How can you quickly alleviate migraine pain. What are the most effective methods to prevent migraines from worsening. Which natural remedies can help manage migraine symptoms. Are there lifestyle changes that can reduce migraine frequency and severity.

Understanding Migraines: More Than Just a Headache

Migraines are complex neurological conditions that go beyond the typical headache experience. They can cause a variety of debilitating symptoms, making them challenging to manage. For those who suffer from migraines, finding effective relief is crucial.

What exactly sets migraines apart from regular headaches? Migraines are characterized by:

• Intense, throbbing pain, often on one side of the head
• Nausea and vomiting
• Sensitivity to light and sound
• Visual disturbances (aura)
• Dizziness and vertigo

Understanding the unique nature of migraines is the first step in developing an effective treatment strategy. With this knowledge, we can explore various methods to alleviate pain and prevent migraines from worsening.

Temperature Therapy: Harnessing the Power of Cold and Heat

Temperature therapy has been a long-standing method for managing migraine pain. While scientific studies are still exploring the exact mechanisms, many migraine sufferers find relief through this approach.

Cold Therapy for Migraine Relief

Cold therapy has been used to treat migraines for over a century. Recent studies have shown promising results in reducing migraine pain perception. How does cold therapy work?

• Constricts blood vessels
• Slows nerve signals involved in pain transmission
• Provides a numbing effect

To try cold therapy, apply an ice pack or cold compress to your head or neck at the onset of a migraine. This can be particularly effective if heat or sunlight triggered your migraine.

Heat Therapy: An Alternative Approach

While cold therapy is more commonly recommended, some individuals find relief with heat therapy. Heat can help:

• Relax tense muscles
• Improve blood circulation
• Provide a soothing sensation

Experiment with both cold and heat therapy to determine which works best for your migraines. You may even find that alternating between the two provides optimal relief.

Creating a Migraine-Friendly Environment: Reducing Sensory Stimuli

One of the most effective ways to manage a migraine is to create an environment that minimizes sensory stimuli. This approach can significantly reduce pain and prevent the migraine from worsening.

Light and Sound Sensitivity

Many migraine sufferers experience heightened sensitivity to light (photophobia) and sound (phonophobia). To address this:

• Find a quiet, dark room to rest
• Use blackout curtains or an eye mask
• Wear earplugs or noise-canceling headphones
• Avoid screens and bright lights

Aromatherapy and Air Quality

Certain scents can trigger or exacerbate migraines, while others may provide relief. Consider:

• Using an essential oil diffuser with lavender or peppermint
• Ensuring good ventilation in your resting area
• Avoiding strong perfumes or cleaning products

By creating a calm, sensory-friendly environment, you give your body the best chance to recover from a migraine attack.

Hydration and Nutrition: Fueling Your Body for Migraine Prevention

Proper hydration and nutrition play a crucial role in both preventing and managing migraines. Recent research has shed light on the importance of these factors in headache management.

The Power of Hydration

Dehydration is a known trigger for headaches and migraines. A recent study revealed that proper hydration can significantly impact migraine symptoms. Participants who consumed their recommended daily water intake experienced:

• Less frequent headaches
• Reduced pain severity
• Shorter duration of headache episodes

To improve your hydration, aim to drink at least 8 glasses of water per day. Keep a water bottle with you and set reminders to drink regularly throughout the day.

Nutrition for Migraine Management

While certain foods can trigger migraines, others may help alleviate symptoms. Ginger, for example, has shown promise in reducing migraine pain and associated nausea. How can you incorporate ginger into your diet?

• Drink ginger tea
• Add fresh ginger to smoothies or juices
• Try ginger supplements (consult with a healthcare provider first)

Additionally, maintaining a balanced diet rich in fruits, vegetables, and whole grains can help stabilize blood sugar levels and reduce the likelihood of migraine attacks.

Caffeine: A Double-Edged Sword in Migraine Management

Caffeine’s role in migraine management is complex and varies from person to person. For some, it can provide relief, while for others, it may trigger an attack.

Potential Benefits of Caffeine

Caffeine can help alleviate migraine pain by:

• Constricting blood vessels in the brain
• Enhancing the effectiveness of pain-relieving medications
• Providing a mild mood boost

Risks and Considerations

However, caffeine consumption comes with potential risks:

• Dependency and withdrawal headaches
• Increased frequency of migraines with overuse
• Sleep disturbances, which can trigger migraines

If you choose to use caffeine for migraine relief, moderation is key. Limit intake to one cup of coffee or its equivalent, and be consistent with your daily consumption to avoid withdrawal headaches.

