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Migraine treatment

Migraine headache

Migraine is one of the diseases that decrease the quality of life and restrict the activities of daily living. The most common symptoms of this common disease are a pain. This pain, starting from the nape, temple or around the eyes, may worsen as it moves, and may present with a throbbing character and may cause nausea, vomiting, discomfort to the light and sound.

Migraine headaches in episodes occur more than fifteen days a month in three months, each pain lasts at least 4 hours, and if migraine type pain occurs at least 8 days per month, this is defined as “chronic migraine.”

In the treatment of migraine, treatment is planned depending on the frequency, severity and other accompanying medical conditions of the person.

Drugs used in the treatment of migraine help to relieve pain during headache attacks or to stop symptoms such as nausea and vomiting, or to control the frequency of frequent headache attacks.

Botox used in the treatment of chronic migraine disease; Inject under the skin at 31 points on the forehead, both temples, neck, and shoulder. Botox, which is a procedure of about 5-10 minutes, is applied in hospital conditions and by a neurologist.

What are the symptoms of migraines?

Migraine attacks usually start between the ages of 20 to 30, but headache attacks can occur during childhood or adolescence. Migraine attacks can be in four stages: prodrome, aura, headache and postdrome periods. Not all stages may be encountered in every migraine attack.

Prodrome

One or two days before the headache begins, patients may notice minor stimulant changes for an upcoming migraine attack:

  • Constipation
  • Mood changes, pessimism, restlessness
  • Eating Request
  • Neck eclipse
  • Increased thirst and urination
  • Frequent stretching

Aura

Most patients experience attacks without aura. Patients with aura may experience neurological disorders before or after pain. Patients with aura attacks; they may experience problems such as weakness in a sensation of touch (sensory), speech impairment, visual disturbances, numbness or tingling.

Attack

Untreated migraine attacks can last from 4 to 72 hours, depending on the person to person. Attacks can be rare or occur several times a month or a week. The patient had migraine attacks; throbbing in the form of heartbeat, nausea – vomiting, light – excessive sensation to the sound and even touch, blurred vision, dizziness, and in some cases may experience fainting.

Postdrome

After the postdrome (after the attack), the patient feels exhausted, exhausted and slightly relieved. The patient was treated within 24 hours; weakness, dizziness, restlessness, sensitivity to light and sound.

When should you contact a neurologist?

Since the patients do not apply to the neurology department and try to control the headache with pain medication themselves, migraine disease is not known and treatment is not performed.

If you regularly experience migraine attacks and symptoms, it is useful to register them. If you think that your headache attacks and severity have changed, you should see your neurologist as soon as possible.

If you experience any of the following symptoms, you should see a doctor immediately;

  • A sudden, severe headache like thunder
  • Fever, stiff neck, confusion, double vision, lethargy or speech impairment
  • Worsening of headache, especially after a head injury
  • A headache that develops after coughing, effort, straining or sudden movement
  • Headache over 50 years old

Causes of Migraine

Migraine; Although the cause is unknown, it is known to play a role in genetic or environmental factors. The occurrence of attacks is thought to be caused by imbalances in brain chemicals, including serotonin.

During migraine attacks, some chemicals that release pain in the meninges are secreted, causing migraine pain to emerge. Calcitonin gene-related peptide (CGRP) is one of the important chemical transmitters involved in migraine pain.

Migraine Triggers

There are many factors that can trigger migraine attacks:

  • Due to hormonal changes experienced by women, migraine attacks are easier to occur. Estrogen fluctuations can trigger headaches in many women. Women with a history of migraine may experience headaches before or after menstruation when a decrease in estrogen levels occurs. Pregnancy or menopause may cause a migraine to occur, as well as change the course of existing migraine attacks.
  • Hormone medications such as oral contraceptives and hormone replacement therapy may worsen the course of migraine.
  • Some food items; stale cheese, salty and processed foods can trigger a migraine. It is known that sweetener aspartame and preservative monosodium glutamate found in many foods can trigger a migraine.
  • Changing the order of the meal; skipping meals or eating too can also facilitate the occurrence of a migraine attack.
  • Drinks; Alcohol, especially wine and high caffeinated drinks can trigger a migraine.
    Stress plays an important role in migraine attacks. Stress at work or at home can be one of the causes of frequent migraine attacks.
  • Exposure to loud sounds, bright lights, or sunlight can trigger a migraine attack. Some types of fragrance suggest; Some odors, including perfume, thinner, cigarette smoke, can trigger an attack of migraine.
  • Changes in sleep and wake patterns are also known triggers of migraine. Conditions such as insomnia, excessive sleep, deterioration in sleep quality and jet lag may cause the migraine attacks to become more frequent or occur.
  • Sexual activity or intense physical effort may occur in migraine attacks.
  • Ambient overhead pressure or barometric changes can trigger a migraine.
  • Medicines; vasodilators such as nitroglycerin (vasodilators) or oral contraceptives (birth control pills) may aggravate migraines.

