How is migraine diagnosed. What are the treatment options for migraine. Which medications are effective for migraine relief. How can migraine attacks be prevented. What lifestyle changes can help manage migraines. Are there any natural remedies for migraine relief. When should you see a doctor for migraines.

Understanding Migraine Diagnosis: Key Steps and Tests

Migraine diagnosis typically involves a thorough evaluation by a neurologist or headache specialist. The process primarily relies on assessing the patient’s medical history, symptoms, and conducting physical and neurological examinations. For individuals with a family history of migraines, this information can be particularly valuable in reaching an accurate diagnosis.

In cases where the migraine presentation is unusual, complex, or suddenly severe, additional tests may be necessary to rule out other potential causes of head pain. These diagnostic tools include:

• Magnetic Resonance Imaging (MRI): This non-invasive imaging technique uses powerful magnetic fields and radio waves to create detailed images of the brain and blood vessels. MRI scans are instrumental in identifying tumors, strokes, bleeding in the brain, infections, and other neurological conditions that might be causing headache symptoms.
• Computerized Tomography (CT) scan: CT scans employ a series of X-rays to generate cross-sectional images of the brain. This technology helps doctors diagnose tumors, infections, brain damage, bleeding, and other medical issues that could be responsible for headaches.

Migraine Treatment Approaches: Stopping Symptoms and Preventing Attacks

The primary goals of migraine treatment are to alleviate symptoms during an attack and prevent future episodes. Migraine medications fall into two main categories:

1. Pain-relieving medications (acute or abortive treatment): These drugs are taken during migraine attacks to stop or reduce symptoms.
2. Preventive medications: Taken regularly, often daily, these medications aim to reduce the frequency and severity of migraine attacks.

The choice of treatment depends on several factors, including:

• Frequency and severity of headaches
• Presence of associated symptoms like nausea and vomiting
• Level of disability caused by the migraines
• Other medical conditions the patient may have

Medications for Migraine Relief: A Comprehensive Overview

Effective migraine relief often depends on taking medication at the first sign of an oncoming attack. Here are some of the most common medications used to treat migraine pain:

Over-the-Counter Pain Relievers

These include aspirin, ibuprofen (Advil, Motrin IB), and acetaminophen. While effective for mild to moderate migraine pain, prolonged use can lead to medication-overuse headaches and potential gastrointestinal issues.

Triptans

Prescription drugs like sumatriptan (Imitrex, Tosymra) and rizatriptan (Maxalt, Maxalt-MLT) work by blocking pain pathways in the brain. Available in pill, injection, or nasal spray form, triptans can effectively relieve many migraine symptoms. However, they may not be suitable for individuals at risk of stroke or heart attack.

Dihydroergotamine (D.H.E. 45, Migranal)

This medication, available as a nasal spray or injection, is most effective when taken shortly after the onset of migraine symptoms, particularly for migraines lasting longer than 24 hours. Side effects may include worsening of migraine-related nausea and vomiting. It should be avoided by people with coronary artery disease, high blood pressure, or kidney or liver disease.

Lasmiditan (Reyvow)

A newer oral medication approved for treating migraine with or without aura. Clinical trials have shown significant improvement in headache pain. Due to its sedative effects, patients are advised not to drive or operate machinery for at least eight hours after taking it.

CGRP Antagonists

Ubrogepant (Ubrelvy) and rimegepant (Nurtec ODT) are oral calcitonin gene-related peptide (CGRP) receptor antagonists recently approved for acute migraine treatment in adults. These medications have shown effectiveness in relieving pain and other migraine symptoms within two hours of administration. Common side effects include dry mouth, nausea, and excessive sleepiness. They should not be taken with strong CYP3A4 inhibitor drugs.

Preventive Medications: Reducing Migraine Frequency and Severity

For individuals experiencing frequent or severe migraines, preventive medications may be recommended. These drugs are taken regularly to reduce the overall occurrence and intensity of migraine attacks. Some common preventive medications include:

• Beta-blockers: Propranolol, metoprolol, and timolol
• Antidepressants: Amitriptyline and venlafaxine
• Anti-seizure drugs: Topiramate and valproate
• Botox injections: Periodic injections for chronic migraine
• CGRP monoclonal antibodies: Erenumab, fremanezumab, and galcanezumab

The choice of preventive medication depends on individual factors, including the frequency and severity of migraines, other medical conditions, and potential side effects.

Lifestyle Modifications and Non-Pharmacological Approaches to Migraine Management

In addition to medication, several lifestyle changes and non-pharmacological approaches can help manage migraines:

Trigger Identification and Avoidance

Keeping a migraine diary can help identify and avoid personal triggers, such as certain foods, stress, or changes in sleep patterns.

Stress Management

Techniques like meditation, yoga, and deep breathing exercises can help reduce stress-related migraines.

Regular Exercise

Engaging in moderate, regular exercise can help reduce the frequency and severity of migraines.

Sleep Hygiene

Maintaining a consistent sleep schedule and ensuring adequate rest can help prevent migraine attacks.

Dietary Changes

Avoiding known dietary triggers and maintaining a balanced diet can contribute to migraine prevention.

Alternative and Complementary Therapies for Migraine Relief

Many individuals with migraines explore alternative and complementary therapies to supplement traditional treatments. Some popular options include:

• Acupuncture: This traditional Chinese medicine technique may help reduce migraine frequency and intensity.
• Biofeedback: Learning to control certain bodily processes can help manage pain and reduce migraine occurrence.
• Herbal supplements: Certain herbs, such as feverfew and butterbur, have shown potential in migraine prevention.
• Massage therapy: Regular massages may help reduce stress and tension that can trigger migraines.
• Essential oils: Some people find relief using peppermint or lavender essential oils during a migraine attack.

It’s important to consult with a healthcare provider before trying any alternative therapies, as some may interact with medications or have potential side effects.

When to Seek Medical Attention for Migraines

While many migraines can be managed at home, certain situations warrant immediate medical attention. Seek emergency care if you experience:

• An abrupt, severe headache like a thunderclap
• Headache with fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or trouble speaking
• Headache after a head injury, especially if it worsens
• A chronic headache that is worse after coughing, exertion, straining or a sudden movement
• New headache pain if you’re over 50 years old

Additionally, if your migraine pattern changes or your headaches worsen despite treatment, it’s advisable to consult your healthcare provider.

Emerging Treatments and Future Directions in Migraine Management

The field of migraine research is continuously evolving, with new treatments and approaches being developed. Some promising areas of research include:

Neuromodulation Devices

Non-invasive devices that stimulate specific nerves to reduce migraine pain and frequency are gaining traction. Examples include transcranial magnetic stimulation (TMS) and vagus nerve stimulators.

Gene Therapy

Researchers are exploring genetic factors that contribute to migraines, potentially leading to more targeted treatments in the future.

Advanced Imaging Techniques

Improved brain imaging technologies may provide deeper insights into migraine mechanisms, facilitating more precise diagnoses and personalized treatment approaches.

Personalized Medicine

As our understanding of migraine pathophysiology grows, treatments may become more tailored to individual patients based on their specific migraine subtypes and genetic profiles.

These advancements offer hope for more effective migraine management strategies in the coming years, potentially improving the quality of life for millions of migraine sufferers worldwide.

Coping Strategies for Living with Chronic Migraines

Living with chronic migraines can be challenging, but there are several strategies that can help individuals cope with the condition and improve their quality of life:

Education and Self-Advocacy

Learning about migraines and staying informed about treatment options can empower patients to take an active role in their care. This knowledge can also help in communicating effectively with healthcare providers and advocating for appropriate treatment.

Support Groups

Joining a migraine support group, either in-person or online, can provide emotional support, practical tips, and a sense of community. Sharing experiences with others who understand the challenges of living with migraines can be incredibly beneficial.

Workplace Accommodations

Discussing potential accommodations with employers, such as flexible work hours or the ability to work from home during migraine attacks, can help manage the impact of migraines on professional life.

Mindfulness and Relaxation Techniques

Practicing mindfulness, progressive muscle relaxation, or guided imagery can help manage stress and potentially reduce the frequency and severity of migraine attacks.

Pacing and Energy Management

Learning to balance activity and rest can help prevent overexertion, which can trigger migraines. This might involve breaking tasks into smaller, manageable chunks and prioritizing activities.

Emergency Migraine Kit

Preparing a kit with essential items like medication, water, snacks, and comfort items (e.g., eye mask, earplugs) can help manage unexpected migraine attacks, especially when away from home.

By implementing these coping strategies and working closely with healthcare providers, individuals with chronic migraines can develop a comprehensive management plan that addresses both the physical and emotional aspects of living with this condition.