Stress Management and Relaxation Techniques

Stress is a common trigger for migraines, making stress management an essential component of migraine prevention and treatment.

Deep Breathing and Meditation

Practicing deep breathing and meditation can help reduce stress levels and potentially shorten the duration and severity of migraine pain. Try this simple technique:

1. Find a quiet, comfortable place to sit or lie down
2. Close your eyes and focus on your breath
3. Inhale slowly through your nose, feeling your belly expand
4. Exhale slowly through your mouth, letting tension release
5. Continue for 5-10 minutes, or longer if desired

Progressive Muscle Relaxation

This technique involves tensing and relaxing different muscle groups to promote overall relaxation:

1. Start with your toes, tense them for 5 seconds, then relax
2. Move up to your calves, thighs, and so on
3. Work your way up to your head, tensing and relaxing each muscle group
4. Focus on the sensation of relaxation in each area

Regular practice of these techniques can help prevent migraines and provide relief during an attack.

Massage and Pressure Point Therapy

Massage therapy has shown promising results in reducing migraine pain and frequency. It can help relieve tension and promote relaxation throughout the body.

Benefits of Massage for Migraine Relief

Research has demonstrated several benefits of massage for migraine sufferers:

• Significant pain reduction in 80% of participants after one treatment
• Nearly immediate relief for many individuals
• Potential for long-term reduction in migraine frequency

Pressure Point Therapy

Specific pressure points may help alleviate migraine pain. Consider trying these areas:

• Temples
• Base of the skull
• Between the eyebrows
• Earlobes
• Hands and feet (reflexology points)

Gently massage these areas in circular motions for 30 seconds to a minute. If you experience increased pain, stop immediately and consult a healthcare professional.

Lifestyle Modifications for Long-Term Migraine Management

While immediate relief strategies are crucial, making long-term lifestyle changes can significantly reduce the frequency and severity of migraines.

Sleep Hygiene

Maintaining a consistent sleep schedule is vital for migraine prevention. Try these tips:

• Go to bed and wake up at the same time every day
• Create a relaxing bedtime routine
• Avoid screens for at least an hour before bed
• Keep your bedroom cool, dark, and quiet

Regular Exercise

While intense physical activity can trigger migraines in some people, regular moderate exercise can help prevent attacks. Consider:

• Low-impact activities like walking, swimming, or yoga
• Gradually increasing intensity and duration
• Staying hydrated during workouts

Dietary Considerations

Identifying and avoiding food triggers is crucial. Common migraine-triggering foods include:

• Aged cheeses
• Processed meats
• Artificial sweeteners
• Alcohol, especially red wine
• Chocolate

Keep a food diary to track potential triggers and work with a healthcare provider or nutritionist to develop a migraine-friendly diet plan.

By implementing these lifestyle modifications alongside immediate relief strategies, you can develop a comprehensive approach to managing your migraines. Remember that everyone’s experience with migraines is unique, so it may take time to find the perfect combination of treatments that work for you. Be patient with yourself and don’t hesitate to seek professional help if your migraines persist or worsen.

How to Relieve Migraine Quickly (and Stop it From Worsening)

Caffeine, massage, ginger, and over-the-counter pain relievers are just a few of the methods used to help ease migraine pain. Identifying your triggers — and taking other medications — may even help prevent the pain altogether.

A migraine is more than just a headache. It’s a complex neurological condition that can cause a variety of symptoms.

If you experience migraines, you know how painful the condition can be — and how difficult it can be to make a migraine go away. Prevention and early action when a migraine strikes are key to keeping this condition under control.

Here are 12 tips you can try to help treat your migraine early and keep it from getting worse.

If you’ve ever put an ice pack on an injury or a heating pad on a sore back, you know the power of temperature therapy. This can also help when you have a migraine.

Cold therapy has been used to treat migraine for more than 100 years, but there are few scientific studies to suggest why it can help relieve pain for some people. Some theories have suggested that cold therapy can help constrict blood vessels or slow the nerve signals involved with migraine pain.

