatment consists primarily of eliminating provoking factors, including dietary ones. Equally important are regular meals, adequate sleep, reduced consumption of caffeine and alcohol, and dosed physical activity. The patient needs to be taught various relaxation techniques. Pharmacological treatment is indicated for frequent or severe attacks. The most commonly used drugs are beta blockers, calcium antagonists, NSAIDs (naproxen), and antidepressants (amitriptyline). If first-line drugs are ineffective, antiserotonin drugs (methysergide, cyproheptadine (peritol), sodium valproate) are used. In some cases, papaverine or high doses are effective.

What is migraine?

Migraine is a hereditary neurological disease that manifests itself as an increasingly pulsating headache that is not associated with injury, tumors or stroke. According to WHO statistics, migraine is the main cause of spontaneously occurring headaches after tension headaches and one of 19 diseases that most severely disrupt a person’s social adaptation. Loss of performance due to migraine can be so noticeable that the patient is considered disabled.

The financial costs of treating and diagnosing migraine are comparable to the financial costs of treating cardiovascular diseases. The doctor’s task in this case is to accurately establish a diagnosis, differentiate pain during migraine attacks from tension headaches, and select the optimal drug regimen, including nonspecific analgesics, triptans and beta-blockers. Constant observation by a doctor helps to develop a plan for stopping an attack in each individual case. The severity of the disease is determined by the frequency of attacks and their intensity. With a mild form of migraine, attacks occur several times a year, with severe ones - every day, but the most common form of the disease is in which migraine attacks occur from 2 to 8 times a month.

According to medical research, women are more likely to suffer from migraines, experiencing an average of 7 attacks per month versus 6 attacks in men, and the duration of attacks is 7.5 hours in women and 6.5 hours in men. The causes of an attack in women are changes in atmospheric pressure, air temperature and other climate changes, and in men - intense physical activity. The symptoms accompanying migraine also differ: women are more likely to experience nausea and impaired sense of smell, and men are more likely to experience photophobia and.

Precursors of migraine or prodrome are weakness, a feeling of unmotivated fatigue, inability to concentrate, disturbances in attention. After attacks, a postdrome is sometimes observed - drowsiness, weakness, pallor of the skin.

The nature of pain during migraine differs from other headaches - starting from the temple, throbbing and pressing pain gradually covers half of the head, spreading to the forehead and eyes.

One-sided pain can alternate from attack to attack, covering either the left or right side of the head or the occipital region.

With migraine, there is always one or more accompanying symptoms - photophobia, nausea, fear of sound, disturbances in smell, vision or attention.

In 10% of cases of migraine in women, it occurs during menstruation and lasts a day or two from its onset. Menstrual migraine affects one third of all women who have this disease.

Migraine in children usually has drowsiness as an accompanying symptom; attacks of pain go away after sleep. In men, migraines develop after heavy physical exertion; the pain intensifies when climbing stairs, while running or walking, or when lifting heavy objects.

Oral contraceptives and other drugs that affect hormonal balance, including hormone replacement therapy, can significantly increase the risk of an attack, in 80% of cases increasing its intensity.

Irritability, anxiety, fatigue, drowsiness, pale or red skin, anxiety and depression are symptoms associated with migraine that may or may not appear in each individual case.

The arteries in the temple area are tense and pulsating, pain and tension increase with movement, so patients suffer an attack in bed, in a quiet and dark room, to minimize the amount of external irritants.

Nausea and vomiting during migraine

Nausea is an important symptom that helps differentiate migraine pain from other types of pain. This symptom always accompanies attacks and is sometimes so severe that it leads to vomiting. At the same time, the patient’s condition is subjectively alleviated; he feels better for a few minutes. If vomiting does not bring relief, and the pain does not subside within several days, then this may be a sign of migraine status and requires hospital treatment.

Signs of migraine with aura

Migraine with aura has a clear structure of four stages, the duration and intensity of which varies from case to case:

Precursor phase. This stage is also called the prodrome phase. Patients can determine the approach of an attack by a set of symptoms that are different for everyone. The most common symptoms are drowsiness, fatigue, nervousness and inability to concentrate. In some, prodrome, on the contrary, manifests itself with increased activity, insomnia, and increased appetite. After this stage, an aura begins; if a migraine without an aura, then it usually has no warning signs.

Aura phase. The aura reflects the changes that occur in the brain before the onset of an attack. Appears in only a third of all migraine cases; even in one patient, the aura can occur from attack to attack and does not always resolve in the same way. Its symptoms are not painful, but can cause concern for the patient, especially if this happens for the first time. Thus, the visual aura - spots before the eyes, zigzag patterns that distort the picture, fog and blurred outlines of objects, the inability to accurately determine their size and ratio - can cause anxiety in a person and fear for vision. Distortions of tactile, sound, and olfactory sensations are also characteristic of the aura stage. There may be a feeling of numbness and tingling in the extremities, usually starting from the fingers and gradually moving up to the head, affecting the face and cheeks. In this case, numbness concerns only one half of the body - the one opposite to the localization of pain. If during a migraine attack the pain covers the left side of the head, then at the aura stage the right side of the body goes numb. A person may experience problems with attention and concentration, making it difficult for them to carry out daily activities, work, and sometimes even speak. The duration of the stage is from 10 minutes to half an hour; in some cases, the aura can last even several hours.