Migraine – Diagnosis and treatment

Diagnosis

If you have migraines or a family history of migraines, a doctor trained in treating headaches (neurologist) will likely diagnose migraines based on your medical history, symptoms, and a physical and neurological examination.

If your condition is unusual, complex or suddenly becomes severe, tests to rule out other causes for your pain might include:

• Magnetic resonance imaging (MRI). An MRI scan uses a powerful magnetic field and radio waves to produce detailed images of the brain and blood vessels. MRI scans help doctors diagnose tumors, strokes, bleeding in the brain, infections, and other brain and nervous system (neurological) conditions.
• Computerized tomography (CT) scan. A CT scan uses a series of X-rays to create detailed cross-sectional images of the brain. This helps doctors diagnose tumors, infections, brain damage, bleeding in the brain and other possible medical problems that may be causing headaches.

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Treatment

Migraine treatment is aimed at stopping symptoms and preventing future attacks.

Many medications have been designed to treat migraines. Medications used to combat migraines fall into two broad categories:

• Pain-relieving medications. Also known as acute or abortive treatment, these types of drugs are taken during migraine attacks and are designed to stop symptoms.
• Preventive medications. These types of drugs are taken regularly, often daily, to reduce the severity or frequency of migraines.

Your treatment choices depend on the frequency and severity of your headaches, whether you have nausea and vomiting with your headaches, how disabling your headaches are, and other medical conditions you have.

Medications for relief

Medications used to relieve migraine pain work best when taken at the first sign of an oncoming migraine — as soon as signs and symptoms of a migraine begin. Medications that can be used to treat it include:

• Pain relievers. These over-the-counter or prescription pain relievers include aspirin or ibuprofen (Advil, Motrin IB, others). When taken too long, these might cause medication-overuse headaches, and possibly ulcers and bleeding in the gastrointestinal tract.

  Migraine relief medications that combine caffeine, aspirin and acetaminophen (Excedrin Migraine) may be helpful, but usually only against mild migraine pain.

• Triptans. Prescription drugs such as sumatriptan (Imitrex, Tosymra) and rizatriptan (Maxalt, Maxalt-MLT) are used to treat migraine because they block pain pathways in the brain. Taken as pills, shots or nasal sprays, they can relieve many symptoms of migraine. They might not be safe for those at risk of a stroke or heart attack.

• Dihydroergotamine (D.H.E. 45, Migranal). Available as a nasal spray or injection, this drug is most effective when taken shortly after the start of migraine symptoms for migraines that tend to last longer than 24 hours. Side effects can include worsening of migraine-related vomiting and nausea.

  People with coronary artery disease, high blood pressure, or kidney or liver disease should avoid dihydroergotamine.

• Lasmiditan (Reyvow). This newer oral tablet is approved for the treatment of migraine with or without aura. In drug trials, lasmiditan significantly improved headache pain. Lasmiditan can have a sedative effect and cause dizziness, so people taking it are advised not to drive or operate machinery for at least eight hours.
• Ubrogepant (Ubrelvy). This oral calcitonin gene-related peptide receptor antagonist is approved for the treatment of acute migraine with or without aura in adults. It’s the first drug of this type approved for migraine treatment. In drug trials, ubrogepant was more effective than placebo in relieving pain and other migraine symptoms such as nausea and sensitivity to light and sound two hours after taking it. Common side effects include dry mouth, nausea and excessive sleepiness. Ubrogepant should not be taken with strong CYP3A4 inhibitor drugs.
• CGRP antagonists. Ubrogepant (Ubrelvy) and rimegepant (Nurtec ODT) are oral CGRP antagonists recently approved for the treatment of acute migraine with or without aura in adults. In drug trials, drugs from this class were more effective than placebo in relieving pain and other migraine symptoms such as nausea and sensitivity to light and sound two hours after taking it. Common side effects include dry mouth, nausea and excessive sleepiness. Ubrogepant and rimegepant should not be taken with strong CYP3A4 inhibitor drugs.
• Opioid medications. For people who can’t take other migraine medications, narcotic opioid medications might help. Because they can be highly addictive, these are usually used only if no other treatments are effective.
• Anti-nausea drugs. These can help if your migraine with aura is accompanied by nausea and vomiting. Anti-nausea drugs include chlorpromazine, metoclopramide (Reglan) or prochlorperazine (Compro). These are usually taken with pain medications.

Some of these medications are not safe to take during pregnancy. If you’re pregnant or trying to get pregnant, don’t use any of these medications without first talking with your doctor.

Preventive medications

Medications can help prevent frequent migraines. Your doctor might recommend preventive medications if you have frequent, long-lasting or severe headaches that don’t respond well to treatment.

Preventive medication is aimed at reducing how often you get a migraine, how severe the attacks are and how long they last. Options include:

• Blood pressure-lowering medications. These include beta blockers such as propranolol (Inderal, InnoPran XL, others) and metoprolol tartrate (Lopressor). Calcium channel blockers such as verapamil (Verelan) can be helpful in preventing migraines with aura.
• Antidepressants. A tricyclic antidepressant (amitriptyline) can prevent migraines. Because of the side effects of amitriptyline, such as sleepiness, other antidepressants might be prescribed instead.
• Anti-seizure drugs. Valproate and topiramate (Topamax, Qudexy XR, others) might help if you have less frequent migraines, but can cause side effects such as dizziness, weight changes, nausea and more. These medications are not recommended for pregnant women or women trying to get pregnant.
• Botox injections. Injections of onabotulinumtoxinA (Botox) about every 12 weeks help prevent migraines in some adults.
• CGRP monoclonal antibodies. Erenumab-aooe (Aimovig), fremanezumab-vfrm (Ajovy), galcanezumab-gnlm (Emgality), and eptinezumab-jjmr (Vyepti) are newer drugs approved by the Food and Drug Administration to treat migraines. They’re given monthly or quarterly by injection. The most common side effect is a reaction at the injection site.

Ask your doctor if these medications are right for you. Some of these medications are not safe to take during pregnancy. If you’re pregnant or trying to get pregnant, don’t use any of these medications without first talking with your doctor.

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Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Lifestyle and home remedies

When symptoms of migraine start, try heading to a quiet, darkened room. Close your eyes and rest or take a nap. Place a cool cloth or ice pack wrapped in a towel or cloth on your forehead and drink lots of water.

These practices might also soothe migraine pain:

• Try relaxation techniques. Biofeedback and other forms of relaxation training teach you ways to deal with stressful situations, which might help reduce the number of migraines you have.
• Develop a sleeping and eating routine. Don’t sleep too much or too little. Set and follow a consistent sleep and wake schedule daily. Try to eat meals at the same time every day.
• Drink plenty of fluids. Staying hydrated, particularly with water, might help.
• Keep a headache diary. Recording your symptoms in a headache diary will help you learn more about what triggers your migraines and what treatment is most effective. It will also help your doctor diagnose your condition and track your progress in between visits.

• Exercise regularly. Regular aerobic exercise reduces tension and can help prevent a migraine. If your doctor agrees, choose aerobic activity you enjoy, such as walking, swimming and cycling. Warm up slowly, however, because sudden, intense exercise can cause headaches.

  Regular exercise can also help you lose weight or maintain a healthy body weight, and obesity is thought to be a factor in migraines.

Alternative medicine

Nontraditional therapies might help with chronic migraine pain.

• Acupuncture. Clinical trials have found that acupuncture may be helpful for headache pain. In this treatment, a practitioner inserts many thin, disposable needles into several areas of your skin at defined points.
• Biofeedback. Biofeedback appears to be effective in relieving migraine pain. This relaxation technique uses special equipment to teach you how to monitor and control certain physical responses related to stress, such as muscle tension.
• Cognitive behavioral therapy. Cognitive behavioral therapy may benefit some people with migraines. This type of psychotherapy teaches you how behaviors and thoughts affect how you perceive pain.
• Meditation and yoga. Meditation may relieve stress, which is a known trigger of migraines. Done on a regular basis, yoga may reduce the frequency and duration of migraines.
• Herbs, vitamins and minerals. There is some evidence that the herbs feverfew and butterbur might prevent migraines or reduce their severity, though study results are mixed. Butterbur isn’t recommended because of safety concerns.

A high dose of riboflavin (vitamin B-2) may reduce the frequency and severity of headaches. Coenzyme Q10 supplements might decrease the frequency of migraines, but larger studies are needed.

Magnesium supplements have been used to treat migraines, but with mixed results.

Ask your doctor if these treatments are right for you. If you’re pregnant, don’t use any of these treatments without first talking with your doctor.

Preparing for your appointment

You’ll probably first see a primary care provider, who might then refer you to a doctor trained in evaluating and treating headaches (neurologist).

Here’s some information to help you get ready for your appointment.