Even recent studies haven’t pinpointed exactly how cold can help relieve migraine pain, but two recent studies did find that ice bands around the neck, or ice packs applied at the onset of a migraine could significantly reduce the perception of migraine pain.

You may need to experiment to decide what feels best for you. Some people find that an ice pack applied to the head offers soothing, numbing relief. This is particularly helpful if sun or heat brought on your migraine.

Sensitivity to light and sound is one of the most common migraine symptoms. Get away from these things if you can. This can help you find relief from your pain and can alleviate stress.

Lie down and pay attention to your breathing. Try taking slow, deep breaths from your diaphragm. Feel your stomach rise with the inhale and fall with the exhale. This can help you relax.

Dehydration can cause headaches and even migraine, but new research shows hydration can reduce and possibly even prevent headache pain. In the study, people who drank their recommended daily water intake had headaches that were:

• less frequent
• less severe
• shorter in duration

If you don’t regularly drink enough water, increasing your intake may both help reduce your migraine pain and prevent repeat attacks.

For some, a cup of coffee may help stop a migraine. For others, caffeine can be a migraine trigger.

Regardless, if you do indulge in caffeine, make sure you don’t drink toomuch. Drinking more than one cup of coffee could set you up for a caffeine withdrawal headache later.

People with migraine who use caffeine more than 3 days per week may develop a dependency. This can lead to more headaches. Moderation is key with caffeine, but it helps many people find relief.

People have to eat to survive, and chewing is an important part of eating. However, studies suggest that excessive chewing might be linked to more headaches and even migraine.

Researchers focused on gum-chewing for the study and found that tension headaches and migraine were more common in people who chewed gum frequently.

While you can’t avoid eating, you may want to rethink chewing gum if you regularly experience migraine. You may also want to consider if you clench or grind your teeth while sleeping, as this could have a similar effect.

Things like extreme stress, a change in sleeping habits, and even strenuous physical activity have been linked to migraine.

While deep breathing and relaxation exercises alone may not cure a migraine completely, these techniques have been shown to lower stress levels and may shorten the duration and severity of migraine pain. Regular meditation and stress-reduction strategies can also help prevent migraine from developing in the first place.

A massage might be a good way to relax and practice self-care, but it can also help relieve tension and may even prevent headaches and migraine. One study found that 8 out of 10 people had their headache pain cut in half with just one massage treatment, and most reported nearly immediate relief.

Where you get a massage can play a role too. Research on pressure points and reflexology in managing headaches suggests that even massages on the feet, hands, and earlobes may help relieve migraine pain.

Some foods can trigger migraine, but others can help get rid of them. Ginger is one of these foods. A new study found that ginger was able to reduce migraine pain significantly in 2 hours, as well as reducing the nausea and vomiting that might be associated with migraine.

While most of the studies used ginger powders, there are all kinds of products that might offer relief, including teas and candies.

Medications are the first thing many people look to when they have a headache, and migraine is no different in this sense. There are many products that can help relieve migraine pain. These can include over-the-counter pain relievers and more targeted prescription therapies.

Below is a list of medications that are used for treating acute migraine pain:

• acetaminophen (Tylenol)
• aspirin
• diclofenac (Cataflam)
• ibuprofen (Advil, Motrin)
• naproxen (Aleve)
• almotriptan (Axert)
• eletriptan (Relpax)
• frovatriptan (Frova)
• naratriptan (Amerge)
• rizatriptan (Maxalt, Maxalt-MLT)
• sumatriptan (Imitrex)
• sumatriptan and naproxen (Treximet)
• zolmitriptan (Zomig)
• chlorpromazine
• droperidol
• metoclopramide (Reglan)
• prochlorperazine (Compazine)
• promethazine (Phenergan)
• dihydroergotamine (DHE-45, Migranal)
• ketorolac (Toradol)
• rimegepant (Nurtec ODT)
• ubrogepant (Ubrelvy)
• lasmiditan (Reyvow)

Other medications may also be used, but the goal of these medications will be to prevent migraine rather than to treat them. Examples include:

• divalproex (Depakote)
• metoprolol (Lopressor)
• propranolol (Inderal)
• timolol (Istalol)
• topiramate (Topimax)
• amitriptyline
• atenolol (Tenormin)
• nadolol (Corgard)
• naratriptan (amerge)
• venlafaxine (Effexor)
• calcitonin gene-related peptide (CGRP) antagonists (Qulipta, rimegepant)
• CGRP monoclonal antibodies (Emgality)
• candesartan (Amias)
• onabotulinumtoxinA (Botox)

Which of these medications — or combination of medications — you use will depend on your individual health, other medications you’re taking, the severity of your migraine, and your symptoms. For migraine prevention, avoiding triggers is key.