Pain phase of migraine– the most difficult phase for the patient, which lasts from several hours to two to three days. The onset of pain can be rapid in ten minutes, or it can go away gradually over several hours. To reduce the intensity of pain and alleviate the patient's condition at this stage, he needs to remain in a horizontal position, limit mobility as much as possible, wrap his head in a cold towel, and avoid light and loud sounds. To relieve a migraine attack, the attending physician prescribes medications - analgesics or triptans, which should be taken at the beginning of the pain stage.

Period after the attack also called the period of resolution - the patient experiences sensations reminiscent of the prodrome phase - nervousness and irritability, weakness, fatigue, weakness in the limbs. Usually all these symptoms go away within 24 hours; it is best to spend this time sleeping.

With increased intensity of attacks, their continuous succession one after another with short intervals of relief, migraine status is diagnosed. It is characterized by symptoms such as slow heart rate, irritation of the meninges, and constant vomiting without the slightest reduction in pain intensity. In this state, a person completely loses his ability to work and must be hospitalized under the supervision of a doctor.

A unilateral headache, occurring from time to time or present constantly, not associated with migraine requires immediate examination by a specialist. Such pain is characteristic of organic brain lesions, and early diagnosis will ensure effective treatment.

Migraine is a neurological disease, so its cause can be pathologies such as:

Muscle spasms of the head and neck;

How does migraine occur and what contributes to its development:

Migraine pain occurs as a result of vascular pathology, in which the cerebral vessels of the dura mater dilate.

By expanding unevenly, these vessels put pressure on the nerve cells next to which they are located.

After vasoconstriction occurs, blood circulation in nearby tissues is disrupted, which can also cause pain.

Systemic diseases, metabolic disorders or central nervous system pathologies can also trigger the development of migraine.

70% of migraine patients have a hereditary predisposition to this disease, parents with a similar pathology.

The mechanism of development of pain during migraine is not fully understood; there are several theories on this matter.

Serotonin as a cause of migraines

Serotonin is a neurotransmitter that causes vasoconstriction and is necessary for the proper transmission of nerve impulses. With a sharp increase in serotonin levels, a spasm of intracranial vessels occurs in the area in which migraine pain is subsequently felt. There are no pain receptors in these vessels, but when a large amount of serotonin is released, the body produces substances that break it down. As a result, their tone is normalized, but the superficial arteries of the temporal region, in which there are pain receptors, expand. When blood flow slows down and blood vessels dilate, pain impulses are generated, which is the cause of pain.

The attack passes as soon as serotonin levels return to normal. According to the serotonin theory of pain, an important role in this process is played by the activity of the trigeminovascular system, which is responsible for the release of pain neuropeptides. This explains why migraine attacks usually occur in people whose cerebral cortex is characterized by increased excitability.

Hypothalamus and migraine

The hypothalamus provides regulation of the endocrine system; the centers of hunger, thirst, and vascular tone are located in this part of the brain. Therefore, paroxysmal migraine headaches are associated with the hypothalamus and come as a reaction to external stimuli.

According to modern research, migraine attacks occur when the level of activity of the hypothalamus is increased. Based on this discovery, it may be possible to develop more effective drugs to treat migraine in the future.

Migraine provocateurs

Nutritional factors. A migraine attack can be triggered by substances contained in food or by the diet itself. Alcohol, even mild alcohol like wine, champagne or beer, can cause migraines. It is also recommended to avoid products with flavoring additives, MSG, aspartame and caffeine. Caffeine, or the lack thereof, is a risk factor for migraines. Thus, a person who is accustomed to drinking a lot of coffee or caffeine-containing products may develop a migraine attack if the amount of caffeine entering the body sharply decreases. Blue cheeses, chocolate, citrus fruits, cocoa, and nuts on the menu can cause a similar reaction due to the content of phenylethamine and tyramine.

Other provoking substances that enter the body from food:

However, more often the mechanism of migraine development is influenced not by food, but by the frequency and quantity of its intake. So, an attack can occur against the background of a strict diet or when skipping a meal, such as breakfast.

Hormonal factors. This primarily concerns menstrual migraine, which is widespread among women. The development of an attack is influenced by fluctuations in the level of estrogen in the blood. It can be triggered by hormone replacement therapy drugs used to treat diseases of the reproductive system, oral contraceptives, as well as ovulation or menstruation.