What you can do

• Keep track of your symptoms. Keep a headache diary by writing a description of each incident of visual disturbances or unusual sensations, including when they occurred, how long they lasted and what triggered them. A headache diary can help your doctor diagnose your condition.
• Write down key personal information, including major stresses or recent life changes.
• Make a list of all medications, vitamins or supplements you take, including doses. It’s particularly important to list all medications you’ve used to treat your headaches.
• Write down questions to ask your doctor.

Take a family member or friend along, if possible, to help you remember the information you receive.

For migraines, questions to ask your doctor include:

• What is likely triggering my migraines?
• Are there other possible causes for my migraine symptoms?
• What tests do I need?
• Are my migraines likely temporary or chronic?
• What is the best course of action?
• What are the alternatives to the primary approach that you’re suggesting?
• What changes to my lifestyle or diet do you suggest I make?
• I have these other health conditions. How can I best manage them together?
• Are there printed materials you can give me? What websites do you recommend?

Don’t hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, including:

• How often do your headaches occur?
• How severe are your symptoms?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?
• Does anyone else in your family have migraines?

16 Highly Effective Migraine Solutions

What Are Migraines?
A recurrent throbbing headache, often in one side of the head, frequently accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraines may include a stage called aura, which is marked by visual disturbances (flashes, splotches, zigzags, or shimmering colored lights surrounding a blind spot).

Why Migraines Happen
“Migraine is a neurobiological disorder involving both neurological and vascular changes in the brain during an attack,” says Susan Broner, MD, medical director of the Manhattan Headache Center in New York City. “People with a genetic predisposition have a reduced threshold for the activation of the brain’s ‘pain centers’ and become hypersensitive to stimuli that cause pain. These set off a wave of nerve cell activity and neurotransmitter release that activates blood vessel inflammation, feeding pain structures deep in the brain.” (Discover how to heal 95+ health conditions naturally with Rodale’s Eat for Extraordinary Health & Healing.)

HOW TO SOLVE MIGRAINES:

Trigger Management: If you’re prone to migraines, certain stimuli may bring them on. Track your headaches on a calendar to look for patterns and potential catalysts such as the following.

Dropping Estrogen Levels: “Before menstruating, women have a steep decline in estrogen that appears to spark migraines,” says Andrew Michael Blumenfeld, MD, director of the Headache Center of Southern California. Low-dose estrogen contraceptives may help.

Alcohol: If you get a “hangover” after one drink, you may actually be experiencing a migraine. Avoid alcohol that gives you a headache within 8 hours of consumption. “The good news is that this cause tends to be very specific,” Dr. Blumenfeld says. “People may do fine with vodka rather than beer, for instance.”

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Missed Meals: Fluctuations in blood sugar can cause a cascade of escalating pain that sets up your migraine response, so don’t go longer than 3 hours without food. Include a lean protein whenever you eat to help keep glucose levels steady, Dr. Broner says.

Caffeine: If you regularly consume large amounts of caffeine, you set yourself up for withdrawal headaches, which can stimulate your brain’s migraine center and turn into migraines. Limit intake to 200 mg a day—that’s roughly one 8-ounce cup of coffee.

Sleep Disruptions: A 2010 study found that sleep-deprived rats experienced changes in key migraine-related proteins. Play it safe by being consistent about when you go to bed and get up.

HOW TO SOLVE MIGRAINES: Natural Remedies

Ice Packs: Always opt for cold rather than heat to stop migraine pain. “Ice is an anti-inflammatory,” says Carolyn Bernstein, MD, clinical director of Harvard Medical Faculty Physicians Comprehensive Headache Center at Beth Israel Deaconess Medical Center.

Supplements: In a recent study, patients who took 400 mg of riboflavin (vitamin B2) daily experienced significantly fewer migraines after 3 months. CoQ10, another supplement, also proved effective in preventing migraines in a clinical study.

Relaxation Techniques: Massage can ease neck and shoulder spasms, while tai chi increases body awareness, making it easier to detect and treat an oncoming headache. Yoga that focuses on mindfulness, such as hatha and restorative yoga, may also help. (Get started with these 10 yoga poses for emotional health.)

Herbs: New recommendations from the American Academy of Neurology confirm that the herb butterbur can prevent migraines, possibly because it supports healthy blood flow to the brain. Dry-leaf capsules of feverfew may also reduce the frequency of migraines, though the clinical evidence is still inconclusive.

Acupuncture: Several studies have found that it provides some of the same long-term results as drugs but without side effects. While this efficacy may be partly caused by the placebo effect, the treatment can still provide real relief. (Want more info? See 6 Science-Based Benefits of Acupuncture.)

HOW TO SOLVE MIGRAINES: Medical Treatments

Triptans: Introduced in 1991, these prescription drugs (which include Axert, Relpax, and Imitrex) are formulated to stop migraines. They affect almost every migraine-causing mechanism, but they may sometimes cause rebound headaches.

Beta-blockers/Anti-hypertensives: Intended to treat high blood pressure, angina, and fast heartbeats, these drugs, which include propranolol, metoprolol, and timolol, are also used to prevent migraines because they are thought to affect relevant blood vessels. They have few side effects but can sometimes result in dangerous heart-rate drops.

Antiseizure Medications: For some migraine sufferers, prescription drugs to stop seizures (such as topiramate and valporic acid) also reduce migraine frequency by at least 50%, possibly because they inhibit some neurotransmitters. But they can cause adverse side effects, such as confusion and drowsiness.

Anti-depressants: Tricyclics and SSRIs have been shown to be effective in treating migraines. Researchers say this is because some migraine attacks are characterized by abnormal levels of serotonin, which the drugs work to balance. But they’re not usually advised if you don’t need treatment for depression.

Botox: Approved by the FDA in 2010, Botox injections to treat chronic migraines are a clinically proven preventive. A treatment involves about 31 shots, given about every 12 weeks. Side effects are rare.

MORE: The Oddest Pain Relief Tricks That Work

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New treatments could transform the way migraine headaches are treated

UB neurologist, who co-authored editorial in JAMA on migraine treatments, said a new approach “totally upends our prior conceptions”

BUFFALO, N. Y. — An estimated 1 billion people worldwide suffer from migraine headaches, which can cause nausea, severe pain and sensitivity to light and sound. But despite the high incidence of the disorder, patients who have frequent headache and  who typically take two medications — one for prevention and one for acute onset — often have to try several different medications before finding something that is effective.

That difficulty, and new treatments that have the potential to address both acute and preventive therapy of migraine, were the subject of an editorial published last month in the Journal of the American Medical Association by Melissa Rayhill, MD, clinical assistant professor of neurology and adult neurology residency program director in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, and Rebecca Burch, MD, assistant professor of neurology at Brigham and Women’s Hospital and Harvard Medical School.

“The last few years have been revolutionary for headache medicine with the number of treatment advancements,” said Rayhill, who treats patients at UBMD Neurology.

“Nevertheless, there are still far too many patients out there that still haven’t found a treatment that works for them, despite the growing number of therapeutic options.”

She said many patients are not offered effective, migraine-specific therapy, even though there are many available. “In addition, many patients never even seek out care at all because of misconceptions about why they may have headache in the first place,” she said.

But things are rapidly changing in the treatment of migraine. “There are so many good, migraine-specific acute treatment options now,” she said. “For some patients, the quest to find something that works can take months or longer. Many will find a safe and effective acute treatment for their migraine headaches after just one visit to their physician’s office, though typically it may take a couple of medication trials over a few weeks to find a good fit.”

Blurring the lines between acute and preventive treatment

While the traditional approach to chronic migraine treatment has been to prescribe two medications, one that acts as a prophylactic and another that acts on acute episodes, that approach is changing. “In our editorial, we highlighted some recent studies that show some new treatments are blurring the lines between acute and preventive migraine treatment,” Rayhill explained. “One acute therapy was recently shown to be effective in headache prevention when orally dosed every other day, and one intravenous preventive therapy was also shown to be effective in the acute treatment of headache. This new approach totally upends our prior conceptions about migraine treatment.”

In their editorial, Rayhill and Burch discussed a recent study on eptinezumab, which was published in the same issue.

“Eptinezumab is an intravenous therapy approved for preventive treatment that is given in an infusion center or delivered at home by a visiting nurse,” Rayhill explained. “The study suggests it may be helpful for acute therapy as well, though logistical and cost considerations may preclude utilizing this approach in practice more routinely now.”

She added that the other subcutaneously delivered medications in the same class (monoclonal antibodies targeted against calcitonin gene-related peptide, CGRP, a migraine signaling molecule) have not been explicitly studied for acute therapy in large trials, and that in clinical practice these other medications have usually taken weeks to months to see an effect in most patients.  