If you suffer from regular migraine, talk with your doctor about how to prevent them from happening. One of the best ways to do this is to identify and avoid things that can trigger your migraine.

Many doctors recommend that their patients with migraine keep a journal of what they ate or what they were doing when they developed a migraine to look for patterns. Everyone has different triggers and these can range from sleep patterns to certain foods. Even a lack of food, and the low blood sugar or hypoglycemia that results, can lead to a migraine.

If you have identified your triggers, try to avoid them. If you haven’t, consider keeping a headache diary to track your triggers. There are even apps available that can help track and analyze your triggers.

If you need help finding a primary care doctor, then check out our FindCare tool here.

When it comes to treating your migraine, timing is everything. Waiting too long to address your migraine symptoms or take preventive steps can increase how often — and how severely — a migraine strikes.

Some people get warning signs called auras that tell them a migraine is coming. The American Migraine Foundation recommends taking your medication during the prodromal phase of the attack. A prodrome is a warning sign that a migraine is developing. Treating your symptoms in the early stages is your best chance at avoiding a more severe migraine.

One challenge of early treatment is knowing the signs. Prodromal signs can vary widely between people, but they often include things like:

• sensitivity to light or sound
• mood changes, such as irritability, anxiety, or euphoria
• trouble concentrating
• food cravings, usually carbohydrates
• fatigue or yawning

If you’ve had a migraine for a long time, you may be able to easily spot your prodromal symptoms. This will help you be proactive instead of reactive when it comes to treating your pain. If you have migraines frequently or without much notice, you may want to keep your migraine medications with you at all times so you can take them as soon as an attack begins.

Developing a good relationship with the doctor who’s helping you manage your migraine is important. Review your symptoms and triggers with your doctor. Together, you can create a treatment plan that will not only help you manage the pain when a migraine happens, but also keep them from developing in the first place.

A good treatment plan should include:

• identifying the type of migraine you have
• identifying triggers
• avoiding triggers
• taking steps to promote good overall health, including getting enough sleep and eating well
• staying hydrated
• identifying medications and other strategies to help prevent migraine
• establishing a plan for acute migraine treatment
• talking with your doctor about when to seek additional help

The intense pain that comes with a migraine can be intense and debilitating. Talk with your doctor about when to seek emergency treatment.

Intense pain isn’t usually considered an emergency, but if that pain is interfering with your ability to complete your daily tasks, it’s definitely a situation that requires more care. If you can’t get an appointment with your doctor, you may want to consider emergency or urgent care services.

You should seek treatment immediately if you have an intense headache that causes things like:

• uncontrollable vomiting
• loss of consciouness
• seizures or convulsions
• blurred vision or other vision changes
• loss of balance or coordination
• lightheadedness
• a pounding in your chest or high blood pressure

There are many things you can do to prevent and treat migraine pain, but not there isn’t one treatment that works all the time for everyone.

The key to treating migraine is to know and avoid your triggers, treat symptoms early, and find medications or therapies that work best to relieve your specific type of migraine pain.

You should also develop a support system to lean on when a migraine strikes. You may be limited in what you’re able to do while dealing with migraine pain, and support from others is a powerful coping tool.

You can find a diverse community of real people who experience migraine in our free app, Migraine Healthline. Ask questions, seek advice, and access expert resources on managing migraine. Download the app for iPhone or Android.

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Migraine – symptoms, causes and treatment

A migraine is an intense headache that is usually felt as a throbbing or pulsing pain on one side of the head and may last up to 72 hours. Nausea, vomiting, or sensitivity to light and sound may occur with the headache.

Medications can help to relieve the pain and other symptoms, and even prevent some migraines. Coping strategies and lifestyle changes may also help.

General information

Migraines are a type of recurring headache. They can be so severe that the pain is disabling and reduces the quality of life of people affected.

Migraine is one of the most common health conditions worldwide, affecting about 15% of people.

