Mıgraıne Treatment

MIGRAINE

When we share information about Migraine even on social media for Migraine patients, it can sometimes be very boring for them. Since they have already suffered from these pains for years, this information can be annoying for them, as they have read wherever they find a source with Migraine. For example, on my Instagram (@migrendoktorum) page, so sometimes presenting the subject in a humorous way can reduce this boredom for patients. As you can see in the picture, in addition to being humorous, the posts you see in the picture also reveal a meaning as a kind of interpreter of our troubles in explaining their situation. Indeed, Migraine is a difficult disease, even in the workplace, when someone else such as boss, supervisor, colleague says that the person has a headache, I have unbearable migraine pain, I can’t focus, I can’t work, or I want a leave of absence, they may face a number of accusations that have nothing to do with reality, such as whether they are pretending, trying to avoid work, or taking a head holiday again. Even if they do not even encounter them, Migraine patients may have thoughts like “I wonder if they think this way about me”. In other words, if there is a herniated disc pain, for example, it is seen from the outside that the person cannot walk, cannot straighten his/her waist and is in pain, but for Migraine patients, migraine pain may not be noticeable from the outside.

Therefore, even when giving information about Migraine, we encounter the reaction of patients that we have been living with Migraine for years and we have already memorized all the information about Migraine until now, do not give us information about Migraine, give us information about what treatment you are applying, is your treatment really effective, we have tried so many treatment methods so far that we no longer believe that we will get better.

WHAT IS MIGRAINE?

Migraine is a type of headache that can cause recurrent throbbing moderate to severe pain. The pain is usually on one side of the head, and symptoms such as nausea, vomiting and weakness may be observed in addition to the pain. Light and sound can also cause discomfort. The patient usually wants to lie down and rest in a dark and quiet room when migraine pain comes.

Migraine can start in childhood. It is twice as common in women than in men. The fact that it is seen among the same family members suggests that migraine may be genetic. All over the world, about 15% of people are affected by migraine.

Migraine most commonly affects the forehead. Although it usually affects one side of the head, it can also be seen on both sides.

Migraine pain lasts for 4 hours on average and can last for 72 hours to a week if left untreated. In migraine with aura, the pain may be accompanied by an aura or only the aura and no pain may be present. Auras are usually visual (visual phenomena such as seeing various shapes, loss of vision, blinking blind spots, bright spots or flashes of light), but other aura symptoms such as tingling-numbness on one side of the face or arm or leg, auditory (some sounds or music) and speech difficulties may also be seen. These symptoms usually start slowly, increase over a few minutes and may last 15 to 60 minutes.

There are four possible stages of migraine and not all of these stages need to be experienced:

PRODROM, which occurs hours or days before the headache Aura; occurs immediately before the headache

Pain phase; also known as headache phase

Postdrome; effects experienced after a migraine attack PRODROM phase. Prodromal or warning symptoms occur in about 60% of people with migraine and start between two hours and two days before the onset of pain or aura. These symptoms can include a wide range of events, e.g. altered mood, irritability, depression or a sense of wellbeing, fatigue, cravings for certain foods, tense muscles (especially in the neck), constipation or diarrhea, and sensitivity to smells and noise. These symptoms can occur in people with both migraine with aura and migraine without aura.

AURA stage

AURA is a transient focal neurologic event that occurs before or during a headache. It occurs gradually over several minutes and usually lasts less than 60 minutes. Symptoms can be visual, sensory or motor in nature and many people experience more than one symptom. Visual effects are the most common, occurring in almost 99% of cases and as the only symptom in more than half. Visual disturbances are often sparking, that is, a partial area of change in the visual field that flickers. These normally start near the center of vision and then spread out to the sides in zig-zag lines. Usually the lines are black and white, but some people also see colored lines. Some people have a partial loss of visual field, known as hemianopsia, and others have blurred vision.

Sensory aura is the second most common stage, occurring in 30-40% of people with aura. It usually starts with a one-sided tingling sensation in the hand or arm and spreads to the mouth and nose area on the same side. Numbness usually begins with a loss of sense of location and after the tingling subsides. Other symptoms of the aura stage may include speech disturbances and impaired speech ability, spinning and, less commonly, motor problems. Motor symptoms indicate that this is a hemiplegic migraine and, unlike other auras, the weakness usually lasts longer than an hour. An aura rarely occurs without consecutive headaches, which is called a silent migraine.

PAIN stage

Classically, the headache is unilateral, throbbing and moderate to severe in intensity. It usually starts gradually and is aggravated by physical activity. However, in more than 40% of cases, the pain can be bilateral and is often associated with neck pain. Bilateral pain is particularly common in people with migraine without aura, and less commonly the pain may occur mainly in the back or top of the head. In adults, the pain usually lasts between 4 and 72 hours, but in early childhood it often lasts less than 1 hour. The frequency of attacks is variable, ranging from very infrequent throughout life to several times a week. The average is approximately once a month.

Pain is often accompanied by nausea, vomiting, sensitivity to light, sensitivity to sound, sensitivity to odors, fatigue and irritability. Common effects of basilar migraine, a type of migraine associated with the brain stem or with neurological symptoms on both sides of the body, include a feeling of spinning around, lightheadedness and confusion. Nausea occurs in 90% of people and vomiting in one third. Many people therefore seek a dark and quiet room. Other symptoms may include blurred vision, nasal congestion, diarrhea, frequent urination, pallor or sweating. There may be stiffness in the neck, as well as sweating or tenderness of the scalp. In old age, related symptoms are less common.

POSTDROM The effects of migraine can persist for several days after the main headache has passed. This is called a postdrome. Many people report pain in the area of the migraine and some people report impaired thinking for a few days after the headache has gone. The patient may feel tired or “hungover” and may experience headaches, difficulty grasping, gastrointestinal symptoms, mood changes and weakness. According to a summary, “Some people report feeling unusually refreshed or euphoric, while others report feeling depressed and out of sorts.

CAUSE

The underlying causes of migraine are unknown. However, it is thought to be related to a mixture of environmental and genetic factors. In two-thirds of cases, migraine runs in the family and rarely occurs due to a single gene disorder.

GENETIC FEATURE

Migraine is not classified as a hereditary condition. However, it often occurs in several members of the same family. Therefore, if you have one or more close relatives with migraines, you are more likely to develop migraines.

Studies with twins indicate a 34-51% chance of a genetic influence in the occurrence of migraine headaches. This genetic link is stronger for migraines with aura than for migraines without aura.