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What is migraine?

Migraine is a type of headache characterized by recurrent attacks of moderate to severe throbbing and pulsating pain on one side of the head. The pain is caused by the activation of nerve fibers within the wall of brain blood vessels traveling inside the meninges (three layers of membranes protecting the brain and spinal cord).

Untreated attacks last from four to 72 hours. Other common symptoms include:

• Increased sensitivity to light, noise, and odors
• Nausea
• Vomiting

Routine physical activity, movement, or even coughing or sneezing can worsen the headache pain.

Migraines occur most frequently in the morning, especially upon waking. Some people have migraines at predictable times, such as before menstruation or on weekends following a stressful week of work. Many people feel exhausted or weak following a migraine but are usually symptom-free between attacks.

A number of different factors can increase your risk of having a migraine. These factors, which trigger the headache process, vary from person to person and include:

• Sudden changes in weather or environment
• Too much or not enough sleep
• Strong odors or fumes
• Emotion
• Stress
• Overexertion
• Loud or sudden noises
• Motion sickness
• Low blood sugar

• Skipped meals
• Tobacco
• Depression
• Anxiety
• Head trauma
• Hangover
• Some medications
• Hormonal changes
• Bright or flashing lights

Migraine is divided into four phases, all of which may be present during the attack:

1. Premonitory symptoms occur up to 24 hours prior to developing a migraine. These include food cravings, unexplained mood changes (depression or euphoria), uncontrollable yawning, fluid retention, or increased urination.
2. Aura—Some people will see flashing or bright lights or what looks like heat waves immediately prior to or during the migraine, while others may experience muscle weakness or the sensation of being touched or grabbed.
3. Headache—A migraine usually starts gradually and builds in intensity. It is possible to have migraine without a headache.
4. Postdrome—Individuals are often exhausted or confused following a migraine. The postdrome period may last up to a day before people feel healthy again.

The two major types of migraine are:

1. Migraine with aura, previously called classic migraine, includes visual disturbances and other neurological symptoms that appear about 10 to 60 minutes before the actual headache and usually last no more than an hour. Individuals may temporarily lose part or all of their vision. The aura may occur without headache pain, which can strike at any time. Other classic symptoms include trouble speaking; an abnormal sensation, numbness, or muscle weakness on one side of the body; a tingling sensation in the hands or face, and confusion. Nausea, loss of appetite, and increased sensitivity to light, sound, or noise may precede the headache.
2. Migraine without aura, or common migraine, is the more frequent form of migraine. Symptoms include headache pain that occurs without warning and is usually felt on one side of the head, along with nausea, confusion, blurred vision, mood changes, fatigue, and increased sensitivity to light, sound, or noise.

Other types of migraine include:

• Abdominal migraine mostly affects young children and involves moderate to severe pain in the middle of the abdomen lasting one to 72 hours, with little or no headache. Additional symptoms include nausea, vomiting, and loss of appetite. Many children who develop abdominal migraine will have migraine headaches later in life.
• Basilar-type migraine mainly affects children and adolescents. It occurs most often in teenage girls and may be associated with their menstrual cycle. Symptoms include partial or total loss of vision or double vision, dizziness and loss of balance, poor muscle coordination, slurred speech, a ringing in the ears, and fainting. The throbbing pain may come on suddenly and is felt on both sides at the back of the head.
• Hemiplegic migraine is a rare and severe form of migraine that causes temporary paralysis—sometimes lasting several days—on one side of the body prior to or during a headache. Symptoms such as vertigo, a pricking or stabbing sensation, and problems seeing, speaking, or swallowing may begin prior to the headache pain and usually stop shortly thereafter. When it runs in families the disorder is called familial hemiplegic migraine (FHM). Though rare, at least three distinct genetic forms of FHM have been identified. These genetic mutations make the brain more sensitive or excitable, most likely by increasing brain levels of a chemical called glutamate.
• Menstrual migraine affects women around the time of their period, although most women with menstrually-related migraine also have migraines at other times of the month. Symptoms may include migraine without aura, pulsing pain on one side of the head, nausea, vomiting, and increased sensitivity to sound and light.
• Migraine without headache is characterized by visual problems or other aura symptoms, nausea, vomiting, and constipation, but without head pain.
• Ophthalmoplegic migraine an uncommon form of migraine with head pain, along with a droopy eyelid, large pupil, and double vision that may last for weeks, long after the pain is gone.
• Retinal migraine is a condition characterized by attacks of visual loss or disturbances in one eye. These attacks, like the more common visual auras, are usually associated with migraine headaches.
• Status migrainosus is a rare and severe type of acute migraine in which disabling pain and nausea can last 72 hours or longer. The pain and nausea may be so intense that people need to be hospitalized.