Migraine headaches usually first appear during adolescence or early adulthood. They may occur infrequently or several times per month – the frequency varies from person to person. They tend to peak during a person’s 30s and become less frequent and less severe in later life.

Women are three-times more likely to have migraine headaches than men. A tendency to get migraines appears to be inherited, i.e. migraine runs in families.

Causes

The exact mechanism by which migraines occur is not known. The current theory is that it is a disorder of nerves and blood vessels in the brain.

Migraine attacks may be triggered by dietary, hormonal, emotional, physical, and environmental factors, including:

• Certain sensory stimuli, such as loud noises, bright lights, strong odours or perfumes, smoking, and exposure to second-hand smoke
• Sudden intense exercise or other physical exertion, including sexual activity
• Stress and anxiety at work or home
• Changes in sleep patterns, such as getting too much or not enough sleep
• Drinking alcohol
• Certain foods, including chocolate, aged cheeses, salty foods, fermented foods, and meats containing nitrates (eg: bacon, hot dogs, salami)
• Food additives, such as monosodium glutamate (MSG) and artificial sweeteners
• Missing meals or fasting
• Changes in hormone levels during a menstrual cycle or with the use of oral contraceptives and / or hormone replacement therapy
• Variations in the environment, eg: a change in the weather or atmospheric pressure

Signs and symptoms

The main symptom of a migraine is usually a headache that gets worse with movement and is disabling, ie: prevents a person from carrying out normal activities.

A migraine attack may progress through four phases, the signs and symptoms of which can overlap:

1. Early signs: Subtle changes one or two days before a migraine occurs that indicate a migraine may be coming, including constipation, yawning, mood changes, food cravings, and neck stiffness.
2. Aura: Some people experience aura before or during the headache. Aura symptoms, which develop over five minutes and last for up to one hour, may include: Visual disturbances, such as flashes of light, zig-zag patterns, or blind spots; numbness or tingling on one side of the face or in an arm or leg; and feeling dizzy or off balance.
3. Headache: This phase can last from 2 to 72 hours, and is defined by a moderate to severe headache that is throbbing or pulsing, and usually only on one side of the head. A person may also be more sensitive to light, sounds, odours, and touch; and experience chills and sweating, nausea and vomiting, blurred vision and light-headedness.
4. “Hangover”: After a migraine attack, a person may feel drained and washed out. Confusion, moodiness, dizziness, weakness, and sensitivity to light and sound may also be experienced the following day.

You should see your doctor immediately, or go to an A&E clinic, if you have any of the following signs and symptoms that might indicate a more serious medical problem such as a ruptured brain aneurysm, stroke or meningitis:

• Severe and sudden headache that causes intense pain
• Headache with a fever over 38 degrees, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or difficulty speaking
• Headache after a head injury, especially if the headache gets worse
• Chronic headache that gets worse after coughing, physical exertion, straining, or a sudden movement
• Age older than 50 years and a severe headache is experienced for the first time.

Diagnosis

There is no specific test to diagnose a migraine. For a diagnosis to be made, your GP will take your medical history and will need to identify a pattern of recurring headaches and any associated symptoms.

Keeping a diary of your migraine attacks can help with the diagnosis and treatment. A migraine diary should note the date, time, and activity when the migraine began, how long it lasted, the symptoms, any medication taken and their effects.

Your GP may also recommend tests to rule out other possible causes for your headache if your condition is unusual, complex, or suddenly becomes severe.

You may be referred to a neurologist (brain and nervous system specialist) for further assessment and treatment if a diagnosis is unclear, you have chronic migraine (occurring on 15 or more days per month), or initial treatment has failed to control your symptoms.

Treatment

There is no cure for migraine headaches – the aim of treatment is to relieve the symptoms as soon as they start and try to prevent further attacks. More than one treatment may help and it may take time to determine what treatments work best. This will involve trying different types or combinations of medicines.

Pain-relievers

Over-the-counter pain-relievers, such as paracetamol, aspirin, and ibuprofen, can help to reduce symptoms. They tend to be most effective when taken at the first appearance of the signs and symptoms of a migraine attack.

Triptans

These are prescription drugs developed specifically for migraine headaches. It is thought that triptans work to relieve migraine pain and other symptoms by blocking pain pathways and constricting blood vessels in the brain. Some people find it effective to combine a triptan with a pain-reliever.

