How can you effectively manage different types of headaches. What are the key principles of headache treatment. When should you consult a specialist for headache relief. Discover expert-backed strategies for migraine, tension, and cluster headaches.

Understanding Headache Types and Their Characteristics

Headaches are a common ailment that can significantly impact daily life. To effectively manage headaches, it’s crucial to understand the different types and their unique characteristics. The main categories of headaches include:

• Primary headaches: These occur independently and are not caused by underlying health conditions. Examples include migraines, tension-type headaches, and cluster headaches.
• Secondary headaches: These are symptoms of other health issues, such as sinusitis, head injuries, or more severe conditions like strokes or infections.
• Painful cranial neuropathies: Rare but extremely painful conditions like trigeminal neuralgia and persistent idiopathic facial pain fall into this category.

Identifying the specific type of headache you’re experiencing is the first step towards effective treatment. Healthcare professionals use various diagnostic tools and criteria to determine the nature of your headache, which in turn guides the treatment approach.

General Approaches to Headache Management

While specific treatments vary depending on the type of headache, there are some general strategies that can be beneficial for many sufferers:

1. Lifestyle modifications: Regular sleep patterns, stress management, and maintaining a balanced diet can help reduce headache frequency and severity.
2. Trigger identification and avoidance: Keeping a headache diary can help you identify and avoid personal triggers, such as certain foods, environmental factors, or activities.
3. Hydration: Ensuring adequate fluid intake can prevent dehydration-related headaches and may alleviate symptoms of existing headaches.
4. Regular exercise: Engaging in moderate physical activity can help reduce tension and improve overall well-being, potentially decreasing headache occurrences.
5. Relaxation techniques: Practices such as deep breathing, meditation, or yoga may help manage stress and reduce headache intensity.

Can complementary therapies help with headache management? While research is ongoing, some people find relief through acupuncture, massage therapy, or dietary supplements. However, it’s essential to consult with a healthcare provider before trying any new treatments, especially if you’re taking other medications.

Migraine Treatment: Comprehensive Strategies for Relief

Migraines are intense, often debilitating headaches that can be accompanied by various symptoms such as nausea, sensitivity to light and sound, and visual disturbances. Treatment for migraines typically involves a combination of approaches:

Acute Treatment

Acute treatments are designed to relieve pain and associated symptoms during a migraine attack. Options include:

• Over-the-counter pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen
• Triptans: Prescription medications that target specific brain chemicals involved in migraines
• Ergotamines: Another class of prescription drugs that can help alleviate migraine pain
• Anti-nausea medications: To address nausea and vomiting associated with migraines

Preventive Treatment

For individuals experiencing frequent or severe migraines, preventive treatments may be recommended. These can include:

• Beta-blockers: Medications that can help reduce the frequency and severity of migraines
• Antidepressants: Certain types may help prevent migraines, even in non-depressed individuals
• Anti-seizure medications: Some drugs used to treat epilepsy have shown effectiveness in migraine prevention
• CGRP antagonists: A newer class of drugs specifically designed for migraine prevention
• Botox injections: For chronic migraine sufferers, regular Botox treatments may help reduce headache frequency

How effective are lifestyle changes in preventing migraines? While medication can be crucial for many migraine sufferers, lifestyle modifications can also play a significant role. Maintaining regular sleep patterns, managing stress, avoiding known triggers, and staying hydrated can all contribute to reducing the frequency and severity of migraine attacks.

Tension-Type Headache: Strategies for Relief and Prevention

Tension-type headaches are the most common form of headache, characterized by a dull, aching sensation often described as a tight band around the head. Treatment approaches for tension-type headaches include:

Acute Treatment

• Over-the-counter pain relievers: Acetaminophen, ibuprofen, or aspirin can often provide relief
• Combination medications: Products containing caffeine, aspirin, and acetaminophen may be more effective for some individuals

Preventive Measures

For chronic tension-type headaches, preventive strategies may include:

• Stress management techniques: Relaxation exercises, cognitive-behavioral therapy, or biofeedback
• Physical therapy: To address muscle tension in the neck and shoulders
• Regular exercise: To promote overall well-being and reduce muscle tension
• Improving sleep habits: Ensuring adequate, quality sleep can help prevent tension-type headaches

Are there any specific exercises that can help alleviate tension-type headaches? Gentle neck and shoulder stretches, as well as exercises to improve posture, can be beneficial. Some people find relief through practices like yoga or tai chi, which combine physical movement with relaxation techniques.

Cluster Headache: Specialized Treatments for a Unique Condition

Cluster headaches are extremely painful headaches that occur in cyclical patterns or clusters. Due to their unique nature, they often require specialized treatment approaches:

Acute Treatments

• Oxygen therapy: Inhaling 100% oxygen through a mask can provide rapid relief for many sufferers
• Triptans: Particularly in injectable or nasal spray forms for quick action
• Lidocaine nasal drops: To provide local numbing and pain relief
• Octreotide: An injectable synthetic hormone that can be effective for some individuals

Preventive Treatments

Preventing cluster headaches often involves medications taken at the start of a cluster period, such as:

• Calcium channel blockers: To help reduce blood vessel constriction
• Corticosteroids: Short-term use to break a cycle of headaches
• Lithium carbonate: Particularly for chronic cluster headache prevention
• Nerve block injections: To interrupt pain signals in specific nerves

Why is rapid treatment crucial for cluster headaches? Cluster headaches typically reach peak intensity quickly, often within minutes. Swift intervention can help minimize the duration and severity of the attack, providing much-needed relief for sufferers of this intensely painful condition.