Environmental factors. Changes in seasons, fluctuations in temperature, pressure, humidity, heat or frost, and dry indoor air can act as provocateurs. The same goes for noise, unexpectedly loud sounds, bright flashing lights or fluorescent lighting that irritates the visual receptors.

Sleeping mode. This is especially true for sleep migraines - an attack can develop both against the background of lack of sleep and when oversleeping. Going to bed late or waking up late, jet lag, sleepless nights - all these factors can contribute to the onset of migraines.

Internal factors. Migraine attacks can occur due to chronic pain in the spine as a result of cervical osteochondrosis. In addition, internal provocateurs can be a lack of magnesium and iron in the body, sudden changes in blood glucose levels, and anemia.

Taking medications. In addition to hormonal drugs, reserpine, nitroglycerin, ranitidine, hydralazine, and histamine in drugs can cause migraine.

Psychophysiological factors. Emotional overload, prolonged tension, sudden relaxation after a stressful situation, nervous breakdowns, anxiety and attacks of fear, suppression of emotions, both negative and positive. Psychophysiological provocateurs cause migraines in ambitious people, perfectionists with high demands on themselves.

Other factors. Injuries and damage to the skull, excessive physical activity, including sexual activity, overwork, sudden change of environment due to moving.

The following types of migraine are known in clinical practice:

Panic – this migraine is characterized by symptoms such as suffocation, chills, rapid heartbeat, and swelling of the face.

Chronic migraine– characterized by the regularity of attacks with an increasing intensity of pain with each subsequent one. Chronic migraine can be diagnosed if attacks repeat for three months, 15 times a month.

Menstrual migraine– migraine attacks are dependent on the level of estrogen in the blood, so they appear depending on the cycle.

Sleep migraine - its manifestation depends on the person’s sleep pattern, usually occurs after waking up or during sleep.

Symptoms of aura during migraine:

Speech impairments (reversible) – it is impossible to pronounce a sentence or formulate a thought;

Visual aura – spots, dots, stripes, fog before the eyes, blurry outlines of objects;

Numbness, tingling in the limbs, disturbances in tactile sensations.

Headache occurs an hour or less after the aura or together with it, intensifies with walking and other physical activity, is unilateral and is accompanied by nausea, phonophobia, and photophobia. The attack lasts from four hours to three days.

Diagnosis of migraine

Migraine treatment should be carried out only after diagnosis, since without a correct diagnosis, self-medication can be dangerous, causing complications in the form of drug-induced pain.

To make a diagnosis, a specialist needs data on the frequency and duration of the attack, anamnesis and clinical picture of the disease. In difficult cases, the doctor may require an MRI of the cervical spine and brain, and rheoencephalography data.

When making a diagnosis, it is necessary to distinguish episodic tension pain from attacks of throbbing headaches during migraine attacks.

How to distinguish tension pain from migraine headache:

Less intensity

The nature of the pain is pressing and squeezing the head like a hoop, rather than pulsating

Two-way character

Does not increase with physical activity

Tension headaches are provoked by factors such as constant emotional stress, stress, prolonged exposure to an uncomfortable position, which impairs blood circulation in the head. This type of headache is also characterized by light and photophobia, nausea, as with migraine.

Many properties of the nootropic drug Cortexin provide grounds for its use in people with migraine. Moreover, both for emergency relief of an attack and for prevention. According to numerous researchers, by reducing the level of serotonin in the blood, Cortexin causes the effect of relaxing excessive pulsation of blood vessels, which is a characteristic symptom of migraine. In addition, the drug Cortexin has the following actions:

Neurotropic – improves cognitive functions (memory, attention, thinking).

Neuroprotective - protects neurons from damage by toxic factors.

Antioxidant - increases the survival of neurons under conditions of stress and lack of oxygen.

Tissue-specific - helps improve the functions of the cerebral cortex and the general tone of the nervous system.

The drug is administered by injection. The course of treatment is usually 10 days.

In the treatment of migraine, two approaches are used - the first is aimed at stopping the attack and alleviating the patient’s condition, the second approach is aimed at preventing relapse.

Migraine is a periodic attack of headache of medium and high intensity, intensifying even with minimal physical activity, bright light, or loud sound. During an attack, a person may become unable to work, so symptoms must be eliminated at the first manifestations.

For moderate headaches, when it is necessary to relieve the pain quickly, fast-acting drugs are prescribed: Dialrapid, Amigrenin, Summamigren and others. For example, Dialrapid begins to act 15-20 minutes after administration, which is comparable to injectable dosage forms and faster than tablets.

Dialrapid is an ideal option for the treatment of migraines, since its composition allows you to relieve pain in the first half hour, even in the acute phase. Patented technology based on the interaction of potassium bicarbonate and potassium diclofenac helps achieve truly high results. Diclofenac potassium dissolves in water better than diclofenac sodium, and potassium bicarbonate creates a microenvironment around the active substance, which promotes accelerated absorption and helps the drug to be completely absorbed by the body. A pronounced effect occurs within the first 5 minutes after using the drug, and the high peak plasma concentration is comparable to injectable analogues.