Anti-emetics

Anti-sickness medicines, known as anti-emetics, can reduce the vomiting and nausea associated with a migraine headache. They may even be beneficial in people who do not experience nausea or vomiting during their migraine attack. Anti-emetics are prescription medications and are usually taken with pain-relievers and triptans.

Preventative medicines

Preventative medicines may be prescribed to reduce the severity or frequency of migraines. They are used when other medications don’t work; when migraines are severe, long lasting or frequent; and when avoiding possible triggers has not helped to prevent migraine attacks. These include various medications that were initially developed and used to prevent seizures in people with epilepsy, treat angina and high blood pressure, and antidepressants.

Medication overuse

Taking too many pain relievers to treat migraines and other types of headache can result in a rebound headache, which may feel like a tension-type headache or migraine-like attack. Rebound headaches usually improve within two to four weeks of stopping the medication that has been overused.

Self-help

Some simple self-help steps can help to relieve migraine signs and symptoms:

• Sleep or lie down in a quiet, cool, dark room
• Avoid strenuous activity
• Place a cold flannel on your neck or forehead
• Avoid drinking alcohol or sugary drinks
• Try to relax by listening to music or through meditation
• Do not read, watch TV, or drive.

Prevention

The following lifestyle changes and coping strategies may help to reduce migraine frequency and severity:

• Recognise what triggers your migraines and try to avoid or minimise them. Keep a headache diary can help to identify your triggers
• Establish a daily routine with regular sleep patterns and regular meal times
• Manage stress and anxiety. Relaxation and stress-reducing exercises such as yoga, tai chi, and meditation can help to lower stress levels. Cognitive behavioural therapy (CBT) and other coping strategies may also be helpful
• Exercise regularly. Aerobic exercise (e.g., walking, swimming, cycling) helps to reduce tension. But it is important to warm up slowly because sudden, intense exercise can trigger migraines
• Lose weight, if overweight or obese. Obesity may be a factor in migraines
• If you are a woman who has migraines that seem to be triggered or made worse by oestrogen, talk to your doctor about avoiding or reducing medications that contain oestrogen
• Limit caffeine intake
• Stay hydrated by drinking water throughout the day.

Further information and support

Neurological Foundation of New Zealand

Freephone: 0508 BRAINS (0508 272 467)
Email: [email protected]
Website: https://neurological.org.nz

Healthline

Freephone: 0800 611 116
Website: www.healthline.govt.nz

References

Goadsby P.J., Holland P.R., Martins-Oliveira M., et al. (2017). Pathophysiology of migraine: a disorder of sensory processing. Physiol Rev. 2017 Apr;97(2):553-622.
Mayo Clinic (2018). Migraine (Web Page). Rochester, NY: Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201 [Accessed: 21/03/19]
MedlinePlus (2017). Migraine (Web Page). Bethesda, MD: US National Library of Medicine (NIH). https://medlineplus.gov/ency/article/000709.htm [Accessed: 21/03/19]
NHS inform (2019). Migraine (Web Page). Glasgow: National Health Information Service, National Health Service (NHS) Scotland. https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/migraine [21/03/19]
Obermann M., Holle D. Recent advances in the management of migraine. F1000Research. 2016 Nov 21;5:2726.
O’Toole, M.T. (Ed.) (2017). Migraine. Mosby’s Dictionary of Medicine, Nursing & Health Professions (10th ed.). St Louis, MI: Elsevier.

Created: April 2019

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symptoms and treatment / Blog / Clinic EXPERT

Migraine was previously associated with feelings and the subtlety of a creative nature. Suffered from it: Julius Caesar, Ludwig van Beethoven, Charles Darwin, Peter I and others. But what is clear is that migraine is a highly disabling primary disease.

In Russia migraine is diagnosed in 1 out of 5 women and 1 out of 16 men. And these are only patients with an established diagnosis of migraine.

A migraine attack consists of several phases (prodrome, aura, painful phase, postdrome), and headache is just one of them. In the days before the headache and after it subsides, other symptoms may occur, such as fatigue and muscle stiffness.

Some people also develop a neurological disorder known as an aura. Symptoms include spots of light or geometric shapes in the field of vision, loss of vision, and tingling in the arm or leg. They develop within 15–20 minutes and last less than an hour. It is widely believed that auras are caused by a wave of depolarization that travels slowly through the brain, known as cortical spreading depression (CDP).