Who is more likely to have migraine?

Migraines occur in both children and adults but affect adult women three times more often than men. Migraines are genetic. Most migraine sufferers have a family history of the disorder. They also frequently occur in people who have other medical conditions. Depression, anxiety, bipolar disorder, sleep disorders, and epilepsy are more common in individuals with migraine than in the general population. Individuals who have pre-migraine symptoms referred to as aura have a slightly increased risk of having a stroke.

Migraine in women often relates to changes in hormones. The headaches may begin at the start of the first menstrual cycle or during pregnancy. Most women see improvement after menopause, although surgical removal of the ovaries usually worsens migraines. Women with migraine who take oral contraceptives may experience changes in the frequency and severity of attacks, while women who do not suffer from headaches may develop migraines as a side effect of oral contraceptives.

How is migraine treated?

Migraine treatment is aimed at relieving symptoms and preventing additional attacks. Quick steps to ease symptoms may include:

• Napping or resting with eyes closed in a quiet, darkened room
• Placing a cool cloth or ice pack on the forehead
• Drinking lots of fluid, particularly if the migraine is accompanied by vomiting

Small amounts of caffeine may help relieve symptoms during a migraine’s early stages.

Drug therapy for migraine is divided into acute and preventive treatment. Acute or “abortive” medications are taken as soon as symptoms occur to relieve pain and restore function. Preventive treatment involves taking medicines daily to reduce the severity of future attacks or keep them from happening. The U.S. Food and Drug Administration (FDA) has approved the drugs enenmab (Aimovig) for the preventive treatment of headache and galcanezumab-gnlm (Emgality) injections to treat episodic cluster headache. The FDA also has approved lasmiditan (Reyvow) and ubrogepant (Ubrelvy) tablets for short-term treatment of migraine with our without aura. Headache drug use should be monitored by a physician, since some drugs may cause side effects.

Acute treatment for migraine may include any of the following drugs:

• Triptan drugs increase levels of the neurotransmitter serotonin in the brain. Serotonin causes blood vessels to constrict and lowers the pain threshold. Triptans—the preferred treatment for migraine—ease moderate to severe migraine pain.
• Ergot derivative drugs bind to serotonin receptors on nerve cells and decrease the transmission of pain messages along nerve fibers. They are most effective during the early stages of migraine.
• Non-prescription analgesics or over-the-counter drugs such as ibuprofen, aspirin, or acetaminophen can ease the pain of less severe migraine headache.
• Combination analgesics involve a mix of drugs such as acetaminophen plus caffeine and/or a narcotic for migraine that may be resistant to simple analgesics.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce inflammation and alleviate pain.
• Nausea relief drugs can ease queasiness brought on by various types of headache.
• Narcotics are prescribed briefly to relieve pain. These drugs should not be used to treat chronic headaches.

Everyone with migraine needs effective treatment at the time of the headaches. Some people with frequent and severe migraine need preventive medications. In general, prevention should be considered if migraines occur one or more times weekly, or if migraines are less frequent but disabling. Preventive medicines also are recommended for individuals who take symptomatic headache treatment more than three times a week. Physicians also will recommend that a migraine sufferer take one or more preventive medications two to three months to assess drug effectiveness, unless intolerable side effects occur.

Several preventive medicines for migraine were initially marketed for conditions other than migraine.

• Anticonvulsants may be helpful for people with other types of headaches in addition to migraine. Although originally developed for treating epilepsy, these drugs increase levels of certain neurotransmitters and dampen pain impulses.
• Beta-blockers are used to treat high blood pressure and are often effective for migraine.
• Calcium channel blockers are used to treat high blood pressure treatment and help to stabilize blood vessel walls. These drugs appear to work by preventing the blood vessels from either narrowing or widening, which affects blood flow to the brain.
• Antidepressants work on different chemicals in the brain; their effectiveness in treating migraine is not directly related to their effect on mood. Antidepressants may be helpful for individuals with other types of headaches because they increase the production of serotonin and also may affect levels of other chemicals, such as norepinephrine and dopamine.

Natural treatments for migraine include riboflavin (vitamin B2), magnesium, coenzyme Q10, and butterbur (medicinal plant).

Non-drug therapy for migraine includes biofeedback and relaxation training, both of which help individuals cope with or control the development of pain and the body’s response to stress.