Medication-Overuse Headache: Breaking the Cycle

Medication-overuse headache (MOH), also known as rebound headache, is a secondary headache disorder caused by the frequent use of pain relief medications. Addressing MOH involves:

1. Identifying the overused medication: This could be over-the-counter pain relievers, triptans, or other headache medications.
2. Gradual withdrawal: Under medical supervision, the overused medication is typically reduced or stopped.
3. Managing withdrawal symptoms: Temporary worsening of headaches and other symptoms may occur during withdrawal.
4. Establishing a new treatment plan: This may involve preventive medications and non-pharmacological approaches.
5. Patient education: Understanding the risks of medication overuse and learning proper use of acute medications is crucial.

How long does it take to recover from medication-overuse headache? The recovery process can vary, but many patients start to see improvement within a few weeks to a couple of months after stopping the overused medication. However, full recovery and establishing an effective new treatment regimen may take several months.

Rare Headache Disorders and Facial Pain: Recognizing and Addressing Unique Conditions

While less common, rare headache disorders and facial pain conditions can be extremely debilitating. Some examples include:

• Trigeminal neuralgia: Characterized by severe, shock-like pain in areas of the face
• Persistent idiopathic facial pain: Continuous pain in the face without a clear cause
• Hemicrania continua: A constant, one-sided headache with periodic intensifications
• New daily persistent headache: A sudden onset of daily headaches that persist

Treatment for these conditions often requires a multidisciplinary approach and may include:

• Anticonvulsant medications
• Tricyclic antidepressants
• Nerve blocks or other interventional procedures
• In some cases, surgical interventions

Why is early diagnosis crucial for rare headache disorders? Prompt recognition and diagnosis of these conditions can lead to more effective treatment strategies, potentially preventing the development of chronic pain and improving quality of life. If you’re experiencing unusual or severe headache symptoms, it’s important to consult with a healthcare professional for proper evaluation.

When to Consult a Specialist for Secondary Headaches

While many headaches can be managed effectively with general approaches, certain situations warrant consultation with a headache specialist or neurologist. These include:

• Sudden, severe headaches often described as “the worst headache of your life”
• Headaches accompanied by neurological symptoms such as weakness, vision changes, or speech difficulties
• New or different headache patterns in individuals over 50
• Headaches that worsen with coughing, exertion, or sudden movements
• Headaches that don’t respond to standard treatments or significantly impact daily life
• Headaches in individuals with a history of cancer or HIV

What diagnostic procedures might a specialist use to evaluate secondary headaches? Depending on the suspected cause, a specialist might order various tests, including:

• Neurological examination
• Brain imaging studies (CT scan or MRI)
• Blood tests to check for infections or other systemic issues
• Lumbar puncture (spinal tap) in cases where meningitis or increased intracranial pressure is suspected

Early evaluation of potentially serious secondary headaches is crucial for timely diagnosis and treatment of underlying conditions.

In conclusion, effective headache management often requires a multifaceted approach tailored to the specific type of headache and individual patient needs. By understanding the various types of headaches, their characteristics, and available treatment options, individuals can work with healthcare providers to develop comprehensive strategies for relief and prevention. As research in this field continues to advance, new treatment options and insights may emerge, offering hope for improved management of these often debilitating conditions.

How to Treat a Migraine or Severe Headache: Strategies for Pain Relief

When you find yourself dealing with a migraine or severe headache, it can be difficult or impossible to focus on anything else until the pain subsides. Aside from taking medication, there are several ways to help relieve migraine pain and symptoms like light sensitivity, nausea, or dizziness. Here are five strategies for migraine relief that can make a huge difference.

Find a Dark Room

It is very common to experience sensitivity to light during a migraine. If you can, find a dark room where you can sit or lie down to rest when you feel a migraine coming on. Use blinds or curtains to block the windows, and use an eye mask or cold pack to block any extra light from your eyes. Try to take a nap if you can. If you can’t completely step away from what you’re doing, wearing sunglasses inside and turning off the lights can go a long way.

Try to Hydrate

Dehydration is a factor in causing some headaches and can also make headaches worse. If you are able, drink plenty of water and/or electrolyte-filled liquids to stay hydrated during a migraine.

Use a Cold Pack

Cold packs can provide one of the most immediate forms of relief when you’re suffering from a migraine or intense headache. The cold constricts blood vessels and alleviates symptoms by reducing inflammation. You can make your own cold pack by putting ice cubes in a towel, using a bag of frozen fruit or vegetables, or even using a damp washcloth. Make sure your cold pack is not too cold and causing pain on its own. Sometimes a cold shower can help as well! We recommend alternating 15 minutes with the cold pack and 15 minutes without.

Use a Heating Pad

Depending on where your symptoms are, a heating pad may be able to provide a different relief. Using a heating pad on the back of your neck or head can help relieve muscle tension that might be causing your headache. Make sure your heating pad is not so hot that it is burning you or causing skin irritation. Similarly to our last point, a hot shower or bath could also reduce muscle tension and help you relax.

Try Massage

Massage is an excellent way to relieve pain from a tension headache. Apply light pressure to your forehead, neck, temples, or other pain point for a few minutes at a time. You can also try a gentle massage on the back of your neck, shoulders, or upper arms.

Using these methods can help ease a severe headache or migraine pain apart from medication or work side-by-side with medication. If you are having trouble relieving headache pain or your headaches/migraines become more frequent, visit your primary care provider to see if you have further pain management or prevention options.

Do you have more questions about migraine relief in Salem, Oregon? Contact our friendly staff at WFMC Health or become a new patient today!

Filed Under: Family Health Care

WFMC

Headache Treatment – Migraine & Headache Australia

Medically reviewed by Dr. Trudy Cheng. Last updated 28 May 2021 

While there is no absolute cure for headache, there are a number of helpful treatment options for managing your headache. Depending on what type of headache you have, you can try medication, lifestyle changes, or complementary therapies (such as supplements or meditation). Always consult your medical practitioner before taking any form of treatment.