The history and neurological examination are usually sufficient to diagnose migraine. Primary headache does not require instrumental diagnosis. They are prescribed only in cases where we suspect a secondary cause of pain based on the so-called red flags. Before visiting a neurologist or for a clear idea of ​​the nature and frequency of headache, a headache diary is filled out.

1. At least five attacks meet criteria 2-5

2. Headache attacks that last 4-72 hours with no or no treatment

3. Headache has at least two of the following four characteristics:

• unilateral
• throbbing
• moderate or severe pain
• complicating or avoiding routine physical activity (eg, walking or climbing stairs)

4. At least one of the following for headache:

• nausea and/or vomiting
• photophobia or phonophobia

Emergency therapy First-line drugs. Over-the-counter analgesics (NSAIDs) are used worldwide for the acute treatment of migraine. Triptans are classified as second-line drugs, while ditans and hepants are used as third-line drugs.

For those patients in whom migraine continues to impair quality of life despite optimized rescue management, additional preventive therapy should be considered.

As with rescue medicines, preventive medicines can also be divided into first, second and third line drugs. First-line drugs are β-blockers without intrinsic sympathomimetic activity (atenolol, bisoprolol, metoprolol, or propranolol), topiramate, and candesartan. If these fail, second-line agents including flunarizine, amitriptyline, and sodium valproate may be considered. Third-line drugs include four anti-CGRP monoclonal antibodies: erenumab, fremanezumab, galcanezumab, and eptinezumab. These antibodies have been approved for preventive migraine therapy in the past few years.

Chronic migraine: description of the disease, causes, symptoms, cost of treatment in Moscow ; [4] => Disability; [5] => Suicide. )

Description of the disease

Chronic migraine is a persistent headache of significant intensity, leading to impaired ability to work, and in severe cases, to disability. With this form of the disease, headache attacks are repeated several times a day. It is extremely dangerous to tolerate them and not take any measures, since there is a high risk of developing serious complications. The fact that migraine has become chronic can be suspected if the headache does not go away for more than a week, and its attacks are repeated several times a day with short breaks. The treatment of the violation is carried out by a neurologist, who should be contacted without fail. The disorder may proceed with or without an aura in the classic simple pattern.

The fact that migraine has begun to turn into a chronic form is indicated by certain features of the condition, which should alert a person. Most often, chronic headache does not appear on its own, but against the background of a prolonged lack of treatment for a common migraine. At the same time, at the time of the transition of the disease to a more severe form, the patient notices that the attacks become more frequent, gradually becoming daily, and their intensity and duration increase. Also, in this condition, manifestations associated with the processes of cerebrovascular accident begin to increase, which is worsened over long periods of time, and not short-term, as in the usual form of pathology. To prevent the development of a chronic form of migraine, only the correct and timely treatment of the disease with the involvement of a doctor helps. If at the first attacks of the disease you do not seek medical help, the risk of developing a chronic form increases significantly.

There are many reasons that cause migraine to become chronic. Chronic migraine without aura or with aura is provoked by the same factors. With constant exposure, they lead to severe disruption in the process of blood circulation, and spasm of the vessels that feed the brain becomes regular. In the event that initially there is no migraine, the factors that cause chronic pathology cannot be harmful. The main provocateurs that contribute to the degeneration of migraine into a chronic form are:

• obesity – against the background of metabolic disorders in the body, the risk that vascular spasms become regular becomes much higher. There is also an accumulation of cholesterol in them, due to which blood circulation worsens;

• constant stress – they cause attacks in a simple form of the disease. If they are not eliminated, vasospasm will become more frequent, due to which the patient’s condition will seriously deteriorate;

• Constant overwork is one of the main reasons why migraines become chronic;

• the use of large doses of caffeine – the substance causes changes in the functioning of the vascular system and leads to the fact that the vessels lose the ability to fully maintain their tone and often spasm, causing a problem;

• the use of a number of hormonal drugs – most often oral contraceptives can provoke a problem, which lead to serious changes in the hormonal background that are not natural for the body;

• taking too many analgesics – the problem occurs when the body gets used to them, which causes a daily headache, which, as a rule, is not associated with the initial migraine;

• alcohol abuse – in persons suffering from alcoholism or a condition close to it, chronic migraine almost always appears.