The most modern drugs against migraine were synthesized 20 years ago; they are derivatives of serotonin and have a complex effect:

Trigeminal nerve – decreased sensitivity, analgesic effect;

Cerebral vessels - reduce the pulsation of brain vessels, which provokes pain, without affecting other vessels;

Receptors and pain neuropeptides - reduce the amount of neuropeptides, thereby eliminating pain.

A migraine attack with aura can be relieved by immediately taking Papazol. A hyperbaric chamber, a hot or cold bath, individually for each case, helps to alleviate the patient’s condition.

How to quickly relieve a migraine attack?

A combination of painkillers, antiemetics and non-steroidal anti-inflammatory drugs can stop an attack in 40% of cases.

Zolmitriptan - taken in a dosage of 2.5 mg, has a high rate of analgesic action.

Sumatriptan - acts four hours after administration, works effectively in 80% of cases. For severe attacks accompanied by vomiting, it is administered subcutaneously. For rapid onset of effect, apply in the form of a spray.

Naratriptan at a dosage of 2.5 mg reduces the likelihood of relapse and has few side effects.

Ergotamine is rarely used; triptans are more often used.

Migraine prevention

Metoprolol, timolol and other beta blockers are used for the prevention of attacks, with restrictions for patients with heart failure or bronchial asthma.

Sodium valproate and pizotifen may cause drowsiness and weight gain, which is why their use is limited.

Aspirin is rarely used for migraine prevention because there is no approved dosage.

Amitriptyline helps relieve pain during a migraine attack caused by.

General rules for migraines

The destructive effect of alcohol and nicotine on the vascular system can trigger a migraine attack and increase the intensity of pain. Therefore, an important condition for migraine prevention is giving up bad habits.

Energy drinks, coffee and other foods with high caffeine content should be excluded from the diet. Caffeine has a stimulating effect on the body, which provokes a person to perform greater loads than he is normally capable of.

Maintain a sleep schedule so that the body’s rest and regeneration processes take place more intensively. The most important period is considered to be from 20:00 to midnight; it must be spent in sleep. If a person is awake until 3:00 or longer, the consumption of his energy resources increases noticeably, and the body not only does not recover, but is also depleted.

Eliminate from your diet foods that promote development - fast food, smoked foods, foods with preservatives, flavors and flavorings. Their use not only provokes diseases of the cardiovascular system, but can also cause an attack.

Light physical activity and walks in the fresh air train the body, make it more resistant to stress and reduce the likelihood of an attack.

Regulate the intensity of mental activity, do not overload the body and avoid emotional stress and nervous breakdowns to minimize the likelihood of an attack.

There are contraindications. It is necessary to consult a specialist.

Education: In 2005, she completed an internship at the First Moscow State Medical University named after I.M. Sechenov and received a diploma in the specialty “Neurology”. In 2009, she completed her postgraduate studies in the specialty “Nervous Diseases”.

Migraine is a neurological disease that manifests itself as intense headache predominantly on one side. The disease is accompanied by autonomic disorders or so-called aura. Typically, an aura is manifested by visual disturbances, nausea and vomiting, and photophobia.

An attack of hemicrania can be caused by various factors: depression, fatigue, strong smells or sounds, changes in atmospheric pressure. Some food products, such as smoked meats, red wine, chocolate, and cheese, can act as a provocateur.

Many people know how migraine manifests itself, but not everyone understands the pathogenesis of the disease. Most scientists are unanimous in the opinion that the main site of pain development is the blood vessels of the brain.

Therefore, it is obvious that the aura accompanying painful attacks is a consequence of vascular spasm and the development of cerebral ischemia. Cases of manifestations of focal neurological symptoms (dizziness, loss of consciousness, tremors of the extremities) may indicate the development of serious pathologies that require immediate treatment.

Causes of neurological symptoms

Vertebral artery syndrome and cervical osteochondrosis

Migraine with focal neurological symptoms can be caused by VA (vertebral artery) syndrome. The vertebral arteries (right and left) are located along the spinal column and pass through the canals formed by the transverse processes of the cervical vertebrae. At the base of the brain stem, the vessels merge into an artery, which branches out and supplies the cerebral hemispheres with blood.

The cause of pathological processes can be cervical osteochondrosis. Degenerative changes in the vertebrae and their spinous processes lead to compression of the spinal nerves, arteries and veins that supply blood to the brain. The neurological manifestation of osteochondrosis is the occurrence of vertebrobasilar insufficiency, manifested by the following symptoms:

• Nausea and vomiting;
• Decreased vision and hearing;
• Dizziness;
• Impaired coordination of movements;
• Loss of consciousness;
• Temporary amnesia;
• Partial or complete paresis of the limbs.