This article covers the principles of headache management, including:

1. 1. 1. Understanding and diagnosing your headache;
      2. General approaches towards headache management;
      3. Treatment of migraine;
      4. Treatment of tension-type headache;
      5. Treatment of cluster headache;
      6. Medication-overuse headache;
      7. Rare headache disorders & facial pain;
      8. When to see a specialist for secondary headaches

There is still a lot we don’t know about managing headache disorders, and they are often dismissed as ‘just a headache’ – even though chronic headaches can be a disabling condition for some patients. Through funding research, we hope that we can raise the profile of headache disorders and contribute towards discovering life-changing new treatments.

Key terms

Term	Definition
Primary headache	Distinct headache disorders that occur on their own and aren’t the result of another health condition (i.e. migraine, cluster headache).
Secondary headache	Headaches occurring due to another health condition (common causes are sinusitis and head injuries, more severe cases include stroke or infections).
Painful cranial neuropathies	This includes the trigeminal neuralgia and persistent idiopathic facial pain. These are very rare but extremely painful, and recognising the symptoms is important so that patients can understand their condition.
Acute treatment	Medications designed to treat headache & any associated symptoms, taken at the onset of an attack.
Preventive treatment	Lifestyle changes or medications intended to reduce the frequency and severity of attacks. Lifestyle changes include techniques like cognitive behavioural therapy and meditation.
Episodic	Headache disorders causing headache on 14 days or less per month (in migraine and tension-type headache). Headaches occurring in periods from 7 days to one year, separated by pain free periods lasting at least 3 months (in cluster headaches).
Chronic	Headache disorders causing headache on 15 or more days per month for more than 3 months (in migraine and tension-type headache) Headaches occurring for one year of longer without remission, or with remission periods lasting less than 3 months (in cluster headaches).
Persistent	Secondary headache disorders of more than 3 months duration.

1) Diagnosis: why do I have a headache?

Before a doctor can start to treat your headache, they will need to understand what is causing your headache. The International Headache Society recognises over 200 headache types, although the two most common types of primary headaches are migraine and tension-type headache (TTH). Cluster headache and other trigeminal autonomic cephalalgias (TACs) are less common, but are extremely painful, and recognising symptoms early is important.

You can use our headache types directory to identify what your symptoms might mean before consulting a doctor to confirm the diagnosis. It’s helpful to keep a headache diary in the weeks leading up to your appointment, recording the number of headache days, severity, and any relevant symptoms. This will help your doctor look for any patterns or triggers, and will ensure you don’t forget to tell them about any specific symptoms.  

Symptoms of primary headache disorders (1)

	Migraine	Tension-type headache (TTH)	Cluster headache (CH)
Temporal pattern	Episodic migraine: recurrent attacks lasting from 4-72hrs. Frequency is often 1-2/month but can vary from 1/year to 2/week. Freedom from symptoms between attacks.	Frequent episodic TTH: recurrent attacks lasting a few hours to a few days. 1-14 headache days per month with freedom from symptoms between attacks.	Episodic CH: frequent short-lasting attacks (at least 1 per day lasting 15-180 minutes). They recur in 6-12 week bouts, once or twice a year, then remit for 3 or more months.
	Chronic migraine: headache on 15 or more days/month, with migrainous features on at least 8 days/month.	Chronic TTH: 15 or more days affected per month (often daily & unremitting).	Chronic CH: similar, but without remission between bouts.
Typical headache characteristics	Pain is often unilateral and pulsating.	Can be unilateral but pain is more often generalised. It may spread to the neck and is typically described as pressure or tightness.	Strictly unilateral (although can occasionally switch sides), pain is around the eye or over the temple.
Headache intensity	Typically moderate to severe.	Typically moderate to severe.	Extremely severe.
Associated symptoms	Aura (in a minority of attacks). Nausea and/or vomiting, light sensitivity, or sound sensitivity are all common.	Frequent episodic TTH: no typical other symptoms, except for possible light/sound sensitivity. Chronic TTH: may cause mild nausea, but not vomiting.	Any or all of the following autonomic features: red and/or watering eye, running or blocked nostril, or drooping eyelid. This occurs only on the same side as the head pain.
Reactive behaviour	Avoidance of physical activity (maybe bed rest), preference for dark and quiet.	None specific.	Marked agitation, unable to lie still during attacks.

2) General approaches toward headache treatment plans

In most cases, headache can be effectively managed through medication or managing triggers. If you kept a headache diary in order to establish a diagnosis, you might find the answer to managing your headache is there – diaries can show patterns (i.e. menstrual migraine, seasonal cluster headache), triggers, lifestyle and behavioural factors, and help you recognise how much headache days impact your life.

Most headache disorders have guidelines for acute and preventive treatment. Due to the risk of medication overuse headache, preventive treatments are recommended for patients with chronic disorders. Over-the-counter medications like paracetamol or ibuprofen can be used safely for episodic headache, by following the dosage guidelines and not using them more than three times a week (3). 

One of the most important things in headache management is finding an effective treatment with minimal side effects. This is why an ongoing relationship with your doctor is important. Not all medications will be effective, and not all triggers can be avoided. Managing headache will be a balance of pharmaceutical and lifestyle changes to develop a treatment plan that works for you.

3) Migraine

Migraine is the most common reason that patients seek professional help for headache management (2). It is a complex disorder, and treatment can often involve a lot of trial and error in trying to find something that works. Some of the options available include:

• Acute treatments (over-the-counter and prescription)
• Preventive medications (including oral medications, calcitonin gene-related peptide antibodies [CGRPs] and Botox)
• Lifestyle and behavioural changes to avoid triggers
• Nerve stimulation devices
• Complementary treatment (massage, meditation and more)

The good news is that there are some very effective migraine medications, with the most well-known types being triptans (an acute medication). There are five types of triptans in Australia, and studies have found that between 42-76% of patients will respond to at least one type of triptan (4). Conventional preventives include blood pressure medications, antidepressants, and antiepileptics.