Migraine Risk factors

The following causes may increase the risk of migraine in a person:

  • If there is a family member with a migraine, the person is more likely to develop a migraine.
  • Migraine can occur at any age. Hormonal changes in adolescence play an important role in the development of migraine. However, migraine attacks usually start in the 20-30 age range. In the following years, the severity and frequency of migraine attacks may gradually decrease.
  • Migraine is more common in women than in men. The frequency of migraine in childhood is higher in males, but the incidence of females during and after puberty increases significantly compared to males.
  • In people with migraines, a headache may occur just before or after the onset of the menstrual period.
    During pregnancy or menopause, the character of migraine, the incidence of which may change.

Migraine usually passes after menopause. Some women may say that migraine attacks begin or worsen during pregnancy. Many migraine patients do not have migraine attacks during pregnancy. However, migraine usually reappears in the postnatal period.

Unwanted consequences of migraine

Sometimes trying to control migraine pain can cause different problems;

  • Stomach and intestinal diseases: Some high-dose or long-term painkillers can cause stomach or bowel diseases such as abdominal pain, bleeding, gastritis, ulcers.
  • Headache as a result of overuse of medication: Over the last three months, taking more than ten days of high-dose prescription or over-the-counter medication can cause serious, never-ending, continuous drug overuse headaches.
  • Excessive medication headaches occur when the medicines lose their pain-relieving properties and they themselves start to cause headaches. This vicious cycle may require more painkillers. However, this does not relieve the pain, but it will only make the headache more chronic.
  • Serotonin syndrome: Serotonin syndrome is a rare but potentially life-threatening body exposure to excessive serotonin. Care should be taken in terms of serotonin syndrome and medications should be used under doctor control.
  • Chronic migraine: Migraine attacks may become chronic. It is recommended that people with a number of painful days of 15 days or more per month in the last three months should consult with a neurologist for chronic migraines.
  • Migraine status: A migraine attack can last from 4 to 72 hours if left untreated or inadequately treated. Severe migraine attacks lasting more than three days are called “migraine status.
  • Stubborn aura without infarct (vascular occlusion): Transient neurological disorders, often called aura, go away after the headache starts. However, sometimes the aura persists after the pain has resolved and can last for more than a week. In the case of a stubborn aura, the brain should be radiographically MRIed and confirmed that there is no tissue damage or any other problem in the brain.
  • Migrainous infarction (cerebral vascular occlusion): In the case of aura that lasts longer than one hour, it is recommended to consult a neurologist for possible cerebral vascular occlusion. Your doctor may ask for brain imaging to rule out possible cerebral vascular occlusion or bleeding

Migraine Diagnosis

Migraine is a clinical diagnosis. The diagnosis can be made by the neurologist without any further examination during the patient-physician consultation. In cases where there are unusual, different types of pain that do not conform to migraine characteristics, the neurologist may perform a series of investigations to rule out other possible causes.

After laboratory tests and radiological examinations, the causes that cause headaches other than migraine are excluded.

How is migraine treated?

Medications used to treat migraine may help to relieve pain during headache attacks or to stop symptoms such as nausea and vomiting, or to control the frequency of frequent headache attacks. There are many medications for migraine treatment.

Some medications used to treat other diseases such as epilepsy, hypertension, depression are also known to help prevent or relieve migraines. Botox treatment, which is also used in aesthetics, is among the new period treatments.

Based on the assumption that botox, which has a well-known muscle relaxant effect, also affects a number of pain-causing chemicals, there are results that indicate that this drug may be useful in migraine headache and tension headache.

Botox treatment can be recommended especially for patients who have headaches for a long time and who cannot tolerate the side effects of the drugs they use.

 

Drugs used for the treatment of migraine are divided into two broad categories:

Pain-relieving drugs: It is taken during migraine attacks and is used to stop the pain.
Drugs used in prophylactic treatment: These medications are taken regularly on a daily basis to reduce the severity or frequency of migraine attacks.
The treatment strategy depends on the frequency, severity and other accompanying medical conditions of the individual.

Some medications are not suitable for infants in pregnant or nursing migraine patients. Some medications are not used for migraine attacks in children. Your doctor will recommend the most appropriate medication for your migraine attack.

Based on the assumption that botox, which has a well-known muscle relaxant effect, also affects a number of pain-causing chemicals, there are results suggesting that this drug may be useful in migraine headache and tension headache.

Botox treatment can be recommended especially for patients who have headaches for a long time and who cannot tolerate the side effects of the drugs they use.


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