How long does a typical migraine last. What are the different stages of a migraine attack. Which treatments can help alleviate migraine symptoms. When should you seek medical attention for prolonged migraines.

The Typical Duration of a Migraine Attack

Migraine attacks can be unpredictable in their duration, often lasting anywhere from a few hours to several days. The average migraine episode typically spans between 4 to 72 hours, though some individuals may experience symptoms for an extended period. Understanding the timeline of a migraine can help sufferers better manage their condition and seek appropriate treatment.

Do all migraine attacks follow the same pattern? No, migraine experiences can vary significantly from person to person and even between episodes for the same individual. While some people may go through all the stages of a migraine attack, others might skip certain phases or experience them in a different order.

The Five Stages of a Migraine: A Comprehensive Overview

A typical migraine attack can be divided into five distinct stages, each with its own set of symptoms and duration. However, it’s important to note that not everyone experiences all stages during every migraine episode.

1. Prodrome (Warning) Phase

The prodrome phase, also known as the warning or premonitory phase, can occur 1 to 24 hours before the onset of a headache. During this stage, individuals may experience various symptoms that signal an impending migraine attack.

• Food cravings
• Increased thirst
• Neck stiffness
• Mood changes (irritability, anxiety)
• Fatigue

Can recognizing prodrome symptoms help prevent a full-blown migraine? While it may not always be possible to prevent an attack, identifying these early warning signs can allow individuals to take preventive measures, such as avoiding triggers or taking medication, potentially reducing the severity of the upcoming migraine.

2. Aura Phase

Approximately 25% of migraine sufferers experience the aura phase, which typically occurs 10 to 30 minutes before the headache begins. Aura symptoms can last anywhere from 5 minutes to an hour and may include various neurological disturbances.

• Visual disturbances (colored spots, flashing lights, zigzag lines)
• Sensory changes (numbness, tingling)
• Speech and hearing disturbances
• Weakness or dizziness

Is it possible to have an aura without a subsequent headache? Yes, some individuals may experience aura symptoms without developing a headache afterward. This phenomenon is known as a “silent” or “acephalgic” migraine.

3. Headache Phase

The headache phase, or main attack, is often the most debilitating stage of a migraine. It can last from a few hours to several days and is characterized by intense, throbbing pain, often on one side of the head.

• Pulsating or throbbing pain
• Sensitivity to light, sound, and smells
• Nausea and vomiting
• Blurred vision
• Dizziness

Why does physical activity often worsen migraine pain? Movement can increase blood flow and pressure in the head, exacerbating the already painful symptoms of a migraine. This is why many sufferers find relief by resting in a quiet, dark room during an attack.

4. Resolution Phase

As the migraine attack begins to subside, individuals enter the resolution phase. During this stage, the intensity of the headache gradually decreases, and other symptoms start to alleviate. The duration of this phase can vary significantly from person to person.

Are there any strategies to expedite the resolution phase? While there’s no guaranteed way to speed up this phase, some individuals find that taking a nap or resting in a calm environment can help alleviate symptoms more quickly.

5. Postdrome (Recovery) Phase

The postdrome phase, also known as the “migraine hangover,” can last up to a day after the headache subsides. During this time, individuals may experience a range of symptoms as their body recovers from the migraine attack.

• Fatigue or exhaustion
• Mood changes (elation or depression)
• Cognitive difficulties (confusion, difficulty concentrating)
• Weakness
• Dizziness

Why do some people feel elated during the postdrome phase? The exact reason for this phenomenon is not fully understood, but it may be related to the brain’s release of endorphins and other neurotransmitters as it returns to its normal state after a migraine attack.

Tracking Migraine Patterns: The Importance of a Migraine Journal

Keeping a migraine journal can be an invaluable tool for both sufferers and healthcare providers. By documenting the frequency, duration, and characteristics of each migraine episode, individuals can gain insights into their personal migraine patterns and potential triggers.

What should be included in a migraine journal? A comprehensive migraine journal should record:

1. Date and time of migraine onset
2. Duration of each phase
3. Severity of symptoms
4. Potential triggers (e.g., foods, stress, weather changes)
5. Medications taken and their effectiveness
6. Any other relevant factors (e.g., menstrual cycle, sleep patterns)

How can a migraine journal help in treatment? By identifying patterns and triggers, individuals and their healthcare providers can develop more targeted prevention and treatment strategies, potentially reducing the frequency and severity of migraine attacks.

Treatment Options: From Over-the-Counter to Prescription Medications

The approach to treating migraines can vary depending on the frequency and severity of attacks. For some individuals, over-the-counter (OTC) medications may be sufficient to manage symptoms, while others may require prescription medications for both acute treatment and prevention.

Over-the-Counter Treatments

For infrequent or mild to moderate migraines, OTC medications can often provide relief. Common options include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen
• Acetaminophen
• Combination medications containing caffeine, aspirin, and acetaminophen

When should OTC medications be taken for maximum effectiveness? It’s generally recommended to take OTC pain relievers at the first sign of a migraine, as they tend to be more effective when taken early in the attack.