Another treatment that she said may be blurring the lines between acute and preventive therapy for migraine is rimegepant, a small molecule, direct CGRP antagonist.

“Rimegepant was recently approved by the Food and Drug Administration for the preventive treatment of migraine after initially being approved for acute migraine treatment in early 2020,” Rayhill said. She added that most acute therapies for migraine are judged by whether they relieve pain and associated symptoms within two hours of taking the medication. In a recent study, rimegepant was also effective in reducing headache frequency (preventing headache) when dosed every other day.

Outlook is improving

While finding the right migraine medication usually takes some time, Rayhill noted that the outlook for patients is definitely improving. “I have seen some dramatic responses to many of our existing conventional medications for both acute and preventive therapy.

“The newer CGRP monoclonal antibody therapies (the intravenous therapy, eptinezumab, and the other three subcutaneously delivered medications in the class) and the CGRP small molecule antagonists (the oral medications rimegepant and ubrogepant) have produced similar dramatic responses in my clinical practice,” she continued.

“It’s important to note that these responses are very individualized, and sadly, some do not respond to any of the above therapies. However, I think where both classes of CGRP therapies shine is in their improved tolerability —  in other words, the decrease in reported side effects in comparison to other conventional therapies.”

Unfortunately, she cautioned, cost remains a huge barrier for many to accessing the CGRP therapies, and insurers are often reluctant to cover them without requiring clinicians and patients to jump through a series of hoops. 

“Migraine is a disabling neurological condition that patients inherit, and there is currently no cure,” Rayhill said. “But because of the number of effective treatments now, the future is brighter than ever for patients who suffer with migraine. Amazingly, there are even more migraine therapies in the pipeline.

“Patients with migraine should be able to expect that the clinicians who care for them are familiar with and comfortable using multiple acute treatment options,” she concluded. “Help is within reach.”

7 Ways to Get Rid of Migraines Fast

More than 30 million Americans suffer from migraines — severe throbbing, pulsing headaches usually accompanied by nausea, vomiting, sensitivity to light and sound, that can last from four hours to several days. About 20% of people who get migraines also experience aura, which often means seeing flashing lights or shapes floating before your eyes, and can include tingling skin, ringing in the ears, changes in taste or smell and an overall strange feeling. “Everyone has a different frequency of migraines and different triggers,” says neurologist Stephen Silberstein, MD, Director of Thomas Jefferson University’s Jefferson Headache Center. “Some people can feel better simply using cold compresses or lying down, but for people who get them frequently — 4 or 5 times a month — the best approach is preventative. You want to stop them before they happen.”

Knowing and avoiding your triggers and following basic headache hygiene (go to sleep at the same time every night, drink plenty of water, get regular exercise and eat regular meals) can help prevent some migraines. It’s also crucial to be aware of your warning signs, which occur during the preliminary or “prodrome” phase of migraine. These may include exhaustion, food cravings, trouble concentrating or reading and sensitivity to light. “Whatever you use to treat your migraines, the earlier you treat it, the better,” says Dr. Silberstein.

Here are some ways to get rid of a migraine that might work for you:

Turn down the lights.

A sensitivity to light — known as photophobia — is one of the hallmark symptoms of migraines, so as soon as you feel one coming on, get to a room where you can turn off the lights and rest in quiet and darkness, says Dr. Silberstein.

Use a cold compress.

According to the National Headache Foundation, people with migraines often find relief from pressing an ice pack against their temple or forehead. You can use a regular ice pack from your freezer, or try ones that are specifically designed to wrap around the head to treat migraines.

Sip caffeine.

Before a migraine, blood vessels tend to enlarge, but caffeine is a vasoconstrictor, which means it causes them vessels to narrow, which can relieve some headache pain. In fact, many over-the-counter headache medicines contain caffeine, though you can ingest it however you most enjoy it, says Dr. Silberstein: “Caffeine is caffeine, whether it comes in a pill, a cup of coffee, or a can of cola,” he says. Silberstein points out that drinking a lot of caffeine in your daily life, however, can cause rebound headaches on days when you don’t have that cup of Joe early enough, so be mindful of how much you drink, and if caffeine works for you, save the double espressos for days when you really need it to fight that headache.

Explore meditation or yoga.

Though the evidence is mixed on whether meditation or yoga can truly dial down migraine pain, Dr. Silberstein points out that any practice that helps you control your breathing can be beneficial in migraine management. “When you take a deep breath, it acts as a vagus nerve stimulator, sending info to your brain to turn the pain down.”

Try a massage.

In one small study, migraine patients who massaged their temples with a menthol gel found some relief from headache pain. (You can try it using peppermint essential oils, which contain menthol). Another small study showed that lavender oil can have a similar effect. Dip a few drops on your fingers and massage small circles into your temples, or simply put the oil in a diffuser and see if the scent has any positive effect. If you want to apply topically, remember to never, ever apply undiluted essential oil to your skin — it can cause a very unpleasant reaction (for example, if your skin is then exposed to sunlight, it can create a burn). Dilute essential oils with a gentle neutral oil, like olive, coconut, or grapeseed.

Try switching to green light.

Exposure to light has long been known to trigger or exacerbate migraines, but researchers at Harvard Medical School discovered that green light is far less disturbing than other colors. (While blue and red light cause the largest magnitude of electrical signals to be generated in both the retina and the brain, green light caused the weakest signals.) Using a lamp designed to emit the most soothing light possible (such as the Allay Lamp) can help you get through your migraine without sitting in the dark for hours.

Talk to your doctor about migraine medication.

There are several FDA-approved migraine medicines you can buy over-the-counter at the drugstore, including Excedrin Migraine (which includes acetaminophen, aspirin, and caffeine) and Advil Migraine (which contains the NSAID ibuprofen). If those don’t do to the trick, talk to your doctor about triptans, a class of prescription drugs that you take as soon as you feel your migraine coming on. In addition to tablets, these are available in nasal sprays and rapid-relief injectables, which work best when you want quick pain relief, says Dr. Silberstein. There are several different kinds of triptans — your doctor can discuss the potential side effects, and which might be best for you. The FDA has also approved a new therapy called non-invasive vagus nerve stimulation (nVNS), in which you use a small electrical device to stimulate the vagus nerve in your neck; research suggests that nVNS can provide migraine relief within 30 to 60 minutes, but the device is expensive and not usually covered by insurance. Ask your headache doc for more information.

Marisa Cohen
Marisa Cohen
Marisa Cohen is a Contributing Editor in the Hearst Health Newsroom, who has covered health, nutrition, parenting, and the arts for dozens of magazines and web sites over the past two decades.

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Headache and migraine remedies that are safe during pregnancy | Your Pregnancy Matters

Most women deal with headaches at some point in their lives. Data from the Centers for Disease Control and Prevention suggest that one in five women had a severe acute headache or migraine in the previous three months. Additionally, migraines are more common in women than men – approximately 18 percent of women have them compared to 6.5 percent of men.

Because headaches and migraines are so common, it’s probably no surprise that many women deal with them during pregnancy. For the majority of pregnant women, occasional headaches or migraines are no cause for alarm, and most standard treatments are safe. However, suffering a severe headache at key times during or after pregnancy can indicate a serious medical emergency.

Common types of headaches and treatment options

Primary headaches

Primary or acute headaches arise once in a while and typically pass after a few hours. Tension headaches are the most common type and are characterized by muscle tightness and localized pain in the head and neck.

Primary headaches in pregnant women usually can be treated at home. Rest, a neck or scalp massage, hot or cold packs, and over-the-counter anti-inflammatory drugs such as Tylenol, aspirin, or ibuprofen can reduce the pain. However, if you start to have frequent or severe headaches, talk to your doctor to determine the cause.

Migraines

Migraines tend to be episodic (frequent and long-lasting) and typically cause additional neurological symptoms, such as:

● Blurred or tunnel vision

● Hallucinations

● Light sensitivity

● Nausea and vomiting

Studies have shown that migraines can be triggered by hormonal changes, including right before your period or as a result of taking oral contraceptives. Interestingly, some women who have migraines find that the frequency or intensity of their symptoms decreases during pregnancy. Research does not suggest, however, that pregnancy triggers the onset of migraines – if you have your first migraine during pregnancy, it’s likely coincidental.

Treatment during pregnancy is fairly similar to standard treatment. Anti-inflammatory drugs are generally safe and effective during pregnancy when used in a limited manner. Midrin is a commonly prescribed headache medication that contains acetaminophen along with a mild sedative. Midrin also has vasoconstrictive properties, which means it narrows the blood vessels, thereby reducing blood flow and pain. 

Sumatriptan, commonly known as Imitrex, is another medication that reduces blood flow to the brain. It works best to stop a migraine if it’s taken as soon as symptoms present. Most nausea medications prescribed to women with migraines are safe to use during pregnancy, but I suggest reviewing the medications you take for migraine relief with your obstetrician at your first prenatal visit, just to be safe. 