Most doctors will recommend a combination of pharmaceutical treatment and lifestyle management. While it’s good to recognise triggers, particularly early on in treatment, it’s important to accept that not every trigger can be controlled(1). Many migraine patients require some kind of medication, and recognising this will help you avoid the stress of trying to manage migraine solely through lifestyle changes. 

You can find a more comprehensive guide to migraine management here.

4) Tension-type headache (TTH)

Tension-type headache (TTH) is the most common headache, and is generally described as ‘featureless’ due to the lack of accompanying symptoms. Most people have experienced a tension-type headache at some point, however for some people it can be frequent or chronic.  

Patients with infrequent headaches (less than two days per week) can usually use over-the-counter painkillers (1). Unlike migraine, there aren’t any TTH-specific medications available for acute treatment, and triptans won’t be effective for TTH. 

If you have more than two headache days per week, consider:

• Psychological intervention (i.e. cognitive behavioural therapy) to reduce stress, which might be causing your frequent headaches
• Increasing physical activity or movement throughout the day
• Improving sleep duration, quality and consistency
• Reducing the quantity of processed foods, examine dietary triggers
• Increase hydration levels throughout the day with water or herbal teas 
• Preventive medication (depending on your doctor’s advice)

The preventive medications for TTH are primarily used as antidepressants, but can be effective in preventing headache provided there aren’t any side effects.

Preventive drugs with evidence of efficacy in frequent episodic or chronic TTH (1)

5) Cluster headache

Cluster headache is a type of trigeminal autonomic cephalalgia (TAC), characterised by short-lasting but extremely severe headache. The pain is localised around one eye and can be accompanied by bloodshot, irritated and swollen eyes; restlessness; sweating; and congestion.  

Due to the short attacks, most acute medications are not recommended for cluster headache. Over-the-counter painkillers will only kick in after the attack ends, so these should be avoided if you are experiencing cluster headache. Some triptans are used, but they need to be injected to work quickly enough.

Preventive medications play a bigger role in management, but they need to be started in between clusters. Seeing a headache specialist may be appropriate for people living with cluster headache. If you are experiencing these symptoms, ask your GP for a referral to a neurologist or headache specialist.

Current landscape for cluster headache treatment (5)

6) Medication-overuse headache (MOH)

Medication-overuse headache (MOH) is characterised by headache occurring on 15 or more days per month, and often begins as episodic migraine or TTH (1). Some medications can aggravate headache disorders, including: 

• Simple analgesics (ibuprofen, paracetamol, aspirin)
• Triptans
• Opioids
• Combination medications (any of the above combined with caffeine)

If you have been using any of the above medications to treat these headache disorders and have experienced an increase in headache days, it could be due to MOH. Most doctors will try to prevent MOH through patient education, but it can be easy to overuse medication without realising. 

The only way to manage MOH is to stop taking the medication as quickly as possible, and early intervention has the best results. Your doctor might recommend (1):

• Stopping immediately (cold turkey)
• Tapering off your intake, more commonly advised for opioids
• Replacing the overused medication with another acute treatment alternative and establishing a more robust plan to help prevent future attacks 

Unfortunately, your headache will likely worsen for 1-2 weeks with withdrawal symptoms, but the good news is that the long-term results are generally good. Once your headache has reverted to the previous frequency of episodic TTH or migraine, you can work on a new treatment plan with your doctor that prioritises preventive strategies.

7) Rare headache disorders & facial pain

These disorders include trigeminal neuralgia and persistent idiopathic facial pain (PIFP). Trigeminal neuralgia involves recurrent electric-shock-like pains in one side of the face, and can be triggered by seemingly innocuous stimuli (even brushing your hand against your face). PIFP causes dull, aching, poorly localised facial pain, which occurs for over two hours per day (1).

While they have different symptoms, both of these rare disorders have a huge impact on patients, and can be physically, psychologically and socially debilitating. General painkillers are not effective for these disorders. If you are experiencing these symptoms, ask your GP for a referral to a specialist – treatment is complex, and a specialist will be able to screen for possible other causes of the pain.

Trigeminal neuralgia and PIFP both have preventive medications available. These need to be taken at a low dose to begin with, and gradually increased due to possible side effects. Many people find these preventives helpful, and if the pain stops altogether patients can possibly taper down the dosage and eventually cease medication (1).

8) Secondary headaches

In some cases, headaches can be a symptom of something more serious. If you experience any of the following symptoms without an explanation (6), it’s best to speak to your doctor as soon as possible. 

• Thunderclap headache (intense, exploding and hyperacute onset)
• Progressive headache, worsening over weeks
• Persistent morning headache with nausea
• Headache associated with:
  • Unexplained fever
  • Change in personality or consciousness
  • Neck stiffness
  • Neurologic symptoms: double vision, visual changes, tinnitus, weakness, changes in sensation, changes in balance
• New onset headache for:
  • Patients with history of cancer
  • Patients with immunodeficiency (including HIV)
  • Adults over 50
  • Anyone with family history of glaucoma
  • Patients during pregnancy
• Aura symptoms that
  • Last longer than an hour
  • Include motor weakness
  • Are different from previous aura
  • Occur for the first time on using oral contraceptive pill

Source: references 1 & 2

Most people are familiar with mild headaches that occur infrequently. But when headache becomes more common, disruptive and debilitating, it’s important to seek care. With over 200 headache types, the treatment strategy is greatly informed by the diagnosis – even treatment between the major headache types listed here can be so different. That is why it is critical for an accurate diagnosis before an effective treatment plan can be put in place to reduce the frequency and severity of your headache. 