Prescription Medications

For individuals with more frequent or severe migraines, prescription medications may be necessary. These can include:

• Triptans (e.g., sumatriptan, rizatriptan)
• Ergotamines
• Anti-nausea medications
• Preventive medications (e.g., beta-blockers, anti-seizure drugs, CGRP antagonists)

How do preventive medications differ from acute treatments? Preventive medications are taken regularly to reduce the frequency and severity of migraine attacks, while acute treatments are used to alleviate symptoms once a migraine has begun.

Non-Pharmacological Approaches to Migraine Management

In addition to medication, various non-pharmacological approaches can be effective in managing migraines. These strategies can be used alone or in combination with traditional treatments to provide comprehensive migraine care.

Lifestyle Modifications

• Maintaining a regular sleep schedule
• Staying hydrated
• Eating a balanced diet
• Managing stress through relaxation techniques or exercise
• Avoiding known triggers

Alternative Therapies

Some individuals find relief through alternative therapies, although their effectiveness can vary from person to person:

• Acupuncture
• Biofeedback
• Massage therapy
• Cognitive-behavioral therapy
• Herbal supplements (e.g., feverfew, butterbur)

Can dietary changes help prevent migraines? For some individuals, certain foods or food additives may trigger migraines. Identifying and avoiding these triggers through an elimination diet or food diary can potentially reduce the frequency of attacks.

When to Seek Medical Attention for Migraines

While most migraines can be managed at home or with the help of a primary care physician, there are instances when immediate medical attention is necessary. It’s important to recognize the signs that indicate a need for urgent care.

When should you go to the emergency room for a migraine? Seek immediate medical attention if you experience:

• A sudden, severe headache unlike any you’ve had before
• Headache accompanied by fever, stiff neck, confusion, or seizures
• Headache following a head injury
• Persistent aura symptoms lasting more than an hour
• New or worsening symptoms in individuals over 50

How can you differentiate between a severe migraine and a more serious condition? While it can be challenging to distinguish between a severe migraine and other neurological conditions, any sudden, severe headache that is markedly different from your usual migraine pattern should be evaluated by a medical professional to rule out more serious causes.

The Impact of Migraines on Quality of Life

Migraines can significantly impact an individual’s quality of life, affecting personal relationships, work productivity, and overall well-being. Understanding the far-reaching effects of migraines is crucial for both sufferers and their support networks.

Workplace Challenges

Migraines can lead to decreased productivity and increased absenteeism in the workplace. Some challenges faced by migraine sufferers in professional settings include:

• Difficulty concentrating during attacks
• Missed workdays due to severe symptoms
• Challenges in meeting deadlines or attending meetings
• Potential stigma or misunderstanding from colleagues

How can employers support employees with migraines? Employers can help by creating a migraine-friendly work environment, offering flexible work arrangements, and providing education about migraines to reduce stigma and promote understanding.

Social and Family Life

Migraines can also strain personal relationships and limit social activities. The unpredictable nature of migraine attacks may lead to:

• Cancelled plans or social engagements
• Difficulty participating in family activities
• Feelings of isolation or guilt
• Strain on relationships due to the need for care during attacks

How can family and friends support a loved one with migraines? Understanding the nature of migraines, offering practical help during attacks, and being flexible with plans can greatly support individuals living with migraines.

Emotional and Mental Health

The chronic nature of migraines can take a toll on an individual’s emotional and mental well-being. Some common psychological effects include:

• Anxiety about future attacks
• Depression related to chronic pain and lifestyle limitations
• Frustration with the unpredictability of the condition
• Low self-esteem due to perceived limitations

Can addressing mental health improve migraine outcomes? Yes, managing stress and addressing any underlying mental health concerns can potentially reduce the frequency and severity of migraine attacks. Cognitive-behavioral therapy and stress management techniques can be valuable tools in a comprehensive migraine management plan.

Emerging Treatments and Future Directions in Migraine Research

The field of migraine research is continuously evolving, with new treatments and therapeutic approaches emerging. Understanding these advancements can provide hope and new options for individuals struggling with migraines.

Novel Pharmacological Approaches

Recent years have seen the development of new classes of migraine medications, including:

• CGRP (Calcitonin Gene-Related Peptide) antagonists for both acute and preventive treatment
• Ditans, a new class of acute migraine medications
• Neuromodulation devices for acute and preventive treatment

How do CGRP antagonists differ from traditional migraine medications? CGRP antagonists target a specific pathway involved in migraine pain, potentially offering more targeted relief with fewer side effects compared to older medications.

Non-Invasive Neuromodulation

Several non-invasive neuromodulation devices have been approved for migraine treatment, including:

• Transcranial magnetic stimulation (TMS) devices
• Electrical nerve stimulation devices
• Vagus nerve stimulators

Can neuromodulation devices replace traditional migraine medications? While these devices show promise, they are often used in conjunction with other treatments rather than as a complete replacement. Their effectiveness can vary among individuals, and they may be particularly useful for those who cannot tolerate or do not respond well to traditional medications.

Personalized Medicine Approaches

The future of migraine treatment may lie in personalized medicine, tailoring treatments to an individual’s specific genetic and physiological profile. Areas of research include:

• Genetic testing to predict medication response
• Biomarker identification for more targeted treatments
• Precision medicine approaches based on individual migraine patterns and triggers

How might personalized medicine change migraine treatment in the future? By identifying individual factors that contribute to migraines, personalized medicine approaches could lead to more effective, targeted treatments with fewer side effects and improved outcomes for migraine sufferers.