Certain drugs called ergotamines have a stronger vasoconstrictive effect and can adversely affect fetal growth. They also can stimulate uterine activity. Because of this, they absolutely should not be used during pregnancy. 

Severe migraines might require hospitalization so you can receive fluids, pain medication, or anti-nausea medication through an IV if you are unable to keep medications down.  

Alternative Migraine Treatments | Migraine Home Remedies

Alternative migraine relief methods do not rely on chemicals, substances, or medications. Instead, they use herbal remedies, natural solutions, and combinations of different therapies to provide effective symptom relief and migraine prevention.

The Migraine Relief Center has specialists who work with patients to create a balanced combination of medication and alternative pain relief. With our help, you can discover which alternative methods are the most beneficial for you as an individual.

Alternative Pain Relief for Migraines

Stress is a known origin of migraine and tension headaches. The Migraine Relief Center can implement stress control techniques such as biofeedback, stress management using medications, and sleep improvement. Relaxation training can go a long way toward natural migraine control. We offer alternative treatments such as:

A healthy diet can reduce stress, combat depression, and improve sleep – three things that influence migraines. We have registered dieticians who can create a food plan specifically geared toward migraine prevention and symptom relief. Good nutrition, exercise, and a sleep schedule may be the key to solving your migraine problem.

Herbs, Homeopathic, and Home Remedies

For hundreds of years, people have used certain herbs and homeopathic remedies to effectively block migraine headaches and reduce the risk of attacks. The Migraine Relief Center believes in these remedies and has seen their success in patients first hand. Our specialists may recommend herbs such as:

• Essential and aromatic oils. Scented oils can encourage relaxation, reduce stress, and improve mood. If depression plays a part in your migraines, try citrus scents. If they’re triggered by lack of sleep, try juniper, chamomile, or marjoram oils.
• If sinus pressure or sinusitis contributes to head pain, try a belladonna remedy. Belladonna can reduce pressure and congestion in the sinuses. This herb works on the circulatory system and blood vessels, and it can reduce severe pain from sinus headaches.
• Iris versicolor (Northern Blue Flag). This flower is proven to help symptoms associated with migraines, such as nausea and dizziness. Paired with pain relievers, iris versicolor can be an effective approach to natural migraine symptom control. Ginger can also help with nausea naturally.

Some people suffer from migraines triggered by scents. If this is the case, essential oils or strong-smelling herbs may not be the right remedy for you. However, almost everyone can comfortably tolerate light scents like coconut, jasmine, and lemongrass. These herbal and natural remedies may be just the things to help with your migraine symptoms.

Supplements for Treating Migraines

Supplements, or vitamins, may be able to help some people conquer migraines. While this approach won’t work for everyone, it’s worth a try in most cases. Since triggers are unique for each person, you need to work with a specialist to come up with the supplement plan that works for you. Supplements we may recommend to migraine sufferers include:

• Vitamin B2 (riboflavin). Taking 400 milligrams of vitamin B-2 daily may treat migraines. Riboflavin may cause discolored urine, but it otherwise has no known side effects.
• Taking 75 milligrams daily may prevent migraines in some people. Butterbur can cause itchy eyes, diarrhea, upset stomach, fatigue, drowsiness, and allergic reactions in people who are allergic to ragweed and other related herbs.
• Taking 400 milligrams per day can help magnesium deficiency – something that may cause migraines. Side effects may include upset stomach, diarrhea, nausea, and vomiting.
• Vitamin D. Supplementing your diet with more vitamin D may reduce the frequency of attacks, according to some studies. Most people do not experience side effects when taking regular doses of vitamin D. Taking too much can lead to fatigue, weakness, and nausea.

Supplements are one potential solution to migraine headaches. They can help fill in gaps in your diet, giving your body the nutrients it needs. The right vitamins can reduce the number of migraine attacks you experience and make those you do feel less severe. Supplements can be a great addition to a migraine treatment program.

Massage for Migraine Treatment

The Migraine Relief Center has also seen the effectiveness of massages in some migraine patients. Massage can release endorphins, increase serotonin levels, reduce sleep disturbances, and relieve stress. All of this can result in fewer migraines and symptom relief. The licensed massage therapists at The Migraine Relief Center integrate a variety of massage techniques in treatment plans, including:

• The most common form of massage in the West. It is the founding type of massage for all other types. It can either be a slow and gentle experience or vigorous, depending on the client’s individual needs.
• Deep tissue. This type of massage therapy uses firm pressure to reach the deeper skin tissues and underlying layers of muscle. It is similar to a Swedish massage, but it uses more pressure to release chronic muscle tension.
• Sports massage therapy is specifically for athletes. The therapist can tailor the massage according to the athlete’s sport. Sports massages focus on areas of the body that the sport impacts, with the goal of increasing flexibility and preventing injuries.
• Prenatal. Pregnant women have unique needs when it comes to massage therapy. Prenatal massage can reduce stress, relieve pregnancy-related discomforts, and improve overall well-being in mothers.
• Massage for the elderly can increase blood flow, combat depression, reduce arthritis pain, and improve joint mobility. Massage, as we get older, is important for all-around health and well-being – physical and emotional.

Signing up for regular massages can bring lasting migraine relief. Paired with relaxation techniques and stress management, massages can eliminate physical and emotional tension. Our center will address your specific needs when prescribing massage for migraines.

Massages may not be the right alternative therapy for those with kidney failure, heart failure, blood clots, contagious skin problems, osteoporosis, or recent surgeries.

Topical Treatments for Migraine Relief

Another type of alternative therapy to consider is topical treatments. Some topical drugs work directly on the nerve endings in the affected area, reaching below the surface of the skin to provide relief from migraine symptoms. Popular topical migraine treatments include:

• Topical Regional Neuro-Affective (TRNA) Therapy. This non-systemic drug is a cream that patients apply to the back of the neck, at the hairline. It works directly on free nerve endings to provide rapid and prolonged pain relief. Side effects are minimal since it doesn’t use drugs in systemic or cerebral blood.
• Triptans come in patches that you place on your skin. They relieve swelling and constrict blood vessels in the brain. Although it’s not clear how they stop migraines, studies have shown effectiveness in this capacity in many patients. Triptan patches may relieve head pain, decrease sensitivity to light and sound, and decrease nausea.
• Topofen (ketoprofen). This promising transdermal gel reduces pain in patients with severe migraines in several studies. It inhibits the cyclooxygenase enzyme and reduces neurogenic inflammation – two things thought to be key factors in migraine development. Patients absorb this topical product quickly, making for effective relief.
• This is an ingredient naturally found in hot peppers, such as cayenne. Patients can apply capsaicin in cream form to stimulate and decrease pain signals in the body. This cream may increase pain at first, but then the pain will decrease. Doctors may recommend this topical solution to those who suffer from cluster headaches in particular.
• Cefaly device. A FDA-approved device that works as an external trigeminal nerve stimulator (e-TNS). It uses an adhesive electrode, placed on the forehead, and a magnetic connection to the Cefaly. The device sends micro-pulses to the trigeminal nerve, preventing migraine attacks. It may be helpful for those with frequent migraines.

If you aren’t fond of taking medications for your migraines, consider these many alternative treatments. A combination of homeopathic, medication and other remedies may be the solution to your chronic migraine attacks. Work with the knowledgeable specialists at The Migraine Relief Center to discover your ideal treatment program.

We use traditional and alternative methods according to the unique needs of each individual patient. Schedule your initial evaluation today.

5 Holistic Remedies for your Kid’s Headache

2. Magnesium

Magnesium can be used both to acutely treat a headache, as well as to help prevent more chronically occurring headaches. An easily absorbable form of magnesium like Magnesium Glycinate, is my recommendation. The dose is determined by the child’s age and size, as well as by what has worked for them in the past. Since magnesium is relaxing, the daily preventive dose is best given in the evening.

3. Riboflavin

Even in the conventional world, Riboflavin (also known as Vitamin B2) is given to help prevent headaches, with evidence most available specifically for migraines. Again, the daily dose would be determined depending on the child’s size and age.

4. Acupuncture

Both standard and needle-free acupuncture can be used as a treatment for acute headaches, and also as a preventive strategy for chronic headaches. This is a therapy that we are happy to be able to offer at CentreSpringMD, performed by our certified acupuncturist.