The patient may experience intense pain, starting in the area of ​​the occipital part of the head and the seventh vertebra, spreading to the parietal region, to the forehead, temple, ear and eyes. When you turn your head, you may feel a strong crunching and burning sensation in the neck area - the so-called cervical migraine.

Neurological headaches are usually caused by excessive compression of the occipital and facial nerves and have an intense shooting character. Painful sensations spread along the location of the nerves and are characterized by duration and constancy, lack of proper effect from the prescribed treatment.

Seizures can significantly limit performance and disrupt the usual rhythm of life. There are several types of migraine with focal neurological symptoms: facial, pharyngeal, hemiplegic.

Pharyngeal migraine

Much less often, specialists diagnose pharyngeal migraine. Pharyngeal migraine occurs as a result of damage to the sympathetic weave of the vertebral artery and is accompanied by sensations of a foreign body in the throat and a violation of the swallowing reflex.

In other cases, paresthesia (numbness, loss of sensitivity, tingling, crawling) and one-sided painful sensations involving the pharynx, hard palate, and tongue may occur. Chills, increased sweating, and spots in the eyes are also observed.

Any turn of the neck or change in head position leads to an increase in pain attacks. If you can find the optimal position of the head, the headache may weaken and disappear completely.

Facial migraine

Facial migraine is diagnosed as trigeminal neuralgia and is accompanied by neurotic reactions: strong excitement or vice versa, emotional numbness, aggression, hysterical state.

Shooting pain radiates to the area of ​​the lower jaw or neck, sometimes to the area around the eyes. The attacks are difficult to stop and can recur several times a week, accompanied by accompanying pain in a certain part of the head.

Facial migraine with focal neurological symptoms can recur systematically. Cold wind or just communication is enough to cause unpleasant sensations.

A characteristic symptom of the disease is the presence of so-called trigger points, careless touching of which can trigger the onset of an attack. In the area of ​​the carotid artery, pulsation increases, swelling and redness are visualized, and touching it is painful.

Hemiplegic migraine

To establish a diagnosis, the doctor conducts a thorough medical history and prescribes a set of examinations to exclude other causes of attacks. Treatment of hemiplegic migraine consists of a complex of drugs and measures used for other types of the disease, and depends on the severity of the condition and the individual data of the patient.

Hemiplegic migraine can be divided into two forms: a disease without complications and a disease complicated by neurological manifestations with paresis of one half of the body. The disease can be considered as a hereditary autoimmune disease.

This is a rare, severe form of hemicrania, characterized by attacks of headache with central paresis, temporary impairment of speech and sensitivity.

Paresis is manifested by difficulty in motor activity of the fingers, followed by spread to the corresponding side of the body and an increase in throbbing headache.

Such disorders can only in very rare cases reach the level of paralysis.

Unlike classic migraine, accompanied by aura, the first symptoms of hemiplegic hemicrania are paresthesia and headache, which are subsequently joined by reversible neurological symptoms: dizziness, double vision, short-term amnesia, fever, speech disorders.

In some cases, symptoms may be complicated by epileptic seizures.

Treatment, diagnosis

Migraine with focal neurological symptoms is difficult to treat and requires an integrated approach. The choice of methods and drugs depends on the origin of the migraine.

Diagnosis is based on collecting anamnesis and identifying characteristic complaints. In addition to collecting anamnesis, the specialist must conduct additional high-tech studies:

1. X-ray of the cervical or lumbar spine.
2. Dopplerography of the vessels supplying the brain.
3. MRI of the spine.
4. Blood test for cholesterol and lipids.

Neurologists treat hemicrania with focal neurological symptoms. If measures are started on time, then pain attacks can be quickly stopped or significantly minimized.

As a rule, treatment includes the use of ointments with active anti-inflammatory and analgesic components, medications that promote the regeneration of cartilage tissue, as well as:

• Medicines that improve blood circulation, such as cinnarizine;
• Anti-inflammatory and painkillers: nurofen, diclofenac, indomethacin nimesulide;
• B vitamins;
• Antispasmodics;
• Neuroprotectors to protect the brain from hypoxia;
• Triptan drugs: Sumatriptan, Sumamigren, Imigran spray;
• Antidepressants - Cymbalta, Velafax;
• Anticonvulsants.

Prevention

To correct the disease, consultation with a neurologist and comprehensive treatment are necessary. It is necessary to understand that therapeutic measures are intended only to relieve pain and relieve inflammation.

In order for the disease to bother you, you need to avoid stress as little as possible, lead a healthy lifestyle: play sports, take walks in the fresh air, eat a balanced diet.

Non-drug methods will help control the situation. Manual therapy, acupuncture massage, yoga classes are excellent disease prevention. It is very important to know the first manifestations of an attack and be able to stop them in time.

If the correct treatment is selected, then manifestations of migraine with focal neurological symptoms have a favorable prognosis - a decrease in the number of attacks and their intensity.