As research continues to advance our understanding of migraines, new treatment options and management strategies will likely emerge, offering hope for improved quality of life for those affected by this challenging condition. Staying informed about these developments and working closely with healthcare providers can help individuals navigate the evolving landscape of migraine care and find the most effective treatment approaches for their unique needs.

How Long Do Migraines Last? Timeline, Symptoms, and Treatment

Migraine episodes may last anywhere from a few hours to multiple days. Seek medical attention if your symptoms last longer.

A migraine attack typically lasts from 4 to 72 hours but can also last longer. It can be difficult to predict how long an individual episode will last, but charting its progress may help.

Migraine episodes can usually be divided into four or five distinct stages. Not all people with migraine experience each of these phases during each episode. Phases can include:

• warning or premonitory phase
• aura (not all people with migraine experience this phase, and those who do may not experience it during every episode)
• headache, or main attack
• resolution period
• recovery or postdrome stage (not all people with migraine experience this phase, and those who do may not experience it during every episode)

Some of these phases may only last briefly, whereas others may last much longer. You may not experience each phase with every episode you have. Keeping a migraine journal can help you track any patterns and prepare for what’s to come.

Keep reading to learn more about each stage, what you can do to find relief, and when to see a doctor.

Sometimes, migraine can begin with symptoms that have absolutely nothing to do with a headache.

These symptoms can include:

• craving certain foods
• increased thirst
• stiff neck
• irritability or other mood changes
• fatigue
• anxiety

Premonitory symptoms can last anywhere from 1 to 24 hours before the aura or headache phases begin.

About 25% of people with migraine experience aura. Aura symptoms typically happen before the headache, or main attack, occurs. It often occurs 10 to 30 minutes before the headache pain begins.

Aura symptoms can last anywhere from 5 minutes to 1 hour.

Aura can include a wide range of neurological symptoms. You may see:

• colored spots
• dark spots
• sparkles or “stars”
• flashing lights
• zigzag lines
• “heat waves”

You may feel:

• numbness or tingling
• weakness
• dizziness
• anxiety or confusion

You may also experience disturbances in speech and hearing. In rare cases, fainting and partial paralysis are possible.

Although these symptoms usually precede a migraine headache in adults, it’s possible for them to occur at the same time. Children may be more likely to experience an aura at the same time as their headache.

In some cases, aura symptoms may come and go without ever leading to a headache.

Most cases of migraine aren’t accompanied by aura symptoms. Migraine without aura moves directly from the warning stage into the headache stage.

Headache symptoms are typically the same for migraine with and without aura. They may include:

• pulsing pain on one or both sides of your head
• sensitivity to light, noise, odors, or even touch
• blurred vision
• nausea
• vomiting
• loss of appetite
• lightheadedness
• worsening pain with physical activity or other movement

During a migraine attack, many people may be unable to work or continue with their usual daily activities.

This phase is the most unpredictable, with episodes lasting anywhere from a few hours to a few days.

Many migraine headaches gradually fade in intensity. Some people find that taking a nap can help relieve their symptoms. Children may only need to rest a few minutes to see results. This is known as the resolution phase.

As the headache begins to lift, you may experience the recovery phase. This can include a feeling of exhaustion or even of elation. You may also feel:

• moody
• dizzy
• confused
• weak

Your symptoms during the recovery phase may pair with symptoms you experienced during the warning phase. For example, if you lost your appetite during the warning phase you may now find that you’re ravenous.

These symptoms may last for up to a day after your headache.

There isn’t one right way to treat a migraine. If your migraine episodes are infrequent, you may be able to use over-the-counter (OTC) medications to treat symptoms as they occur.

If your symptoms are chronic or severe, OTC treatments may not be helpful. A doctor may be able to prescribe stronger medication to treat existing symptoms and help prevent future attacks.

Home remedies

Sometimes, changing your environment may be enough to relieve the bulk of your symptoms.

If you can, seek solace in a quiet room with minimal lighting. Use lamps instead of overhead lighting, and draw the blinds or curtains to block sunlight.

The light from your phone, computer, TV, and other electronic screens may exacerbate your symptoms, so limiting your screen time may help.

Applying a cold compress and massaging your temples may also provide relief. If you aren’t feeling nauseous, upping your water intake may also be helpful.

It can also help to track, identify, and avoid what’s triggering your symptoms. This may help reduce symptoms and prevent them from recurring.

Common triggers can include:

• stress
• certain foods
• skipped meals
• drinks with alcohol or caffeine
• certain medications
• not getting enough sleep
• hormonal changes
• weather changes
• concussions and other head injuries

OTC medication

OTC pain relievers may help with symptoms that are mild or infrequent. Common options include:

• aspirin (Bayer)
• ibuprofen (Advil)
• naproxen (Aleve)

If your symptoms are more severe, you may want to try a medication that combines a pain reliever and caffeine, such as Excedrin. Caffeine has the potential to both trigger and treat migraine episodes, so you may want to avoid this product unless you’re sure that caffeine isn’t a trigger for you.