5. Eliminate Food Triggers

I often encourage kids who suffer frequent headaches to keep a headache diary to include a log of their food/drink intake. Food sensitivities can be a root cause for recurrent headaches, so looking for food associations in a headache diary often helps find the culprits. Remember that symptoms from food sensitivities are not always immediate; they can take 24 hours to 5 days to develop. A few years ago, I discovered that the root cause of my headaches was a significant gluten/wheat sensitivity. I know now that the onset of my severe headache or migraine is not until at least 24 hours after accidental ingestion. Sometimes, just eliminating common food culprits like wheat/gluten, dairy (especially hard cheeses), MSG, and chocolate can be enough to decrease the frequency and severity of headaches. If doing this does not do the trick, we can test for food sensitivities using our ALCAT or IgG testing modalities.

One of the most gratifying things I get to do as a holistic pediatrician is treat headaches, especially since I suffered so regularly from headaches most of my life. Finding the root causes, and supporting the body as it heals is a favorite part of my job. Do you have a favorite natural headache remedy? Let us know in the comments!

90,000 “Analgesics only make it worse.” The doctor – about whether it is possible to cure a migraine | HEALTH

Women, men and even children suffer from migraine headaches. Some do not even know about their diagnosis, drink pain relievers and explain the headache with nausea “magnetic storms”. What is this disease and how to treat it, “AiF-Yug” told chief neurologist of the Ministry of Health of the Krasnodar Territory Marianna Barabanova.

Bad inheritance

Olga Kisileva, “AiF-Yug”: Marianna Anatolyevna, tell us how common such ailment as migraine is?

Marianna Barabanova : The prevalence of migraine ranges up to 25% in women and up to 10% in men.Typically, migraines first appear between the ages of ten and 20. By the age of 35-45, the frequency and intensity of migraine attacks reach a maximum, and after 55 years in most patients it stops.

In 60-70% of patients, the disease is hereditary. A special severity is that migraines do not get sick for a year or two or three, but, as a rule, for most of their lives. The disease can proceed in a mild form, and then, at some periods of life, become aggravated, worsened and become chronic. It is estimated that if seizures occur twice a month (the most common frequency), then a person loses two years of creatively active life.

– How to understand that a headache is a migraine? What are her symptoms?

– Migraine is a chronic illness that manifests itself in episodic attacks of headache. But this is a special headache, and it stands out from other forms. When a typical migraine attack develops, it goes through several stages.First, the prodromal period. In 50% of patients, it is accompanied by irritability, decreased mood, unusual food preferences, and a feeling of “burst of internal energy.” It may appear several hours or one to two days before the attack.

The second phase is the aura. It lasts 10-30 minutes. Most often, at this stage, patients can see unusual figures in front of their eyes, flashes of light, “fogging” space. There are other disorders, for example, auditory or olfactory hallucinations, tingling, numbness in the fingers, spreading up the arms, less often there is speech impairment or difficulty in finding words. The most severe is the stage of pain. Lasts more than four hours without treatment or if treatment is ineffective.

In patients with migraine, the risk of getting myocardial infarction is twice as high and the risk of cerebrovascular accident is three times higher.

Severe pain of high intensity on one side of the head, more often in the forehead, eye and temple. A feature is the obligatory alternation of the sides of the pain. Pulsating or pressing, which is worse with movement.A migraine attack is often accompanied by concomitant symptoms: nausea, hypersensitivity to light, sounds, odors, and lack of appetite.

The stage of resolution – when the headache subsides, but a feeling of fatigue, irritability, difficulty concentrating may remain. It may take the next day before the patient fully recovers. So, the duration of a migraine attack can be up to several days.

Coffee, weather, stress

– What can provoke an attack?

– There are several factors.For example, alcohol (especially sweet alcoholic beverages such as red wine or champagne), aged cheeses, chocolate, refusing or overusing coffee, dehydration, and delayed or skipped meals.

A sleep disorder can provoke an attack: both a deficiency and an excess. Physical stress, travel through time zones, changes in weather, bright or flickering lights, strong smells, sounds, emotional stress or relaxation after a period of intense stress, changes in hormonal levels in women – all this can cause the development of a migraine attack.

– How is migraine diagnosed?

– “Migraine” is a clinical diagnosis, that is, it is completely based on the analysis of patient complaints and anamnesis data. The doctor asks the patient carefully – this is the basis for the correct diagnosis of migraine. Additional research methods are required in case of an atypical course of the disease, as well as the presence of “danger signals”. This is a thundering headache, pain with an atypical aura (lasting more than one hour or with motor weakness), a first-onset headache in a patient over 50 years old, an increasing headache that worsens over several weeks, with a change in posture or coughing, straining.

Check yourself

There is a simple screening method for diagnosing migraine. Several questions need to be answered. This small test suggests a patient has a migraine so that they can be referred to a headache specialist in the future.

1. In the past three months, has your headache been accompanied by nausea or vomiting?
2. Was there any intolerance to light and sounds at the time of the headache attack?
3. Has the headache limited your ability to work, study, or daily activity for at least one day?

If you answer yes to two of the three questions, the probability of a migraine is 93%.

Eliminate provocateurs

– Can this disease be cured?

– The fact is that this is not just a headache, but a serious neurological disease. It is necessary to treat, because it has been shown that in patients with migraine the risk of getting myocardial infarction is twice as high and the risk of cerebrovascular accident is three times higher.

First, it is important to educate the patient on how to cope and live with a headache. The migraine sufferer must reconsider his lifestyle.With the help of a doctor, you need to find your triggers, that is, the factors that provoke headache attacks.

Secondly, any headache should be promptly and adequately arrested and eliminated. But only with the help of drugs prescribed by a doctor.

Thirdly, if necessary, the doctor selects preventive treatment.

The choice of treatment for migraine depends on the intensity and frequency of migraine attacks; the patient’s medical history; the presence of concomitant disorders that greatly aggravate the course of an attack, worsen the condition of patients in the interictal period and, in general, lead to a pronounced deterioration in the quality of life.Such disorders include depression and anxiety, autonomic disorders, including panic attacks, disturbed sleep at night, tension and soreness of the pericranial muscles, and gastrointestinal disorders.

Frequent use of analgesics is absolutely wrong, and it does not matter what drugs they are: citramon, paracetamol or pentalgin. With this abuse of analgesics, attacks of any headache become more frequent, the so-called abusal headache occurs, and the migraine becomes chronic.

Adequately selected therapy in almost all cases can significantly reduce the frequency of migraine attacks and improve the patient’s quality of life. But the diagnosis and selection of therapy should be carried out by a neurologist.

There is an opinion that migraine is a disease of geniuses and high intellectuals. Guy Julius Caesar, Karl Marx, Karl Linnaeus, Charles Darwin, Alfred Nobel, Sigmund Freud, Blaise Pascal, Ludwig van Beethoven, Pyotr Ilyich Tchaikovsky, Richard Wagner, Frederic Chopin suffered from headaches.Perhaps this is why the myth arose that migraines are a price to pay for talent. However, it is not. Simple and great personalities suffered from diseases of ordinary people. The migraine problem affects about one tenth of the world’s population. The first physician to professionally describe migraines was Hippocrates. He noted that before the pain itself, a person may experience visual impairment, and during an attack – vomiting.

90,000 Migraine treatment – how to relieve pain, what helps and how not to

Migraine requires close medical supervision.But few patients go to the doctor. Research carried out by a group of American scientists from the Albert Einstein College of Medicine found that the vast majority of people with migraines did not consult with doctors. Of 2,500 people, 1,675 (67%) said that they had to stay in bed due to migraines.

Let’s list the mistakes that migraine patients make.

Self-medication for migraine

A common mistake is to relieve pain on your own, without a doctor’s prescription, with medicines purchased at a pharmacy.

By trusting drug advertising, people start taking analgesics 15 days a month or more. The uncontrolled use of painkillers leads to chronic daily pain, dependence on the drug is formed, the neurologist of the Moscow State Medical University named after N.I. Sechenova Natalia Karatygina. An alarming problem arises: the remedy no longer helps, and the person can no longer do without medication.

According to Marina Koreshkina, head of the Headache Treatment Center, only 25% of migraine patients consulted a doctor, considering this reason to be frivolous to see a doctor.

Scientists from the German, Austrian and Swiss Headache Societies and the German Society of Neurology have collected the most common recommendations for self-treatment of migraine and analyzed them. The doctors concluded: none of the substances that are used in self-medication for the prevention of migraines can be considered effective.

Only 25% of migraine patients consulted a doctor.

Alcohol for headache relief

Some patients try to get rid of headaches with alcohol, as it can dull the senses and reduce nervous tension.The problem is only getting worse.

Alcohol relaxes the blood vessels, more blood flows through them. The pressure decreases, the heart rate increases. As a consequence, the nerves in the brain stem that connect the brain and spinal cord are stimulated, leading to migraines. Dutch scientists from the Leiden University Medical Center conducted the corresponding research. According to the results of a survey of 2197 patients, it was found that alcoholic beverages became a trigger in 35.6% of survey participants.