Migraine is a chronic neurological disease characterized by recurrent severe headaches. A distinctive feature is that most often the pain spreads only to one half of the head. This is a very common problem. It is found in 10% of people. Attacks can occur rarely - several times a year, but in most patients they occur 1-2 times a week.

The fair half of humanity often suffers from attacks of severe headaches. But many men also face this problem. Another name for migraine is the disease of aristocrats. It is believed that headaches occur more often in people who engage in mental work.

What it is?

Migraine is a neurological disease, the most common and characteristic symptom of which is episodic or regular severe and painful attacks of headache in one (rarely in both) half of the head.

In this case, there are no serious head injuries, stroke, or brain tumors, and the intensity and pulsating nature of the pain is associated with vascular headache, and not with tension headache. Migraine headache is not associated with an increase or a sharp decrease in blood pressure, an attack of glaucoma, or an increase in intracranial pressure (ICP).

The very first symptoms that resemble migraines were described by ancient healers from the time of the Sumerian civilization even before the birth of Christ in 3000 BC. A little later (around 400 AD), Hippocrates identified migraine as a disease and described its symptoms. However, migraine owes its name to the ancient Roman physician Claudius Galen. In addition, he was the first to identify a feature of migraine - the localization of pain in one half of the head.

It is noteworthy that migraines often become the companion of geniuses. This disease, like no other, “loves” active and emotional people who give preference to mental work. For example, such outstanding personalities as Pontius Pilate, Pyotr Tchaikovsky, Edgar Allan Poe, Karl Marx, Anton Pavlovich Chekhov, Julius Caesar, Sigmund Freud, Darwin, Newton suffered from it. Modern celebrities have not escaped migraines either. Suffering from headache attacks, such famous personalities as Whoopi Goldberg, Janet Jackson, Ben Affleck and others live and work.

Another interesting fact (though it has not been scientifically proven): migraines are more likely to affect people who strive for perfection. Such individuals are ambitious and ambitious, their brains are constantly working. It’s not enough for them to do everything perfectly, they have to be the best. Therefore, they are very responsible and conscientious about everything, they work “for themselves and for that guy.” Essentially, they are workaholics.

The mechanism of development of migraine headaches

As you know, migraine is a special type of headache, the mechanism of development of which is unique and unlike any other. Therefore, most headache medications are ineffective for migraines.

A migraine attack occurs in several successive phases:

1. Spasm of the arterial vessels of the brain and the development of short-term hypoxia of the brain. It is with this phase that the development of migraine aura is associated.
2. Then comes dilatation, or expansion, of all types of brain vessels (arteries, veins, venules, arterioles and capillaries). At this stage, a typical throbbing headache develops.
3. Swelling of the walls of blood vessels and the perivascular space develops, which makes them rigid to signals for reverse narrowing. This phenomenon determines the duration of migraine headaches.
4. The last stage is characterized by the reverse development of migraine and is also called post-migraine syndrome. For some time after the pain stops, the patient may complain of general weakness, fatigue, and a feeling of “staleness” in the head.

Despite the available data on the nature of migraine headaches, new information appears every day, as this problem is actively studied by scientists around the world. For example, according to recent medical publications, the hypothalamus of the brain plays a significant role in the pathogenesis of migraine, and this provides new opportunities for the invention of effective drugs for the treatment and prevention of migraine.

Causes of migraine

One of the mysteries is the causes of migraines. Based on many years of observations, it was possible to establish some patterns of the occurrence of attacks.

Migraines affect both men and women, but they occur twice as often in women as in men. There is a dependence of the incidence of the disease on lifestyle, so it has been established that people who are most susceptible to migraines are socially active and ambitious people, people in professions that require high mental activity, as well as housewives. Cases of migraine are extremely rare among people in working professions whose activities involve constant physical activity.

People suffering from it attribute many factors to the causes of migraine, but in fact, their direct influence on the development of the attack could not be established, so such factors can only be considered predisposing, or a “trigger moment” that is triggered when the true cause of the disease appears. Causes of migraine include:

• Some types of products: hard aged cheeses, red wine, chocolate, fish of the mackerel family, smoked meats, coffee;
• Stress or experienced psycho-emotional arousal.;
• Certain types of medications, such as oral contraceptives;
• Sudden changes in weather (weather-dependent form of migraine);
• Strong physical activity;
• Premenstrual syndrome.

Typically, experienced patients know what exactly provokes a migraine attack in them, and they try to exclude the influence of this factor, thus they manage to reduce the frequency of attacks, but not get rid of them completely.

Classification

Depending on the symptoms of migraine, the disease is divided into the following types:

• hemiplegic (the ability to perform an action with a hand or foot is lost);
• migraine status (lasts more than one day).
• retinal (affects half of the head and the eye area, a sharp decrease in vision is possible);
• basilar (occurs in young women, fraught with cerebral infarction in the absence of adequate treatment);
• ophthalmological (affects the visual organs, drooping of the eyelid occurs, loss of visual function);
• abdominal (often found in children and young men, accompanied by cramps and abdominal pain);

In medical practice, there are also concepts of migraine with and without aura.