References

1. 1. 1. TJ Steiner et al, 2019, Aids to management of headache disorders in primary care (2nd edition). https://doi.org/10.1186/s10194-018-0899-2 
      2. WJ Becker et al, 2015, Guideline for primary care management of headache in adults. PMID: 26273080. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541429/pdf/0610670.pdf 
      3. F Ahmed, 2012, Headache disorders: differentiating and managing the common subtypes. https://doi. org/10.1177%2F2049463712459691 
      4. C Cameron et al, 2015, Triptans in the Acute Treatment of Migraine: A Systematic Review and Network Meta-Analysis. https://doi.org/10.1111/head.12601 
      5. DY Wei et al. 2019, Managing cluster headache. http://dx.doi.org/10.1136/practneurol-2018-002124
      6. CC Chiang et al. 2020, Diagnosing secondary headaches. Practical Neurology, vol 19, no.4 p31-40

Pain in your head: how to cope with a migraine

People have suffered and are suffering from headaches. In medieval Persia, it was treated most often with castor oil, today there are more advanced methods. But the origin of headache is actually still unknown. The British neuroscientist Amanda Ellison in her book describes the mechanisms and features of different types of headaches, talks about the struggle of medicine with the “universal curse” for centuries, refers to the experience of leading scientists and the stories of ordinary patients.

We share an excerpt where the author talks about the phases of migraine development, as well as its connection with yawning.

Amanda Allison

Alpina non-fiction, 2021

Not every really bad headache is a migraine, just like a bad cold is not the flu. Unless, of course, you’re a man. The flu is a completely different beast, and those of you who have actually experienced it know this. Migraines have a specific set of symptoms and are now recognized as something completely separate from other types of headaches. In the next two chapters, we will look at these symptoms to understand what causes them and how our body reacts to them.

There are two and a half categories of migraine. You can have a migraine with an aura – it is called a classic migraine, or a migraine without aura, that is, a common one. I myself periodically experienced both. You can also have an ocular migraine, that is, an aura without a pain component – you immediately go to a feeling of lethargy, so I consider this half of the category. However, as we shall see, all these variants are largely characterized by four stages of flow.

The most interesting aspect of migraine is that it is event outside the headache component . Migraine is not just a headache, it is a phenomenological event, which, as already mentioned, consists of four separate phases:

• Prodromal phase

• Aura

• Pain phase

• Postdromal

It is important to consider each of the phases, because it is new information about what is happening in our brain and what causes certain phenomena. And she will clarify how we could deal with migraines.

This is how something unpleasant happens – the prodromal phase

I spoke with people who suffer from migraine and learned a lot. However, the most important fact I have found is that most of these patients do not recognize the first stage of this disease, the prodromal phase, quite well. Once, for example, I met with David and his mother in the summer – it was at an event dedicated to discussing various aspects of a headache – and witnessed a very heated debate on this topic. David’s mom swore she’d notice his migraine before he did. “With all due respect to you, mom,” the son retorted (you know for sure that the intonation with which further words will sound will be far from respect), “I think that it’s already I would be better than all people knew when my head hurts. I objected (not in favor of David) that often the last person to notice a migraine is the person who is suffering from a migraine attack. Indeed, there is strong, though only recently presented, evidence to support this fact. Ana Gago-Veiga, from the Headache Department at the Sanitary Hospital in Madrid, found that only about a third of the patients she interviewed could be considered good predictors—in the sense that they could identify an impending migraine in more than 50% of cases. And this was only due to the fact that their prodromal symptoms were quite obvious and included severe yawning, drowsiness, food cravings, intolerance to light, intense thirst, or blurred vision. After listening to the explanation I gave to David and his worried mom, he sheepishly replied that he had never linked these symptoms to his migraine before. “And I was tying,” said his mother, with excessive, in my opinion, triumph. However, this just goes to show that moms are always right.

As we now know, in order to recognize the first stage, the prodromal phase, a certain introspection is required. During this phase before (the bad thing that is about to happen) there may be some behavioral changes in your behavior related to the changes taking place in the brain, and this can happen a couple of days or hours before the migraine plays out in full force. You may yawn more than usual, be less alert or even sleepy, crave certain foods, or be hungrier than usual. Walking through shops with very bright lighting can make you feel confused. These symptoms should not be underestimated.

In recent years, Peter Godsby of King’s College London and several others have spoken of the value of accounting for these traits in terms of their underlying biological mechanisms. It is the changes in your brain that sometimes trigger the behavior we think of as a trigger for a migraine. We must figure this out. Ultimately, I’m interested in why we have these phenomena. Are these behaviors designed to restore some kind of neurochemical balance that is out of whack in our brains? What can we do to stop migraines from developing? Here’s what we know so far.

A gaping abyss

Let’s start with a yawn. Yawning is a behavioral act that is interesting in that it is both physiological and psychosocial. It’s very easy to get “infected” with yawning – there have even been studies that accurately establish the relationship between how easy it is for you and how much you are capable of empathy. Well, when I write these lines, I’m yawning with might and main, so draw whatever conclusions you want from this, and if you feel like yawning right now, don’t hold back, I won’t judge. The reason we yawn together is because it creates a group state of alertness: when we yawn, a large dose of oxygen enters the body, a fair amount of which reaches your brain, making you feel more rested (this is why we yawn when we are tired) . From an evolutionary point of view, this could be important when the group was hunting a woolly mammoth or something like that. These days, military skydivers often report that they always do a group yawn session before jumping out of an airplane (although, between us, yawning would clearly not be my body’s primary action in this situation).