These medications shouldn’t be used more than 10 to 15 days per month. Doing so can lead to medication overuse headaches.

Prescription medication

If OTC options aren’t working, you may decide to talk with a doctor.

They may be able to prescribe stronger, more targeted medications to help ease the pain.

This may include triptans, such as:

• sumatriptan (Imitrex, Treximet)
• zolmitriptan (Zomig)
• eletriptan (Relpax)
• rizatriptan (Maxalt)
• almotriptan

If your migraine episodes are chronic, a doctor may also prescribe medication to help prevent future episodes. These medications may include:

• Calcitonin-gene-related peptide (CGRP) antagonists: rimegepant (Nurtec ODT) or ubrogepant (Ubrelvy)
• Selective serotonin 1F receptor agonist: lasmiditan (Reyvow)

They may also prescribe medication to help relieve nausea.

If you’re experiencing a migraine episode for the first time, you may be able to relieve your symptoms with home remedies and OTC medications.

But if you’ve had multiple migraine episodes, you may want to make an appointment with a doctor. They can assess your symptoms and develop a treatment plan tailored to your individual needs.

You should see your doctor right away if:

• Your symptoms began after a head injury.
• Your symptoms last longer than 72 hours.
• You’re 40 years old or older and are experiencing a migraine for the first time.
• You develop a sudden severe headache.
• You’re over the age of 50.
• Your headaches have changed in quality.
• You have a headache that occurs with neurological symptoms, such as weakness on one side of the body, numbness, loss of vision, loss of consciousness.

A migraine episode typically lasts anywhere from 4 to 72 hours.

It consists of four or five phases during which you may experience other symptoms. During the headache phase, you may experience throbbing pain and sensitivity to light, sound, smell, or touch.

A doctor can prescribe prescription medication that may help relieve pain and prevent future episodes.

How Long Do Migraines Last? – Cleveland Clinic

You look at the clock. It’s been over an hour. That’s 60 long minutes of your head still pounding from a migraine. Depending on what you’re used to, you may be wondering: Is this normal?

If you live with migraines, you know that when that head pain hits, it can be debilitating. And that pain can continue for anywhere from a couple hours to several days. And in some cases, migraines can go on for even longer — and what’s normal and not normal depends on a number of factors.

Julia Bucklan, DO, explains the common length of migraines — and when you should see a healthcare provider. 

How are migraines categorized?

Not all migraines are created equal. Because they’re such a prevalent and complicated medical issue that there are a lot of categories for different types of migraine attacks. To understand the common length of migraines, it’s helpful to know how migraines are categorized.

According to the International Headache Society (IHS), here are some of the different types of migraine categories that affect the length and duration of the migraine:

• Migraine with aura vs. migraine without aura. 
• Episodic migraine vs. chronic migraine.

The length of your migraine can depend on the type of migraine you experience. 

Aura migraines vs. migraines without aura

Two of the main migraines are migraines with aura and migraines without aura.

Migraine with aura is a type of migraine characterized by the presence of neurological symptoms, referred to as aura. These disturbances can occur either up to an hour before or right in the middle of a migraine headache. 

“For example, if someone has a complicated aura with multiple symptoms — like visual disturbances, sensory changes and difficulty speaking, the migraine can last up to 180 minutes,” explains Dr. Bucklan. In some cases, these motor symptoms can last up to three days.

This is why it’s important to identify what kind of migraine you’re experiencing and what are the common symptoms. Aura symptoms typically develop gradually over a few minutes and can last for up to an hour. Common aura symptoms include:

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• Visual disturbances: These can include seeing flashing lights, zigzag lines, blind spots or experiencing temporary vision loss.
• Sensory changes: You can experience tingling or numbness sensations in your face, hands or other parts of your body.
• Language and speech difficulties: Difficulty finding words, slurred speech or confusion in expressing thoughts.
• Motor symptoms: Weakness or temporary paralysis on one side of your body (hemiplegic migraine) may occur in rare cases.
• Other symptoms: Some people may experience auditory hallucinations, vertigo or olfactory (smell) disturbances. 

On the other hand, a migraine without an aura is the more common type of migraine, where the headache occurs without the presence of an aura. Symptoms of migraine without aura can last anywhere from a few hours to several days. 

Individuals with migraine without aura experience the typical symptoms associated with migraines, including:

• Moderate to severe headache pain.
• Throbbing pain.
• Pain worsening with activity.
• Unilateral pain (affecting only one side of your face). 
• Sensitivity to light. 
• Sensitivity to sound.
• Nausea and vomiting.

Episodic migraines vs. chronic migraines

The next category of migraines that’s important to understand is episodic versus chronic migraines. The difference between episodic and chronic migraines is based on the frequency of migraine attacks. So, how your migraines are categorized will depend on how often you have your migraines throughout a 30-day period. 