Without an aura, the patient experiences frequent headache attacks that can last from four hours to three days in a row. Pain sensations are fixed in a specific part of the head (at a point). The pain intensifies with physical activity, as well as intense mental activity.

Aura is accompanied by a large number of complex, sometimes mixed symptoms that occur long before the attack or immediately with its onset.

Migraine symptoms

The most basic symptoms of migraine in women and men are throbbing, paroxysmal pain in half the head, lasting from 4 to 72 hours. When bending over, the pain intensifies - this is due to excessive expansion of the blood vessels.

A migraine attack may be preceded by an aura - various neurological symptoms: vestibular, motor, sensory, auditory, visual. Visual aura occurs more often than others when a person sees many bright flashes in the left or right field of vision, fragments of the visual field fall out or objects are distorted.

So, the main signs of migraine are as follows:

1. Precursors of migraine are weakness, a feeling of unmotivated fatigue, inability to concentrate, and attention problems. After attacks, a postdrome is sometimes observed - drowsiness, weakness, pallor of the skin.
2. Nausea is an important symptom that helps differentiate migraine pain from other types of pain. This symptom always accompanies attacks and is sometimes so severe that it leads to vomiting. At the same time, the patient’s condition is subjectively alleviated; he feels better for a few minutes. If vomiting does not bring relief, and the pain does not subside within several days, then this may be a sign of migraine status and requires hospital treatment.
3. The nature of pain during migraine differs from other headaches - starting from the temple, throbbing and pressing pain gradually covers half of the head, spreading to the forehead and eyes.
4. In 10% of cases of migraine in women, it occurs during menstruation and lasts a day or two from its onset. Menstrual migraine affects one third of all women who have this disease.
5. With migraine, there is always one or more accompanying symptoms - photophobia, nausea, vomiting, fear of sound, disturbances in smell, vision or attention.
6. Oral contraceptives and other drugs that affect hormonal balance, including hormone replacement therapy, can significantly increase the risk of an attack, in 80% of cases increasing its intensity.
7. The arteries in the temple area are tense and pulsating, pain and tension increase with movement, so patients endure the principle in bed, in a quiet and dark room, to minimize the amount of external irritants.
8. Irritability, anxiety, fatigue, drowsiness, pale or red skin, anxiety and depression are symptoms associated with migraine that may or may not appear in each individual case.
9. One-sided pain can alternate from attack to attack, covering either the left or right side of the head or the occipital region.

According to medical research, women are more likely to suffer from migraines, experiencing an average of 7 attacks per month versus 6 attacks in men, and the duration of attacks is 7.5 hours in women and 6.5 hours in men. The causes of an attack in women are changes in atmospheric pressure, air temperature and other climate changes, and in men - intense physical activity. The symptoms accompanying migraines also differ: women are more likely to experience nausea and impaired sense of smell, and men are more likely to experience photophobia and depression.

How to relieve pain at home?

With minor manifestations of migraine, pain from an attack can be relieved without medication, for which you need to:

• allowing yourself to “sleep”;
• cold and hot shower;
• facial gymnastics;
• washing head;
• head and neck massage;
• acupuncture;
• yoga classes;
• homeopathy.

The simplest home remedy for migraine relief is over-the-counter analgesic tablets containing Ibuprofen, Nurofen, Aspirin, Paracetamol (the latter is the least effective), acting faster and stronger in the form of “effervescent” forms.

To reduce the symptoms of nausea or vomiting, you can use antiemetics, including in the form of rectal suppositories. Antiemetic drugs, promoting the absorption of analgesics from the gastrointestinal tract, enhance their effect.

How to treat migraine?

At home, migraine treatment involves 2 main directions - stopping an attack that has already developed, and preventing the occurrence of attacks in the future.

Stopping an attack. Only a neurologist can prescribe any pain relief during a migraine attack; it depends on the intensity and duration. If the attack is of moderate or mild severity and lasts no more than 2 days, then the doctor prescribes simple analgesics, possibly combined.

1. Combination drugs containing codeine, paracetamol, phenobarbetal and metamizole sodium.
2. NSAIDs (ibuprofen), paracetamol (contraindicated in kidney and liver pathologies), acetylsalicylic acid (cannot be taken if you are prone to bleeding or have gastrointestinal diseases).
3. If the intensity of the pain is high, the duration of attacks is more than 2 days, then Triptans for migraine are prescribed (list of all modern triptans, prices, how to take them correctly). They are available in suppositories, solutions, sprays, and infections.
4. Non-selective agonists - Ergotamine, etc.
5. Auxiliary psychotropic drugs - domperidone, metoclopramide, chlorpromazine.