Lifestyle changes that reduce or prevent migraine attacks in some individuals include exercising, avoiding food and beverages that trigger headaches, eating regularly scheduled meals with adequate hydration, stopping certain medications, and establishing a consistent sleep schedule. Obesity increases the risk of developing chronic daily headache, so a weight loss program is recommended for obese individuals.

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Learn About Clinical Trials

Clinical trials are studies that allow us to learn more about disorders and improve care. They can help connect patients with new and upcoming treatment options.

How can I or my loved one help improve care for people with migraine?

Consider participating in a clinical trial so clinicians and scientists can learn more about migraine and related disorders. Clinical research uses human volunteers to help researchers learn more about a disorder and perhaps find better ways to safely detect, treat, or prevent disease.

All types of volunteers are needed—those who are healthy or may have an illness or disease—of all different ages, sexes, races, and ethnicities to ensure that study results apply to as many people as possible, and that treatments will be safe and effective for everyone who will use them.

For information about participating in clinical research visit NIH Clinical Research Trials and You. Learn about clinical trials currently looking for people with migraine at Clinicaltrials.gov.

Where can I find more information about migraine?

Information may be available from the following resources:

American Headache Society
Phone: 856-423-0043

Migraine Research Foundation
Phone: 212-249-5402

National Headache Foundation
Phone: 312-274-2650 or 888-643-5552

Learn about related topics

• Headache

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The NINDS Publication Catalog offers printed materials on neurological disorders for patients, health professionals, and the general public. All materials are free of charge, and a downloadable PDF version is also available for most publications.

How to Treat a Migraine at Home

If you suffer from frequent migraines, you’re not alone. According to the American Migraine Foundation, more than 37 million Americans suffer from migraines each year. That’s a big chunk of the population, and given that the World Health Organization has placed migraines among the top ten most disabling medical illnesses in the world, it’s easy to see that migraines are a big problem. This is especially true because there’s no cure, only treatment methods to minimize symptoms. Chronic migraine sufferers often see their doctors for regular treatment methods, such as prescription medication, but many individuals who experience migraines less frequently are left to fend for themselves when a migraine strikes. Regardless of how often you experience migraines, we’ve rounded up a list of the most tried-and-true ways to alleviate your migraine symptoms from home. Read on to help find relief.

Find a Dark, Quiet Space to Rest

The first thing you should do when you feel a migraine coming on? Find a dark, quiet space to rest. If you’re home or can get home easily, draw the curtains in your bedroom, turn the air conditioning down, and lie down in bed with an eye cover on. If you can’t get home, try to find a quiet corner somewhere to close your eyes and take a few deep breaths. Sensitivity to light and sound is one of the most common migraine symptoms, so finding a way to minimize your sensory experience can make a world of a difference.

Cool Down

Studies have shown that cold therapy can prove effective in minimizing migraine symptoms, so head to the freezer and grab an ice pack as soon as you feel a headache coming on. Place the ice pack directly on your forehead to ease acute pain, or position it around your neck and shoulders to ease tension.

Acupressure

Some people who experience frequent migraines have reported that acupressure works wonders to ease the pain. Here’s what to do: Once you locate a pressure point, simply press down on it firmly. Here are the most common pressure points to target:

• The space between your index finger and thumb. With the index finger and thumb of your right hand, squeeze the spot between your index finger and thumb on your left hand firmly. Hold for five minutes or so. Repeat on the other hand.
• The arc above your ear. With one finger, trace the outline of your ear against your head. That imaginary line is your pressure point. Place your fingertips along the line, applying gentle pressure to relieve pain. Repeat on the other ear.
• On the underside of your wrist, just beneath your thumb. With your palm facing upward, locate the spot beneath your thumb where your wrist meets your hand and place firm pressure there. Repeat on the other hand.

Try to Relax

Stress plays a big role when it comes to migraines, so it’s essential to do everything you can to remove yourself from a stressful situation when a migraine is coming on. Perhaps you’re ruminating on a work issue while relaxing at home, or maybe an argument with your partner has left you fuming—regardless of the stressor, it can lead to a migraine, and eliminating it can help relieve symptoms. Do what feels relaxing to you to calm down. Maybe take a bubble bath, go for a walk, or bring a good book to bed and curl up under the covers with a cup of tea.

Drink Water

Even mild dehydration can lead to a migraine, so drinking water right away can help when you feel symptoms of a migraine coming on (even if you’re not thirsty). If you don’t feel like drinking water, you could also eat foods high in water content, like watermelon or yogurt, to rehydrate yourself. Sports drinks like Gatorade are also effective since their sodium levels help to replenish your electrolytes, but be wary of their sugar content. It’s best to make a homemade electrolyte drink instead.