However, it’s not just about getting a portion of oxygen. In New York State University researchers Andrew Gallup and his son Gordon placed cooling compresses on their foreheads while watching videos of people yawning. The Gallups noted that people with compresses yawned much less frequently, indicating that yawning, among other things, helps to cool the brain, and if the head is already cold, we are not so easily “infected” with yawning. Cooling down most likely helps us feel more alert, regardless of the extra oxygen. It may also suppress the nerve pathway that is active during yawning.

As an unconscious or automatic behavioral activity, yawning originates in the brainstem, like many other species-specific behaviors such as grooming. Thus, yawning may be a thermoregulatory response (we are too hot) or caused by the need for more oxygen to the brain. Reasoning in this way, it is logical to conclude that in the pre-migraine state, the brain becomes inflamed and its temperature rises and / or it is somewhat depleted of oxygen. Yawning is our way of self-healing by reducing inflammation and increasing oxygen levels.

This effect is specifically related to neurochemistry through the action of dopamine. Dopamine is one of the main excitatory neurotransmitters in the brain and is important for maintaining alertness, but also for movement and for our satisfaction in performing life-sustaining behaviors (for example, in this set of behaviors: eating, drinking, and having sex, although the latter is not classified as a behavior that saves our lives).

Dopamine neurons trigger the act of yawning, causing the hypothalamus to act on the brain stem that directly controls yawning. Thus, dopamine stimulates behaviors that increase our alertness. We know that chemicals that act like dopamine in the brain can cause yawning, and that dopamine-deficient people, such as Parkinson’s patients, yawn less. Because of this, the prevailing view is that higher levels of dopamine cause the symptoms seen in migraines. However, everything is much more complicated, since the key point here is sensitivity to dopamine in a person suffering from migraine: such people seem to be particularly susceptible to the concentration of this neurotransmitter.

There is another opinion. Based on the knowledge that migraine-prone people are hypersensitive to dopamine, Piero Barbanti, head of the Italian Headache Society, and his colleagues at the San Raffaele Hospital in Rome, added to the established notion. Piero has a theory that it is less, not more, dopamine that triggers prodromal migraine symptoms. I can agree with this because the lowered dopamine level would have a depressing effect on the brain and yawning could be provoked in order to “wake” it up. As Piero further explains, dopamine levels are regulated by the hypothalamus, which takes emergency action to keep all hormones and neurotransmitters within strict limits. A rapid increase in the level of dopamine, which the hypothalamus injects into the system, causes nausea in the next stage of migraine. In experiments where subjects are injected with a dopamine agonist (it acts in the body in exactly the same way as dopamine), a very small amount of it causes yawning in people who suffer from migraines, while those who have there are no migraine attacks, it is necessary to start yawning by taking a much larger amount of this substance. When the dosage is increased, the control group member simply yawns, while people suffering from migraines can no longer resist vomiting because they are much more sensitive to dopamine.

How can these two theories be reconciled? What they have in common is the sensitivity of migraine sufferers to dopamine, whether a high or low concentration is needed to induce the symptoms of the prodromal phase. Why is it important for us to know what causes migraine symptoms on a neurobiological level, you may ask. The fact is that understanding this can help stop the development of migraines. In this way, we can establish a connection between dopamine and well-being and we will control this mechanism with the help of our behavior. It’s worth thinking about times when you might have accidentally done something to prevent a migraine by raising your dopamine levels and experiencing pleasurable sensations, such as eating your favorite meal or having an orgasm. Unfortunately, we will never know exactly what these actions were. And this is one of the examples where it is clear to us that there are many gaps in our picture: it is almost impossible to get evidence that we have done something important so that a certain event does not happen.

This is somewhat of a mystery, because dopamine is a good transmitter of pain information, it blocks signal transmission from the trigeminal pain pathway to the brain. But, of course, dopamine is not the only problem, it works hand in hand with serotonin, which, in turn, enhances the action of dopamine, and receptors for both mediators are often located nearby. Another argument is that dopamine may not be doing its job properly due to low levels of serotonin, and that any regulatory release that the hypothalamus tries to release comes too late to stop the pain cascade.

In the “Open Reading” section, we publish excerpts from books in the form in which they are provided by the publishers. Minor abbreviations are indicated by ellipsis in square brackets.
The opinion of the author may not coincide with the opinion of the editors.

Child has a headache | Problems of the child’s adjustment in school

• Children
• Headaches in Children

Read the article about the possible problems that a child may encounter at school: headache, cold, flu – everything you need to know.

How to help your child adapt to a new school

Moving to a new school is a storm of emotions for both the child and the whole family. During the first few days, as a parent, of course, you will wait in hope and trepidation for the end of the school day to see the smiling, happy face of a child running towards you from school.

Even the most pleasant times can be disturbed by your natural worries and anxieties as a parent. One of them is keeping your child healthy in these new circumstances.

How to help your child avoid health problems

From your first day at your new school, you will no doubt be constantly concerned about your child’s health. We will look at the most likely causes of parental anxiety in this article. Let’s talk about colds, flu, headaches, nosebleeds, lice and sun protection

Colds and flu

Children usually get colds more often than adults. It is believed that among schoolchildren the incidence is on average up to 2-5 cases per year, while adults suffer the disease 2-4 times a year. ¹

Especially when a child goes to school for the first time, his immune system can be exposed to all kinds of external stimuli, infectious agents that can cause diseases.

Causes of colds and flu among schoolchildren

Viruses are the most common cause of colds and flu. A significant number of various viruses have been recorded. This is partly why a child may immediately follow one infection with another, since flu or colds are caused by different viruses.