Triptans are drugs developed 20 years ago and are derivatives of serotonin. They act in several directions at once:

1. Triptans act selectively on blood vessels, reducing painful pulsation only in the brain, without affecting the rest of the body's vascular system.
2. They act only on special producing substances (receptors) that provoke the appearance of pain, their number is reduced and the pain goes away.
3. They have a pronounced analgesic effect, reducing the sensitivity of the trigeminal nerve.

For the classic version of migraine with aura, Papazol taken in the first minutes can help. For some, a hot bath helps, for others, exposure to cold, for others, a pressure chamber alleviates the condition.

Experimental treatments for migraine

Experimental methods include treatment using hypnosis, electronic devices, and a special adhesive plaster. However, there is no evidence of their effectiveness and more research is needed.

Due to the disruption of cellular metabolism and activation of lipid peroxidation that occurs in the pathogenesis of migraine, along with conventional drug treatment, the prescription of antioxidants and metabolic drugs that improve energy processes in cells and protect them from damage by free radicals (a combination of vitamins A, E, C, coenzyme Q10, antioxycaps, emoxypin).

For example, a study was recently published that involved 1,550 children and adolescents suffering from frequent migraine attacks. It showed that a number of patients had low plasma levels of coenzyme Q10, and that the recommendation of dietary supplements containing coenzyme Q10 may lead to an improvement in some clinical signs. The authors concluded that to confirm such observations, analyzes with more scientifically sound methodology are required.

In another study of 42 patients, the authors compared the effectiveness of CoQ10 (300 mg/day) and placebo: CoQ10 was significantly more effective than placebo in reducing the frequency of migraine attacks, the duration of headache attacks, and the duration of nausea attacks after 3 months of treatment. The authors evaluate CoQ10 as an effective and well-tolerated means of preventing migraine manifestations.

A team of plastic surgeons at University Hospitals of Cleveland has been working for about a decade on the hypothesis that in some cases, the cause of recurrent headaches and migraines is irritation of the trigeminal nerve caused by spasm of the muscles around it. Studies have been published confirming that headaches are reduced or eliminated by Botox injections and surgical removal of the associated muscles.

Alternative Migraine Treatments

Other ways to treat this disease:

1. Biofeedback. This is a special type of relaxation using special equipment. During the procedure, a person learns to control physiological responses to various influences, for example, stress.
2. Acupuncture. Studies have shown that this procedure helps cope with headaches of various origins, including migraine. But acupuncture is effective and safe only if it is performed by a certified specialist using special sterile needles.
3. Cognitive behavioral therapy. Helps some people with migraines.
4. Massage. An effective preventive measure that helps make migraine attacks less frequent.
5. Herbs, vitamins, minerals, dietary supplements. Such remedies as butterbur herb, feverfew, high doses of riboflavin (vitamin B2), coenzyme Q10, and magnesium help prevent and make migraine attacks less frequent. But before using them, you should definitely consult your doctor.

Preventing migraine attacks

1. Follow your diet and nutrition regimen, do not rush during meals and do not snack on the go.
2. Practice sleep hygiene, the duration of which should be 7-8 hours, where the daytime “quiet hour” should be completely abolished. You need to go to bed in a calm, non-irritable state at the same time (but not too early); it would also be good to get up at the same time.
3. Reduce stressful situations to a minimum, always have harmless means of dealing with them at hand (valerian tablets, etc.), and also do not forget that in other cases it is advisable to seek the help of a psychotherapist who will help you learn to control your behavior.
4. Do not get carried away with alcohol, nicotine and coffee, but if you can afford no more than two cups of your favorite coffee drink a day (in the first half of the day), then you should avoid alcohol and tobacco products altogether.
5. Under no circumstances should you ignore the use of preventive anti-migraine medications prescribed by your doctor. They should also always be at hand.
6. It is a good idea to periodically undergo sanatorium-resort treatment or treatment at a local dispensary, where you can receive non-drug preventive measures (physiotherapy, neck massage, acupuncture).

We must agree that fighting migraines is difficult, but possible. Usually disciplined patients know everything about their illness and in most cases cope, although, of course, you cannot envy them; you need to be on guard all the time. “The one who walks will master the road!” - said the ancients.

Forecast

With competent and comprehensive therapy, the prognosis for this disease is encouraging. The presence of the disease can be evidence of the development of serious ailments, including cancer, abscess, inflammation of the brain, encephalitis, vascular aneurysms, hydrocephalus, etc.

The risk group of people who may experience migraines includes residents of large cities who lead a dynamic lifestyle and neglect rest, girls and women over the age of 20 (especially during menstruation), as well as people with a genetic predisposition to migraines.

For correct diagnosis and optimal treatment, you need to seek help from a neurologist. Only an experienced doctor will be able to distinguish the signs of migraine from other syndromes with similar symptoms, and also recommend step-by-step, effective therapy.