Alcohol can seriously complicate the problem of headaches.

Traditional medicine recipes

There are many recipes for traditional medicine for the treatment of headaches on the Internet. Sometimes the recommendations are on the verge of common sense. It is advised to apply plantain to the forehead, use all kinds of herbal preparations. All absurd recommendations: remove the pain with a chicken egg mixed with hot milk.

Describes traditional medicine and methods that run counter to scientifically proven evidence: alcohol treatment.Patients are offered to drink a mixture of red wine, horseradish and sugar.

At the same time, there are also effective folk recipes:

1. Find points on the edges of the jaw and massage them with your fingers with light pressure.
2. A bath with the addition of a decoction of valerian root will help to quickly stop a migraine attack.
3. Cool a wet towel in the freezer, apply at the beginning of an attack to the affected areas of the head.

Adherents of alternative medicine also believe that turpentine helps in the treatment of migraines.It supposedly improves blood circulation and normalizes blood pressure.

The opinion of doctors about such methods of migraine treatment is skeptical. Yes, it is possible that, as an addition to traditional treatment, adequate traditional medicine can be used, but it will not replace medical assistance.

Many doctors and scientists are skeptical about traditional methods of dealing with headaches.

Caffeine is not an assistant in the treatment of migraines

Taking caffeine leads to increased frequency and intensification of attacks.The study of this issue was carried out by physicians from Boston University. It has been proven that migraine patients should not consume more than three servings of caffeine per day, be it coffee, tea, or energy drinks.

Questionário ID-Migraine ™ e o adequado diagnóstico da migrânea

It is important for people with migraines to rule out possible complications and not experiment with health. Unprofessional actions can aggravate the situation. Visit your doctor on time and be healthy!

How to cure a migraine

Can an attack be prevented if a person feels that it is about to start?

For each patient there is a certain point of no return, when it becomes clear that an attack begins: intolerance to light or sound, nausea, etc.Such manifestations are individual in nature, so it is important to be able to recognize them and take medications in a timely manner to relieve pain in order to prevent an attack from developing. Neck pain and yawning can also be the first symptoms of an impending attack.

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7 ways to get rid of a headache without medication

What to do if the attack has already occurred?

During an attack, especially if vomiting opens, all medicines are best taken in the form of injections, or in liquid form (effervescent tablets, powders).Thus, the medicine is absorbed faster and, accordingly, begins to act faster. You can additionally use antiemetics to speed up the absorption of drugs. During an attack, a short nap can significantly alleviate the condition, therefore, if possible, you should try to sleep.

Can migraines be cured once and for all?

Migraine is a hereditary disease that, unfortunately, cannot be completely cured. But today, thanks to innovative and effective drugs, seizures can be made so rare that they practically do not affect the patient’s quality of life.To do this, three factors must be taken into account. The first is the correct relief of the attack. The second is that preventive therapy is correctly selected. The third is the identification and control of those factors that trigger the onset of migraine attacks: anxiety, depression, sleep disturbances, physical inactivity.

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Is it true that a severe attack can lead to a stroke?

Migraine is a very severe and very unpleasant headache, but the likelihood of developing a stroke is very small.Very rarely there are forms of a severe aura, when a stroke occurs precisely against its background. The only headache that requires an ambulance is a thundering headache, which may be associated with the manifestation of some kind of vascular catastrophe.

What is the route of a patient with a migraine attack? Which doctor should I see?

It is best to find a specialized headache center or office and a headache specialist in your city to find the appropriate treatment.To track the frequency, dynamics of headaches, it is necessary to fill out a headache diary. It has a great diagnostic value, and on its basis in the future the specialist can make a decision about the necessary therapy.

treatment in Moscow, causes, diagnostics, migraine treatment specialist

Migraine treatment in Moscow is recommended to be carried out in a specialized headache clinic with a migraine specialist.

Clinic for Headache and Autonomic Disorders.Wayna is a unique medical institution specializing in the treatment of migraines and all forms of headache. The clinic’s migraine specialists know EVERYTHING that is known in modern medicine and do not refuse to treat migraines and headaches even from the most difficult patients. There are no “random” doctors in the clinic. All doctors are truly unique specialists with a wealth of knowledge, vast experience and active research. Our specialists in Migraine Treatment and Headache are trained and trained in the most reputable universities in Europe and the USA.

We do not just treat, we are responsible for the result!

specialists in the treatment of migraines and headaches

clinic named after Academician Wayne is the Clinical base of the First Moscow State Medical University. IM Sechenov and specializes in the treatment of migraine in Moscow

What is migraine and how to treat it?

Migraine refers to primary headaches, that is, headaches that are not symptoms of any other disease.Treating a migraine headache differs significantly from treating a non-migraine headache. Most often, migraine is inherited, through the female line. Many great people such as Napoleon, Caesar, Elvis Presley, Janet Jackson and others suffered from migraine. However, migraine is not a disease of geniuses. But it was noted that a certain type of personality suffers from migraine, prone to perfectionism, great ambitions, striving for great social success.

On average, the peak of migraine disease occurs at 40 years.

Causes of migraine

For successful treatment of migraine in Moscow, it is necessary to analyze all possible causes of a migraine attack. The main causes of migraines are changes in weather, when cloudy and rainy days replace clear days; stress and violation of the daily routine; lack of sleep, or vice versa, excessive amount of sleep. There are also nutritional causes of migraine provocateurs: hard cheeses, alcohol, smoked meats, chocolate, citrus fruits and fast food. Also, migraine attacks occur on the abolition of caffeine, when, for example, a person at work drinks several cups of coffee a day, and at home on weekends does not have this opportunity.Often, a few days before the onset of a migraine, mood drops sharply. In women, migraine attacks are often associated with the menstrual cycle. 1-2 days before the onset of menstruation, there is a sharp drop in estrogen, which is a provocateur for migraines. To help yourself you need to figure out your personal migraine provocateurs. If you notice that the attacks are becoming regular and of the same type, start keeping a headache diary.

Migraine: treatment and diagnosis

For the diagnosis of migraine, as a rule, you do not need an MRI or CT scan, an ultrasound of the vessels of the brain, since migraine is not associated with vascular damage, with a violation of the blood supply to the brain.However, an extremely important diagnostic technique in the treatment of migraine is keeping a headache diary, in which a person collects information regarding headache attacks over a period of time. It is this information that will allow the doctor to make the correct diagnosis and choose the most effective treatment for migraine .

What headache do I call migraine?

Migraine is a hereditary disease that manifests itself as bouts of pulsating unilateral headache, lasting 4-72 hours, accompanied by increased sensitivity to light, sound, nausea and vomiting.

How often do you get migraines?

According to world statistics, about 14% of the population suffers from migraine, and women are 2.5-3 times more likely than men: the prevalence of this disease in women reaches 20%, in men only 6%. In Russia, about 20 million people suffer from migraine. To the clinic for the treatment of migraine and headache them. Wayne travels to treat migraines from all over the country and neighboring countries. Migraine headache is a disease of young people: the onset of the disease in most falls on the age of 20 years, and the onset after 50 years is not typical.In childhood, migraine is detected in 4% of children and before puberty, no gender differences are noted in its prevalence.

What forms of migraine are there?

International classification of headache distinguishes two main forms of migraine: migraine without aura, which accounts for about 80% of all cases of the disease, and migraine with aura – 20%.

How does a migraine headache manifest itself?

Migraine headache is of an attack-like nature: it grows quickly and also quickly decreases, the patient can name the hours and minutes of the beginning and end of the attack.This distinguishes migraine headache from tension headache, the beginning and end of which are blurred. The duration of a migraine attack is on average about 24 hours, without the use of analgesics or with ineffective treatment of migraine by them. One-sided pain or hemicrania is detected in 60% of attacks, as a rule, there is a “favorite” side, with which pain occurs more often and more strongly. Less commonly, alternating sides or bilateral pain may be noted. In most patients with migraine, the pain is pulsating in nature, of moderate to significant intensity and intensifies with the slightest physical exertion or even moving the head.The migraine aura represents a complex of local reversible neurological symptoms. They are characterized by a duration of no more than an hour, in typical cases 15 -20 minutes; sequential development: visual disturbances appear first, then in 45% of patients visual disturbances are followed by sensory disturbances, 10% are motor and rarely motor aphasia, memory impairment of the type of transient global amnesia, etc. If there is a “light gap” between the aura and the attack of pain it will last no more than an hour, otherwise these are not related events.A characteristic feature of migraine is the presence of a special functional state of the patient, which occurs before the development of a migraine attack – the prodrome and continues after its end – the postdrome. Prodrome occurs in 2-3 hours in about 60% of migraine attacks and is represented by irritability, low mood, drowsiness, anxiety, hyperactivity, impaired concentration, photo and phonophobia, hunger, anorexia, fluid retention, thirst and other symptoms. The presence of a prodrome allows patients to differentiate migraine from other types of headache in advance.For postdroma, which is noted in 90% of seizures and lasts up to a day, typically impaired concentration, fatigue, weakness, muscle weakness, hunger, less often euphoria.