When your child comes down with a cold or the flu, complex bodily processes are triggered, a cascade of biochemical events during which the body releases special substances called prostaglandins. In response to the release of prostaglandins, fever may occur, as well as inflammation and possibly pain. Some cold and flu symptoms are similar. These include runny nose, sneezing and coughing. Often, these common symptoms of illness with the flu are more pronounced than with a cold. In addition, when a child has the flu, a significant increase in body temperature or fever may be observed.

How to protect children from infection – help them protect themselves

It is almost impossible to keep a child free of exposure to cold and flu viruses. However, some measures can help reduce the risk of infection and illness:

• Teach your children to wash their hands regularly or use hand sanitizer gels (such as Dettol) suitable for children, as viruses are easily transmitted through contact with doorknobs, work surfaces furniture or through shared toys.
• If children with colds or flu attend school, explain to your children that germs can get on their hands from various surfaces at school or shared toys. Then tell them that in these cases you should not touch your mouth or nose or rub your eyes. It is necessary to further explain to them that as a result of touching the face, germs and viruses can enter their body, and therefore they can get flu or colds.
• Explain to them that under no circumstances should they pick up or try to use someone else’s handkerchief.

Recently, vaccines have become available to prevent influenza in young children. Learn about flu prevention and seasonal childhood vaccination programs from your pediatrician. If your child does catch a cold or the flu, leave your child at home and make sure they always turn away from other children or cover their mouth when sneezing or coughing, and use paper handkerchiefs. Tell your child in a simple and understandable way about how germs are transmitted.

Treating cold and flu symptoms

As a child’s body reacts actively to fight viruses, the child’s body temperature and fever may rise.

Fortunately, Nurofen® for Children ¹¹ contains ibuprofen, which has antipyretic, anti-inflammatory and analgesic effects. May help reduce symptoms of a cold or flu. Nurofen® for children ¹¹ starts working in 15 minutes and is active up to 8 hours ¹¹ for fever and pain relief.

Headaches

Headaches are common in childhood and adolescence. It is important to discuss the diagnosis with the pediatrician, as well as timely and correct treatment. ⁴

Causes of headaches in school-aged children

Headaches in children can occur periodically for a variety of reasons. It may arise simply because they missed lunch at the school cafeteria. Younger students often prefer to frolic with friends, forgetting about food. In addition, due to the lack of fluid in the body, after too active games, they may also experience a headache.

An emotional factor can also be the cause of a headache. We are talking about the strong negative impact of certain areas of school life on the child, which lead to stress and headaches. Look also at the emotional climate in your family. If it turns out that stress and anxiety at school and at home is indeed taking a toll on your child’s health, talk to your child or teacher to understand the cause of the problem and fix it.

How to protect your child from headaches

First of all, tell your child about the importance of a good breakfast and a well-timed lunch at school to prevent headaches. Some schools have water coolers for children. Explain to the children that they should not hesitate to ask for water if they are thirsty. Teachers are well aware of the need for timely replenishment of water balance in children, especially after outdoor games, sports and on hot days.

Headaches in children can be caused by low blood sugar or lack of sleep. Going to bed at exactly the same time will help here. If your child has a headache before bed, put him in a slightly cool, quiet room.

Child’s headache relief

We have already talked about the benefits of Nurofen® for children ¹¹ and its pain and fever reducing properties. The drug is a remedy for the treatment of headaches in children. Nurofen® for children is used for headaches of varying severity, helping to reduce discomfort and help relieve pain. The following Nurofen® preparations are suitable for children: suspension, tablets from 6 years of age and tablets from 12 years of age. ¹¹ Nurofen® for children in the form of a suspension can be used in children from 3 months. Nurofen® suspension for children ¹¹ has a convenient syringe dispenser, does not contain alcohol, sugar and dyes and is available in two flavors – orange and strawberry.

Headaches in children can be symptoms of various diseases. If you are not sure what to do to help your child, it is best to seek help from a doctor. This must be done if the following symptoms are present:

• The child complains of a further increase in headache.
• Pain resulted from a head injury.
• There is visual impairment.
• Nausea and vomiting developed.
• You have doubts about the causes of these symptoms and are not sure about the correct methods of treatment.

Bleeding from the nose and how to deal with it

Periodic nosebleeds in children are quite common, although it is, of course, disturbing.

Possible causes are quite varied: from dry air to scratches or damage; colds or allergies; sinus infection or other bacterial infection.

But before worrying about the cause, if it wasn’t an injury, you need to know what can be done to stop the bleeding. Immediately.

Stopping a nosebleed in a child

If this happens at home:

• Sit the child in a chair and tilt his head slightly forward. (Do not allow blood to run down the back of the throat, as this may cause coughing or vomiting.)
• Ask the child to breathe through the mouth, then pinch the soft part of the nose under the bridge of the nose. (Older children can do this themselves.)
• Continue to squeeze for a full 10 minutes. You can also apply ice to the bridge of your nose, which can slow bleeding (usually a towel is wrapped around the ice or freezer block).

If your child has frequent nosebleeds, you can regularly use (an older child may self-administer) saline isotonic nasal spray or install a humidifier in the child’s bedroom.

If a nosebleed occurs at school, an older child who has been taught this method most often knows how to deal with the problem. A young child should be assisted by a responsible adult, such as a school nurse or a teacher trained in first aid.

Seek medical attention if bleeding is caused by:

• A blow to the head
• Your child put something up his nose
• Started taking a new drug
• Presence of multiple sources of bleeding. (For example, do the gums bleed too?)
• Extensive bruising all over the body of a child not due to trauma

Or if:

Several 10-minute attempts to stop the bleeding by squeezing the nose did not help.

The child has a nosebleed that is very severe and frightening. However, in most cases this is not a serious problem. Don’t panic and your child won’t worry either.