Eat Ginger

There’s rarely evidence that herbal remedies work to cure what they claim, but when it comes to ginger and migraines, that’s not the case. Ginger has been proven effective in treating migraine symptoms at the same level as prescription sumatriptan medication. It also has fewer side effects than sumatriptan, making it a preferable alternative both for those who try to avoid migraine medication and those who don’t experience migraines frequently enough to seek prescription medication.

Prevent the Next Migraine

The best thing you can do for yourself if you experience frequent migraines is to take as many steps as possible to prevent a migraine ahead of time. That includes getting plenty of rest, exercising regularly, pinpointing your food and beverage triggers so you can avoid them, and getting enough magnesium in your diet. If you experience frequent migraines, you could also talk to your doctor about the possibility of being prescribed preventive medication.

Seek In-Home Treatment from DispatchHealth

When your migraine symptoms are atypical and so severe that you think you need an emergency medical service, turn to DispatchHealth. We provide in-home treatment for migraines so you can avoid all the hazards of traveling with a migraine, including the bright fluorescent lights of an emergency room or urgent care clinic and loud noises from traffic. Our team will assess your situation and determine the appropriate therapy to treat your migraine. We have a pharmacy of medications that can be administered through an injection, by mouth, or intravenously if required, all of which is safe and effective to do in the comfort of your home. Our services cost a fraction a trip to the ER and about the same as an urgent care clinic, and we accept most major forms of health insurance, including Medicare and Medicaid. We also offer an affordable flat rate for uninsured patients, and can be there within a few hours.

See availability, we’ll come to your home

Migraines can be debilitating. Don’t go it alone. Request care online, via phone, or through our app to receive the quick migraine treatment you need.

How to support a person with migraine?

Living with a migraine is not easy, and often a person suffering from this disease needs help and support. If your friend, family member, or partner has a migraine, these tips may help.

• Do not question symptoms
• How to help relieve migraine pain
• Support but not intrusive
• Provide physical assistance
• Help learn triggers

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Don’t question the symptoms

Migraine is a disease that doesn’t show itself outwardly. Because people do not notice the symptoms, there are many misconceptions about migraines. It is often mistaken for a common headache.

It is difficult for people to realize that someone does not believe them due to the lack of visible symptoms. To support a person suffering from migraine, first of all, you need to believe that he really hurts. He needs rest and less stress.

During a migraine attack, in addition to a headache, a person may also experience other symptoms: nausea, vomiting, light or sound sensitivity. It’s pretty tedious.

How to help relieve migraine pain

Everyone experiences migraines differently. To support, it is important first of all to listen to the person, and only then you can try to help. Sometimes just turning off the light is enough. In other cases, a change in habits can help, such as avoiding perfume, certain products, or knowing when to leave a high-profile event.

The best way to find out if you need help is to ask! Don’t ask difficult questions like “How can I help you?” Such questions are too difficult for someone who is in pain. It is recommended to start small, such as whether he needs tea, a pill, or if it would be better to close the blinds. This allows for a simple “Yes” or “No” answer. The longer you know a person by observing their symptoms, the better you will understand how you can help.

Support but not intrusive

Try to help, and not just be interested in the state of the person. Don’t say you know what the person is going through unless you personally have a migraine. You cannot imagine what a person feels during an attack, but you can support with a word, try to help maintain a positive attitude, remind a loved one that he will soon feel better.

People suffering from migraine want to live habitually and be in the circle of relatives and friends, but migraine can become active at any moment and confuse all plans. Support includes the ability to change the schedule and enforce certain restrictions. People with migraine are forced to refuse some activities, due to a change in well-being. It is important for them that others understand that the life of a person with migraine is different from the lives of other people, and the reason for changing plans is the unpredictability of their illness, and not the unpredictability of character.

Provide physical assistance

Nothing is more disruptive than a migraine attack. Provide help as much as you can: cook meals, walk the dog, pick up kids from school, or do other urgent chores. This will help the loved one relax and recover faster.

Help learn about triggers

Migraines are often triggered by environmental irritants such as bright lights, loud noises, or certain foods. You can help your loved one by tracking down potential headache causes and helping them avoid or mitigate those triggers in the future.

Dehydration can also cause a migraine. If the person is not nauseated, offer water. Often, a glass of water can help prevent pain from developing.