• Episodic migraines: Episodic migraines mean you have fewer than 15 headache days per month. People with episodic migraines may experience a range of symptoms, including headache pain, sensitivity to light and sound, nausea and vomiting, but they typically have longer periods of time without migraine symptoms between attacks.
• Chronic migraines: In contrast, chronic migraine is defined as headache attacks that occur on 15 or more days per month for at least three months, with at least eight of those days meeting the criteria for migraine. If you have chronic migraines, you typically experience more severe and disabling symptoms compared to those with episodic migraines and may have difficulty carrying out daily activities or work due to the frequency and intensity of your headaches.

It’s worth noting that the frequency and severity of migraine attacks can vary widely from person to person, and some people may experience a transformation from episodic to chronic migraines over time. If you’re experiencing frequent or severe headaches, it’s important to speak with a healthcare provider to determine the best treatment approach for you.

How long do migraines last?

Overall, the average length of a migraine attack ranges between four and 72 hours, if it goes untreated. But this can vary based on a lot of factors. 

The best way to track how long your migraine is lasting and what’s common for you is by knowing the stages that your migraines can go through.

Stages of a migraine

While your migraine probably feels like one big continuous blob of pain, it actually can have a series of phases. And understanding these stages can help you understand the best course of treatment for you. 

“I think it’s good to have the awareness of different phases,” notes Dr. Bucklan, “because lots of people don’t realize why they feel a certain way.”

Migraine attacks can be divided into four phases. Here’s what occurs during each phase, as well as the average duration of each one: 

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1. The prodrome phase: Also referred to as a “premonitory phase” or “premonitory symptoms,” this phase can actually occur hours or days before the headache even starts. It may include symptoms such as mood changes, food cravings, neck stiffness and increased urination. You may also feel anxiety and a general feeling of unwell, fatigue and increased thirst. This phase generally lasts a few hours to multiple days. 
2. The aura phase: This phase — which only occurs in some people with migraines — can last a few minutes to an hour and is characterized by neurological symptoms such as visual disturbances, tingling or numbness and difficulty speaking. “The average length for visual symptoms is usually more in the 10- to 20-minute period,” says Dr. Bucklan. 
3. The headache phase: This phase is the most well-known and is characterized by moderate to severe headache pain, which can be on one or both sides of your head and may be accompanied by other symptoms like nausea, vomiting and sensitivity to light and sound. This phase can last anywhere from a few hours to several days.
4. The postdrome phase: This phase occurs after the headache and may include symptoms such as fatigue, difficulty concentrating, mood changes and episodes of depression. This phase can often last between 24 and 48 hours. “The depression phase is very real,” confirms Dr. Bucklan. “Some people describe it as being worse than the headache pain.” 

She also says that, in general, not everyone has all the phases. “There can be up to four phases but some people have just pain and none of the other components.”

How long is too long for a migraine?

No matter what type of migraine you have, there’s a point where you should seek medical attention.  

“If it’s going past that 72-hour mark, then it’s considered what we call ‘status migrainosus,’” explains Dr. Bucklan. This is when you should definitely consider going to either the emergency room or seeking medical attention from your healthcare provider — especially if your migraine hasn’t responded to any kind of treatment. 

“At this point, your treatment changes because you’re in this cycle that needs to be broken,” stresses Dr. Bucklan.

How long do migraines last if treated?

Your healthcare provider or neurologist will likely approach your migraine treatment through either preventive treatments or abortive treatments. This means that they’ll either try giving you medication that will help prevent migraines and their frequency, or they’ll give you prescription pain relievers that help stop a migraine shortly after it begins. 

If you have an effective abortive medication, your migraines shouldn’t come anywhere close to the 72-hour mark — but if they do, you should seek medical attention. The length of your migraine will ideally be cut short if you begin treatment right at the onset of symptoms — usually through medication prescribed by your provider. But this will depend on when you take the medication and how long your migraine has been going on already. 

“The goal of preventive treatment is to reduce the frequency and severity of the migraines by at least 50%,” states Dr. Bucklan. 

Depending on your specific triggers, the type of migraine you have and when you begin treatment, the length of your symptoms could last as little as four hours up to a 72-hour period. If the duration of your migraines is changing, be sure to let your healthcare provider know so they can adjust your treatment as needed and help you find relief.

How long migraine lasts in women with headache. Is there a difference for men?

How long migraine lasts in women with headache. Is there a difference for men?

Gimranov Rinat Fazylzhanovich
Neurologist, neurophysiologist, experience – 33 years;
Professor of Neurology, MD;
Clinic for Rehabilitation Neurology. About the author

Publication date: September 20, 2019

Updated: May 16, 2022

A headache is a problem that almost every inhabitant of the earth faces from time to time. There can be many reasons for this.

Article content:

• 1 Phases of migraine
  • 1.1 Prodromal
  • 1.2 Aura
  • 1.3 Headache
  • 1.4 Postdromal 9002 3
• 2 Duration depending on the species
  • 2.1 Simple
  • 2.2 Classic
  • 2.3 Associate
• 3 References

Phases of migraine

Neurologists distinguish 4 stages of the course of the disease. It should be borne in mind that in a particular case, not all of them may appear. Only 3, 4 stages can be clearly distinguished, and 1, 2 are practically not manifested in any way.