Head lice

Let’s not be embarrassed by this problem. This is the one that gives everyone goosebumps. Lice infestation is an extremely unpleasant and constant threat to the school reality, although it is not a serious disease.

Causes of head lice at school

• Since the louse is a wingless insect, spread occurs through close contact, literally from head to head. If a head lice infested child comes into close head contact with a non-head lice child, the louse simply crawls through the hair from the infected child to the healthy one. The female immediately lays her eggs in his hair. New insects soon emerge from the eggs, and the process develops further. We want to reassure you a little: your child did not get lice because he had poorly washed, unkempt hair.
• All types of hair can be attacked by lice.
• Head lice cannot be transmitted from animals.
• The extremely unpleasant itching of a head lice infestation is a common symptom of a skin reaction to a lice bite. ⁵ A child infected with lice may develop pigmentation on the neck due to tissue hemorrhages and inflammation caused by exposure to insect saliva. ⁶

Combing your child’s hair regularly is a good way to control a possible head lice infestation. In this way, lice eggs (nits) or live insects can be detected.

Can you help your child avoid getting lice?

This is quite difficult. You can’t keep your child out of school. Some cut off the child’s hair or tie it back to reduce the risk of it coming into contact with other children’s hair. However, it is extremely difficult to prevent children from playing together or exercising in physical education classes.

The best way to stop the spread of the disease is to inform the school authorities immediately after discovering an infestation. Of course, it is extremely unpleasant that it is you who has to do this, but this will help stop the further spread of lice. Once teachers and other parents are aware of this, they can quickly check on the rest of the children. And the sooner treatment begins, the better it will be for everyone.

Head lice products

Special lotions and sprays are available to get rid of lice. Obviously, one should resort to such means only if lice are found. It usually requires a single or in some cases repeated treatment of the child’s head with lotion to kill the lice. This is because it is often impossible to kill all insect eggs with one application of the lotion.

Combing wet hair is another way to physically remove lice. The main thing is to choose the right comb or brush and remember that this method must be used regularly and in the right way to increase its effectiveness.

Protecting children from sunburn

Despite all efforts to protect children from the sun, sunburn still occurs. This is a serious problem, sun exposure doesn’t have to be visible to cause harm. And this despite the fact that it takes only a few minutes to protect the child from the sun. So, it’s time to remember the basic rules.

Beware of the sun! The Reality of Children’s Exposure to the Sun

Many parents are well aware of the dangers of being out in the sun without proper protection. They are also well aware of the effects of overheating in the sun [too much exposure to the sun] on skin that becomes overdried, damaged, reddened and blistered. We all need to remember that although clouds obscure the sun, they do not block UV rays. They can be dangerous even on a cloudy and cool day.

Sun protection is hard to overdo. Nothing bad will happen if you put too much cream on your baby’s back or ask him to play in dad’s T-shirt. This is easier to do when you have a small child. With a student it is much more difficult. Follow our tips to protect children from sunburn.

• First, talk to a school representative about their sun protection policy. Decide if they are the right level, or if you need to take special steps to protect your child (knowing that this could damage the child’s reputation among peers).
• Preventive measures: Keep children in the shade during particularly hot weather. Make sure they (or their teachers) understand the need for games in a shaded area whenever possible.
• Dress your child in long sleeves and pants, a brimmed hat (if not a cap), UV blocking sunglasses and apply sunscreen.

Wear sunscreen

• For children, a broad spectrum (UVA/UVB) sunscreen with SPF 30 or higher is recommended before going outside – even on cloudy or overcast days.
• Insist that children always use protective creams, which they usually do not like to wear. Become an example for them in the constant use of creams, then they may want to repeat after you.
• Wear protective equipment on all exposed areas of the body. Not only the face, legs and hands should be carefully protected, but also the ears, noses, toes, because sandals are always open to the sun. During the game, the children constantly bend over, while the clothes ride up, exposing their backs. It is important that the clothing is long enough to cover the entire body of the child.
• Do not forget to reapply the cream after it is completely absorbed, as recommended on the package. Remind your student to apply cream before and after sports and outdoor activities. If the child swims outdoors, use a waterproof cream that must be reapplied after bathing and drying the child.

You are not always there to look after the child. So set a goal to get your child into the habit of using sunscreen.

Eye protection:

• Make sure your child wears the recommended UV blocking sunglasses as often as possible. Ophthalmologists and spectacle fitters are happy to offer advice. Usually kids love to wear sunglasses!

Taking care of a student’s health requires constant attention and a lot of effort. Unfortunately, certain health problems still happen. By following our tips and tricks, you can keep them to a minimum.

Just remember that by monitoring your child’s health and making efforts to keep him healthy from the start of the school year, you will help him succeed in all subjects and succeed in school. Give him the best chance to develop and thrive in this new environment.

Sources:

• 1

  G. A. Samsygina, G. S. Koval, Frequently ill children: problems of diagnosis, pathogenesis and therapy7153/

• 2

  New teaching aid “Primary headaches in children and adolescents” edited by Professor N.N. Zavadenko, http://headache-society.ru/rukovodstva-dlya-spetsialistov-/pervichnyie-golovnyie-boli-u-detey-i-podrostkov.html

• 3

  K. N. Suvorova, Pediculosis, http:/ /www.lvrach.ru/2007/10/4716734/

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  Yu. A. Galliamova, I. M. Shakov, I. V. Olenich, Differential diagnosis of pediculosis and its treatment, http://www.lvrach .ru/2010/09/15435035/

• 5

  https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/germs/art-20045289:

  Germs / Understanding and protecting against bacteria, viruses and infection– Mayo Clinic

• 6

  https://my.clevelandclinic.org/health/diseases/9637-migraines-in-children-and-adolescent Migraines in children and adolescents | Cleveland Clinic

• 7

  https://www.