Also, be aware of how your own behavior can affect a person who has a migraine. If the person is sensitive to light and sound, turn off bright lights, turn off the TV and music, take children and pets elsewhere, close doors, and try to remain quiet in the midst of a migraine attack. And from time to time visit the room where the person with the attack is located in case he needs something.

You need to see a doctor if your loved one has:

• the pain is not the same as usual;
• numbness;
• speech problems;
• high temperature;
• shortness of breath.

List your symptoms and tell your doctor what medications you have taken in case you need help.

Source:

How to Best Support Someone with Migraine

https://time.com/5616125/migraines-how-to-help/

https://www.webmd.com/migraines-headaches/inside-migraines-17/slideshow-soothe-migraine

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Abdominal migraine: description of the disease, causes, symptoms, cost of treatment in Moscow

Array ( [0] => Dehydration due to diarrhea and vomiting; [1] => Anorexia with frequent attacks; [2] => Neurasthenia; [3] => Asthenia; [4] => Depression; [5] => Misdiagnosis in which the pathology of the gastrointestinal tract is missed. )

Description of the disease

Abdominal migraine is a specific form of the disease in which the patient suffers from attacks not of a headache, but of pain in the abdomen. This is a psychogenic pain that develops without any pathological changes in the intestines, abdominal organs or peritoneal muscles. The disease is observed in childhood and adolescence, and in adults occurs only as an exception. Pain in pathology strongly resembles an attack of appendicitis or other pathologies of the intestines, which requires a full examination of the patient. The pain syndrome in this migraine is moderate to severe, and in some cases it is unbearable. The disease cannot be ignored, and it requires mandatory treatment with the involvement of a specialist.

The particular danger of this form of the disease is that severe disorders requiring urgent surgical intervention can easily be missed. This phenomenon is possible in cases where the attack is not the first, and the patient takes painkillers to relieve it. In reality, this is not a migraine condition, but symptoms of another disease. As a result, a blurred picture can cause a serious complication that will pose a danger to the life of the patient.

The first migraine in children usually appears between the ages of 2 and 6 years. Attacks occur with varying intensity, as with ordinary migraine, and can be disturbing very rarely, or develop constantly. During sleep, the pain completely subsides, which is associated with changes in the work of the central nervous system at this moment. Up to 20 years, the percentage of patients of both sexes is the same. After 20 years in women, pathology is diagnosed more often, although it is a rare occurrence. The fact that in adults there is almost no pain of a migraine nature in the abdomen is associated with peculiarities in the work of the central nervous system. Most often, the abdominal form of the disease is characterized as childhood migraine.

The pain attack lasts on average from 1 to 2 hours. At the same time, in some patients, it can last only a few minutes, or, conversely, last for 5 days, which is especially dangerous, since it easily leads to severe dehydration that requires medical intervention. Pathology is most often hereditary in nature and occurs in children whose parents faced the same problem in childhood. When diagnosing a disease, the main principle is to exclude the presence of other pathologies in a patient.

Causes

The initial causes of the disease have not been sufficiently studied to date. Only factors that can cause the development of pain syndrome have been established. Pain can occur for the following reasons:

• strong nervous experiences – in children they can occur on many occasions that seem insignificant to an adult and do not require attention. Because of this, parents cannot always determine what provoked the child’s problem;

• metabolic disorders;

• rapid growth – while muscle tissue, bones and internal organs in children do not increase in size in the same way and are forced to catch up with each other;

• wrong mode of sleep and rest;

• a sharp increase in workload – especially often observed at the beginning of schooling. Causes an increase in seizures in children 7 years old;

• physical activities – when they are too big for this age category. Usually this cause occurs in adolescents;

• unbalanced, illiterate nutrition;

• sudden change in weather or climate;

• use of a number of drugs.

To determine the patient’s condition, the doctor needs to know as accurately as possible about what followed the onset of the attack. This will allow not only to make the correct diagnosis faster, but also to prescribe the most effective treatment.

Diagnosis

If abdominal pain occurs, the presence of other pathologies must be excluded. For this, a general examination of the patient is carried out. The main activities are as follows:

• abdominal ultrasound;

• magnetic resonance imaging – performed if possible;

• clinical blood test;

• urinalysis.

It is also important to describe your condition to the doctor as accurately as possible and to name the time of the onset of the attack. Be sure to collect an anamnesis of the disease. The diagnosis is made only after receiving all the data of the examination of the patient.

Performed by

Makhmudova Aza Dzaindievna

Otorhinolaryngologist

Kurbanov Farid Firudinovich

Otorhinolaryngologist surgeon, Ph.D.

Papulova Elena Guryevna

Otorhinolaryngologist

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