Prodromal

The very beginning of a migraine attack. During this period, a spasm of the vascular system of the brain occurs, which after a while will manifest itself as pain. Some people at this stage can already identify the onset of pain by the symptoms that appear:

• sudden irritability, aggressiveness, sudden mood swings;
• sensation of drowsiness, physical fatigue;
• information ceases to be perceived, remembered;
• reduced ability to focus;
• sudden attacks of hunger, thirst.

It can take from 30 minutes to 3 hours from the onset of spasm to the onset of pain. People who often experience seizures already understand from these symptoms that their head will soon ache. Therefore, they manage to take the medicine on time, stop the attack.

Aura

A specific set of signs that does not always appear and not in everyone. On average, only 25% of patients experience these unpleasant sensations that precede the onset of pain. Another 15% encounter them periodically.

Characteristic manifestations:

• appearance of flickering dots or spots in the eyes;
• visual field narrowing;
• change in the perception of color, size of objects;
• nausea;
• auditory hallucinations.

Headache

There is a throbbing pain in a certain part of the head. As a rule, in the temple or near the eye. In some patients, the epicenter of pain moves depending on the attack or even during 1 attack. The pain is pulsating, then rising, then falling. Sharp sharp pain is rare.

Patients often experience concomitant signs of an attack. Even according to them, the duration of a migraine cannot be predicted in advance; it can last from several hours to several days.

Sometimes there is a series of migraine attacks: short bursts of pain for several hours, several days in a row (up to 10). Then the total duration reaches a week. In this case, you must consult a doctor.

Postdromal

Recovery period or “migraine hangover”. The pain subsided, but the body needs time to recover. As a rule, during the day there is weakness, absent-mindedness. During this time, vision is restored, nausea, sound hallucinations pass.

If such symptoms do not disappear within a few hours of the pain subsiding, another attack should be expected.

Duration depending on the type

Depending on the type of disease, it can be predicted how long a head migraine attack will last in a man or woman, how many hours or days a headache can last and how long the break between attacks lasts.

The duration of an attack directly depends on the causes that caused it, the physical condition of the person, predisposition.

A migraine attack can last several days in a row: 2, 3, 4, 5, weeks, depending on the causes. In each of the cases, a selected treatment is necessary, an urgent appeal to the hospital is possible.

Simple appearance

It is characterized by the absence of an aura, any symptoms that anticipate a pain attack. It is considered dangerous, since the pain occurs suddenly, making it impossible to take the medicine in advance.

Pain is felt in the area of ​​the temples, eyes, occasionally in the back of the head. Temporary vasospasm passes quickly, but may return after a short time.

Classic

In the classical course of an attack, the symptoms of the aura come before the pain. According to their activity, you can roughly predict how long the migraine will pass and how many days it will last.

The patient experiences nausea and may vomit with temporary relief. There is increased irritability, sudden changes in mood, physical weakness.

Attacks of the classical type are not considered dangerous if their duration does not exceed several hours, and the frequency is not more than 2-3 times a month.

Associate

One of the complex variants of the disease, as it does not proceed by itself, but is provoked by the pathological state of the body. Or he himself causes complications from the side of health.

Common forms:

• Ophthalmic with visual impairment. The optic nerve is affected, causing problems with vision. Black dots, spots appear, the field of vision narrows, in difficult cases temporary blindness is observed. All symptoms are reversible, disappear after an hour or two after the attack.
• Hemiplegic, when the sensation of different parts of the body disappears. There may be a tingling sensation, goosebumps in the skin and muscles.
• Cerebellar, caused by injuries leading to oxygen starvation of the brain.
• Heart shape. Side effect – complications in the work of the cardiovascular system are irreversible. They are noted with a duration of a migraine attack of several days.
• Vestibular, accompanied by disorders of the vestibular apparatus. The patient becomes clumsy, it is difficult for him to navigate in space, there is a constant ringing in his ears.

It is impossible to predict in advance how long a migraine will last, since an attack, depending on the concomitant reasons, can last 10 minutes, or maybe a day or two.

Migraine should not last more than a week, if the attack lasts 3 days, hospitalization is indicated, during which the doctor will tell you what to do

References

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Gimranov Rinat Fazylzhanovich

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Is it possible to die from a migraine? Headache subjective experience and treatment

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Is it possible to get sick leave for migraine today?

After the classification of headaches appeared in 1988, the doctors said: “Oh, there are migraines!”, and there are other types of headaches, now it is legally possible to receive a sick leave. This problem is being studied more and more every year in the world, patient organizations are being created that try to interact with employers with the help of trade unions. True, in our country I do not see great success in this direction, but in Europe this movement is developing actively.

Our clinic has been operating for 20 years, and, according to our modest statistics, there are no fewer patients, but today we have accepted – this figure is in our database – 51 thousand people. And in Russia there are already a dozen similar clinics, although in tiny Italy there are 36 headache clinics.

How to determine that a headache is already a disease? Where is the border? Maybe this is a temporary phenomenon that is not yet considered a disease.

The classification that exists today is very simple – there are primary headaches that are not associated with any damage to the body. Although we may not yet know what changes occur in the brain at the time of headaches, this topic has not yet been studied.

