Do you understand migraine?
There are various misconceptions about migraine among the public. Some patients believe that migraine is only a headache that occurs on one side of the head, but not a disease; some patients are convinced that the headache must be due to insufficient blood supply to the brain or a tumor, so they go around for medical examination but get nothing; some patients believe that the headache cannot be cured, so they simply do not receive treatment and let the disease torment them; there are also some patients who blindly purchase over-the-counter pain medications, or even use narcotic drugs for a long time, which complicates the condition or causes drug addiction. There are also some patients who blindly purchase over-the-counter pain medications and even use narcotic pain medications for a long time, which complicates the condition or causes drug addiction.
In fact, migraine is a common disease. It affects about 1 in 10 people and is therefore listed by the World Health Organization as one of the top 20 lifelong disorders that seriously affect human life and work. In addition, women are about twice as likely as men to suffer from migraines.
Migraine is mainly characterized by episodic headaches. The number of attacks per year is about 13 per capita, and in women the attacks often coincide with menstrual periods. Each attack can last from 4 hours to 2 days, but usually lasts more than 10 hours. The main manifestations are as follows.
1. Severe throbbing headache. When you touch your own pulse with your hand, you can feel the head throbbing pain one after another with the rhythm of arterial pulsation. Most of the pain is located on one side of the head, but it can also manifest as bilateral headache. Some patients think that migraine must be a unilateral headache because of the misunderstanding of the name of the disease.
2. Hypersensitivity to strong light, loud and sharp noises, and some smells, often wanting to be alone in a quiet, dark place.
3.Nausea and vomiting.
4.The headache will be aggravated when walking, especially when going up and down stairs.
5.Some patients may have visual abnormalities before or during an attack, such as flashes of light, jagged patterns, or dark spots in the visual field. Visual abnormalities that occur before a headache attack are called migraine “aura”.
On days when the attack does not occur, the patient tends to go on as usual. Patients with these symptoms may be seen by a neurologist at a hospital. In general, the diagnosis can be made by understanding the history and pattern of headache attacks and by neurological examination (usually no abnormal findings), but sometimes MRI or CT scan of the brain is needed to rule out other brain diseases such as cerebrovascular malformations or brain tumors when the symptoms are not typical.
Etiology and triggers of migraine
To date, the exact cause of migraine is not known. Firstly, it is thought that the disease has a genetic predisposition because several people in the same family often suffer from migraine. Second, it is now known that during a migraine attack, the level of a chemical in the patient’s brain called 5hydroxytryptamine (also known as serotonin) decreases, causing abnormalities in cerebrovascular function and dysregulation of other chemicals in the brain, resulting in headaches and other symptoms. In addition, a number of factors can induce migraine attacks, called migraine triggers, the common ones are.
1. Strong flashes of light, such as prolonged gazing at a television, computer screen, or other video display device.
2. Continuous, sharp noise.
3. Smoking, or inhaling tobacco, spices, and other odors.
4, changes in sleep rhythms, such as sleeping, staying up late, night work.
5, excessive fatigue, including physical or mental exertion.
6, eating less, or too long between meals, such as skipping breakfast, etc.
7, certain foods, such as red wine, cheese, smoked fish, bacon, chicken liver, hot dogs, chocolate, nuts, etc.
8, lack of water in the body.
9.Endocrine disorders, such as puberty, menstruation, oral contraceptives, menopause, hormone replacement therapy, etc.
Migraine is an individualized disease, and each patient’s attack may be related to one or several of the above triggers, or may be triggered by other triggers.
How to treat migraine?
The treatment of migraine includes treatment during the attack and treatment during the interictal period.
First, we will talk about the treatment during the attack. At the first sign of an attack, or even an aura, you should take pain medication such as painkillers, paracetamol, Benadryl, or Tylenol (OTC). These medications are available in street pharmacies and can be carried with you for emergency purposes. If vomiting occurs at the same time, you should also take anti-emetic medications such as Gastrofacial to prevent the pain medication from being vomited out and not being effective. These medications are indicated for mild to moderate migraine attacks.
If the above-mentioned drugs do not work well and the headache is heavy, you can use the drugs of the class of Traptan, which are currently in clinical use in China, such as Sumatriptan (Yingminger, Yusu) and Zolmitriptan (Zomig), and Rizatriptan which is in clinical trial. These drugs can regulate the imbalance of 5hydroxytryptamine in the brain, and are effective drugs for migraine attacks, but they need to be taken with a physician’s prescription and are expensive. It is suitable for patients with severe attacks but infrequent attacks.
The headache usually disappears within 2 hours with proper rest after taking these medications.
Acupuncture or massage can also help to relieve headache attacks. Patients with intermittent attacks usually do not need medication, but for patients with frequent attacks, such as those who have more than 3 attacks per month, they should take migraine attack prevention medication to reduce the frequency of attacks. Commonly used migraine prevention medications include beta-blockers and antidepressants (amitriptyline, etc.) that require a physician’s prescription. Patients who have frequent attacks should not take commercially available painkillers frequently on their own to avoid rebound headaches.
As we mentioned earlier, migraine attacks are associated with certain triggers, so identifying and taking care to avoid these triggers in daily life can help reduce the frequency of headache attacks. Patients can also take the following measures.
1. Keep a migraine diary. The contents include the time of headache attacks, the effect of medication taken, and possible triggers. By analyzing the attacks and the pre-injury living and eating conditions, look for migraine triggers.
2. Avoid these triggering factors in daily life, such as flashing lights and noise.
3.When you have to use computer or other video display devices for a long time, pay attention to rest between work.
4.Drink more water and less alcoholic or caffeine-containing beverages.
5, maintain a regular sleep.
6.Outdoors activities, fresh air and exercise, 3 times a week for 1 hour each time, can play a role in preventing migraine attacks.
7.Eat regular and moderate meals. Avoid foods that may trigger headaches.
Through proper treatment and lifestyle adjustments, migraine sufferers can reduce headache attacks and alleviate the pain during attacks, thus improving their quality of life.