How is the diagnosis made?

The key to effective migraine treatment is a correct diagnosis. A competent survey can be carried out by a doctor at a migraine treatment clinic in Moscow, since the diagnosis of migraine is made on the basis of interviewing a patient and identifying characteristic clinical signs of the disease.The doctors of the Headache Clinic are highly experienced and highly qualified, which allows them to quickly and correctly diagnose. The most important for practical medicine is the differential diagnosis of migraine with secondary headaches, which are symptoms of another disease. So for migraine, the differential diagnosis with unruptured aneurysm, malformation of the cerebral vessels, transient ischemic attack, epilepsy is relevant. Danger signals are highlighted, if there is at least one of them in the clinical picture, a thorough examination should be carried out (Fig.1). First of all, neurological examination with examination of the motor, sensory and coordination spheres, as well as paraclinical examination. The highest resolution are MRI of the brain and MR-angiography. Ultrasound examination of blood vessels, functional radiography of the cervical spine, EEG, examination of the fundus, visual fields, intraocular pressure and other methods may be important.

Treatment of migraine

Treatment of migraine includes two important stages: treatment of an attack and prevention of attacks.

A patient suffering from recurrent headaches of significant intensity, accompanied by nausea and vomiting, especially when the attacks become more frequent and prolonged, usually experiences serious concern about their health, suggesting that the cause is a tumor, vascular aneurysm or some other fatal disease. The most important task of the doctor is to conduct an informational conversation about what a migraine headache is, about the course, a favorable prognosis of the disease and the absence of a fatal organic disease in the patient.Such a conversation is aimed at relieving stress, normalizing the mental state of a person and is essential for the success of future migraine treatment. At the same time, the patient should be informed that migraine is an incurable disease due to its hereditary nature. In this connection, the main goal of migraine treatment is to maintain a high quality of life in a patient with migraine by teaching him how to quickly, effectively and safely relieve migraine headaches and a number of measures aimed at reducing the frequency, intensity and duration of attacks.This is the essence of a specialist consultation in a migraine clinic. People with migraine are hypersensitive to a wide variety of external and internal factors: hormonal fluctuations, food, environmental factors, sensory stimuli, stress. Identifying individual migraine triggers teaching them to avoid is an important step in the treatment of the disease – migraine. Often, along with migraine, the patient has other chronic diseases that affect his health and should be taken into account when choosing medicines for the treatment of migraines.It is necessary to report them to the doctor.

On the treatment of migraine by the method of botulinum therapy and reflexology. At an appointment with a professor, a neurologist at the Headache Clinic named after V.I. Veyna Naprienko Margarita Valentinovna and a reflexotherapy session at the neurologist, reflexotherapist Safonov Mikhail Igorevich.

Treatment of headache and migraine with botulinum toxin (BOTOX)

Fast, effective, safe.

Life without pain and without dependence on pain medications.

“Mysterious molecule of the century” – this is how the world neurological community called botulinum toxin in 2000. The most widespread opinion is that these drugs are used only in cosmetology practice in order to remove mimic wrinkles. But this is just one of the many facets of botulism toxin use.

Botulinum toxin preparations have become reliable assistants to neurologists all over the world in the fight against chronic headaches of various origins (tension headaches with chronic spasm of the muscles surrounding the skull and neck muscles against the background of neuroses and overstrain, chronic fatigue and chronic migraine.

More than 100 Botox injections were performed in the department.

BOTOX injection will help you if:

• Headache every day or almost every day.
• You feel pain in the neck region extending to the head.
• Migraine attacks occur twice a week or more.
• Failure of early drug therapy, manual therapy, IRT, etc.
• If you have a chronic use of pain medications.

In our center, injections are carried out only by highly qualified specialists with extensive experience, Ph.D. – Berdnikova IN, Oleinik AN There are only about 500 certified specialists in Russia. The professionalism and experience of the doctor is the key to a successful procedure.

Why Botox? How does it work?

The drug has a muscle relaxant and analgesic effect (3-6 months) and local injection of the drug into spasmodic muscles leads to their prolonged relaxation and breaks the vicious circle of chronic headache formation: muscle spasm – pain – increased muscle spasm, etc.Also, botulinum toxin blocks pain receptors of the trigeminal nerve system and the occipital nerves.

What are the benefits of botulinum therapy?

Chronic headache is excruciating to the patient. Treating chronic headache is a difficult task for the physician. And sometimes the use of all schemes of combined drug therapy, therapeutic blockade, manual therapy, physiotherapy – do not lead to relief of pain. The courses of drug therapy (antidepressants, tranquilizers, antiepileptic and anti-migraine drugs) are 6-12 months, all drugs are expensive and, unfortunately, have many side effects and do not always help to remove dependence on pain medications.

The use of botulinum toxin is a single procedure, repeated injections are made as needed, on average, once every 6 months.

A nice gift is that botulinum toxin treatment according to the chronic headache scheme will not only relieve you of headaches, but also remove facial wrinkles on your forehead.

How is the treatment carried out?

Injections are carried out with a thin insulin syringe into the muscles of the proud, frontal, frowning eyebrows, temporal and occipital, upper cervical vertebral muscles at several points in each of them, according to a scheme developed by US neurologists (in the USA, a technique has been developed since 1995, since 2004 it has been included in the medical insurance in the USA).Injections are accompanied by mild, unpleasant, fast-passing sensations. The dose of the drug is calculated individually for the patient, depending on the clinical picture of the disease. The average dose for one procedure is 100 units of Botox.

We are happy to help you overcome the pain! Life without pain for a patient with chronic headache is a daily feeling of happiness!

How to treat a migraine in a child?

For a long time, the problem was solved radically – a pill was given, which provided symptomatic relief.It is not right. It is important to identify the cause, and then make a decision about whether the children need to drink any drugs. Half of all causes are eliminated non-drug.

For example, migraines should not be treated with pills if:

• The pains appeared in girls who are approaching menstruation.

• Pain in the head occurs due to stress (the child often experiences intense excitement, as he is constantly placed in unfamiliar conditions, taught and educated).

• Children’s migraines are caused by problems with posture, in which there is an excessive load on the spine, including the cervical spine.

• Attacks occur due to lack of sleep, dehydration, constant noise, poor nutrition, poor lighting in a residential or classroom, etc.

Cognitive behavioral therapy is now proven to be the best treatment for these types of childhood migraines.The Matzpen Clinic actively uses this practice, and it has proven to be effective in preventing recurrent headaches.

Read also

Painful emotions

First of all, the specialist teaches the child to identify the factors that provoke pain in the head and prevent them. Of course, before that, a diagnosis of a young patient is carried out to identify the exact cause of the migraines. For example, if it is established that it appears due to a load on the spine, then the child will need to be explained how to properly hold his back, sit at a desk, write and read, so that no pain and noise in the head occurs.

At the Matspen clinic, attention is paid to teaching relaxation methods, specialists teach a child to relax the muscles of the head, neck, spinal girdle and those muscle groups that may be associated with headaches. As soon as the child learns to do this, he will be able not only to reduce the intensity of pain, but also to completely prevent migraine attacks.

90,000 Migraine headaches learned to heal with nutrition

Health

07:00 02.07.2021 (updated 12:28 02.07.2021) Get short link

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In order to make life easier for migraine sufferers, scientists suggest consuming less vegetable oils

NUR-SULTAN, July 2 – Sputnik. Scientists from the US National Institute of Aging (NIA) have developed nutritional guidelines for people suffering from migraines, RIA Novosti reports.

They find that in order to reduce migraine headaches, people need to eat more oily fish and reduce their intake of certain vegetable oils high in linoleic acid.

For the experiment, the scientists divided the patients into three groups. The first group ate a lot of fatty fish and ate few vegetable fats. The second group ate a lot of both, and the third was on a diet low in fatty fish and high in vegetable oil.

The nutritionist told about a “tasty” way to restore liver function

Success in reducing headaches was noted in the first group.

Linoleic acid is found in corn, soy and other vegetable oils, as well as in nuts and seeds, belongs to the class of omega-6-unsaturated fatty acids.It can lead to increased inflammation.

Migraine is a neurological disease that is one of the most common causes of chronic headache. According to the US National Institutes of Health, more than four million people worldwide suffer from chronic migraines – they have attacks at least 15 times a month.