Primary headache refers to migraine (periodic attacks of moderate or severe headache). It is usually localized in one half of the head, has a pulsating character, lasts from two hours to three days. Accompanied by nausea, vomiting, in a third of patients there is a short-term visual impairment. The underlying mechanisms of the disease are not fully known. Then there is a tension headache (pressing pain in the head of varying intensity), probably every person has experienced it at least once in their life. Cluster headache (a pronounced series of attacks of pain syndrome in the areas of the projection of the brain on the walls of the cranium, lasting from several weeks to several months). The strength of the pain is so great that there have even been cases of suicide attempts.

And there is the concept of “secondary headache”. For example, we have the flu, we may have a headache, we have recovered, and the headache is gone. That is, a headache that is clearly associated with some kind of condition. When the underlying disease worsens, the headache increases, and when it improves, it decreases.

There was a breakthrough when the international neurological community gave an official definition of the state of pain – this is a subjective experience, we cannot but believe the person. If a person says that he is in pain, we are obliged to believe him. Today we cannot say to a patient: “Well, you know, who doesn’t have a headache, go to work!” The doctor is obliged to respond clearly.

Which doctor treats headaches? Therapist or neurologist?

In general, general practitioners all over the world do this, it has historically happened in our country that neurologists do this. But general practitioners and therapists are still in the lead in terms of negotiability. That is, if I am worried about a headache, should I go to a general practitioner in a district clinic? Yes. And he has to figure it out, if it’s a difficult case and he doesn’t have the qualifications to understand what’s going on, he has to send you to a narrow specialist, they’re called cephalologists.

Are there such doctors in district polyclinics?

In Moscow, not in all polyclinics, but in the districts there are several offices. There is a headache room in the Southern Administrative District, it is state-owned and operates on the basis of the district polyclinic. And if a person does not have the financial ability to go to a private clinic, he can ask for a referral to such offices. There are also pain departments at the Sklifosovsky Institute, at the All-Russian Center for Surgery named after Petrovsky and at the First Med on Pirogovka. These are federal institutions where people can be treated with a referral from the district clinic.

How is a person treated with a headache?

To begin with, it is determined whether the headache is primary or not. It is most important. If the pain arose as a result of something, then this “something” must be removed and the underlying disease treated. Headache is treated taking into account the main diagnosis, today the classification is very large and describes more than 160 types of headache. It is clear that primary care specialists in the district polyclinic cannot and should not understand all this diversity, their task is to provide first aid, and if the situation worsens, narrow-profile people should join. Treatment of any kind of headache, secondary or primary, always consists of two blocks. The first is the treatment of the attack itself, the second is prevention. Legally, this issue is interpreted as follows: if a person has more seizures than twice a week, he can be prescribed preventive therapy. But people are all different, with different pain thresholds, and pain, as I said, is a subjective phenomenon. There are people who have headaches every day. Then the doctor puts the highest score in the questionnaire – 10 (questionnaires with scores are used to classify the severity of the headache). At the same time, the person to the question “Can you work?” replies: “Well, of course, I have to do it.” Another person with 2-3 pain can’t do anything because that’s how they rate their pain. And, for example, if they have a migraine attack, they can collapse completely with a severe attack. They rate their pain at 3 points, and a severe attack is 10 points, when it is impossible to tear your head off the pillow completely. Of course, it is very important to choose the right treatment regimen, it is individual, as well as the right drugs for stopping seizures. For the relief of migraine attacks, there are narrowly targeted drugs. By the way, we have a colossal problem – almost all painkillers are sold in the public domain in pharmacies. As a result, we got another type of headache – drug-induced. People uncontrollably take painkillers, and there comes a point when they develop addiction, and the head hurts already from taking the pills. This is a problem that, from my point of view, should be actively covered, because self-treatment is a dangerous thing, you won’t even notice how you move from one category to another. People who have episodic headaches run into a pharmacy, buy pills, then lose control and no longer understand where the border is when the head hurts six times a month, then sixteen, and then twenty-six. Among our patients there are “champions” who took 20-30 tablets per day! And from year to year there are more such people. It is clear that it is difficult to take time off from work, the level of stress is very high, people hold on to their jobs and at the same time are not sure of medical care, they think that they themselves know what helps them. But this circle closes very quickly, and it is already very difficult, almost impossible for primary care physicians to help such patients. Doctors in the clinic also have an appointment that lasts only 12 minutes; there is no way to question such a patient and understand the cause-and-effect relationships in such a short time.

What is the diagnosis of headache other than the stories of the person himself?

There is a certain percentage of headaches associated with neoplasms. By the way, it is very small, only 2% per year, but it is still someone’s life, and everything here is built very clearly. The doctor interrogates and examines the patient, it can be both a neurologist and a therapist, and if they do not see any neurological signs, then they may not prescribe any diagnosis. There is such a conditional corridor – 30 days. If we treat a patient for 30 days and do not get any effect, the symptoms do not go away or even increase, these are direct indications to send the patient for tomography. Now overdiagnosis (MRI today, everyone can do without any referral and indications), which we plunged into, sometimes we don’t helps, but creates additional problems. For example, we do an MRI to a person, we find some foci in the brain. A sensitive patient immediately panics: “Ahh, my brain is breaking down.” His mood deteriorates, he begins to look for the cause, and very often such foci can be genetic, the same foci were in his mother, father, grandmother. Of course, this is an important study, but often it does not give a causal relationship with headache, and this information has created a problem. In the West, the Nostress! movement is now popular, that is, we do not do additional surveys so as not to have unnecessary information. And then they do a study of the vessels to the patient, they find that one vessel is a little narrower than the other, and that’s all – already a million questions: “Here I already have one vessel, and therefore my head hurts. ” And this is not so, there is no such connection. A 50-year-old man lives normally with this vessel, all vessels cannot be the same. Sometimes such facts confuse even specialists, which leads to incorrect diagnosis. Accordingly, the correct treatment is not prescribed. Therefore, sometimes a doctor does not prescribe an MRI, not because he is sorry, but he does not see much point in this. Although psychologically and humanly I understand this, after a number of famous people died from a brain tumor, we have a total fear of neoplasms, it is very difficult to calm people down. Until the patient himself goes to the MRI and makes sure that he does not have a tumor, it is almost impossible to interact with him further. Although MRI also has errors. All diagnostics are based on the examination and the patient’s story, right? But then we get into the viscous area of ​​the degree of adequacy of the patient. There are psychoses, phantom pains. There are hypochondriacs who make up half of the symptoms. How do you identify and share all this? How do you understand how the patient adequately tells you?

Back to where I started. Complaints are subjective. There are types of headaches associated with mental disorders. In general, it is normal to worry about your health. The only thing is that our anxiety, which should carry security functions, one day can break all barriers, become a disease and destroy our brain with fears. Then a specific treatment is prescribed – sessions of psychotherapy. Of course, if a person has no money or relatives are ill, there are problems, it is wrong to recommend a psychotherapist to him when he would only survive. It is necessary to choose the appropriate therapy so that a person can be in society and adequately solve his problems. And so visiting a psychotherapist could be recommended to all residents of the metropolis.

Is the treatment of headaches based on painkillers?

Not only. Migraine, for example, is a genetic disease (by 70%), so far we cannot do anything with genetics. In our clinic, we are already seeing the third generation of patients in several families. Grandmothers were treated with us, then mothers, now the girls have already come (in most cases, women suffer from migraines), and the medical history is right under the blueprint. We must influence what we can – remove provoking factors. We will not, of course, give a person stupid advice not to be nervous, but we can say that if he is nervous, then let him take valerian so as not to further deepen the stress. Or, if you know you’re in for an experience, take something proactively so you don’t make the situation too dramatic. It is necessary to pay attention to neck pain, sleep and appetite disturbances, and so on. Accordingly, if a person has a headache and sleep disturbance, then until we improve the quality of his sleep, we will not be able to move forward in treatment.

Headaches have triggers such as alcohol, cheese, citrus fruits, chocolate and other foods. We need to keep an eye on this and clean them up. And then there are funny cases when a person comes, complains of a terrible headache, you ask him if he associates this pain with some factors, he says: “Yes, my head hurts after drinking red wine.” The conclusion is obvious. You explain to him how red wine affects the blood vessels, you advise him to exclude it. To which he replies, “That’s impossible. I love him,” and there’s nothing I can do about it, that’s the patient’s choice. Often people know what causes their headaches. So first we remove provocateurs.

If a person develops a headache, for example, at work, you need to look: maybe the ergonomics of the workplace is not good? Maybe you need to move the computer, turn the monitor to make it comfortable, change the chair, add lighting, and – oh, miracle! – the headache has passed or has become much less disturbing. Often the head hurts from improperly selected glasses or lenses. Go to the optometrist, change your glasses – these are simple things that do not come to mind to check.

Often headache from sports. Doctors don’t work in the gym, they watch – young, healthy, come on! And a person cannot “give”, he has such physiological characteristics. And if he attends group classes, and the coach encourages him: “Keep up, a little more, we endure!” – the person is trying, but he is getting worse and worse … Listen, it’s obvious – something is going wrong. Even now, one hobby is fashionable – orthopedic pillows. They must be selected very carefully, taking into account the individual characteristics of the structure of the neck and head. But often, after all, they buy the first ones that come across or give friends for a birthday. A person begins to sleep on such a pillow, and soon it becomes a source of headache. People often do not see such simple connections. Sometimes it is enough to remove the pillow, and nothing needs to be treated. So before you go to the doctor, look around carefully to see if anything needs to be changed.

Can you die from a migraine?

No, migraine is not a fatal disease, no such cases have been recorded. But migraine disrupts the quality of life, so you need to be treated. To stop the attacks, specific painkillers are prescribed. This is not analgin, of course, combined analgesics are generally not good, addiction develops very quickly. They can effectively reduce the attack, we try to prescribe single-component drugs so that addiction develops slowly or does not develop at all, and there is a specific drug and dosage for each type of pain. And preventive measures are already made up of numerous factors and a combination of symptoms. It can be antidepressants, and antiepileptic drugs, and drugs that relax the muscles.

When should a person with a headache see a doctor? When does he have a headache how many times a month?

This is also very subjective. We had patients who had a headache once a year. But they didn’t want her to get sick even this one time. And some have a headache all the time, and this does not bother them. There are no laws here. As long as it does not interfere with your life, you can not apply.