What is status migrainosus. How does it differ from regular migraines. What are the symptoms of status migrainosus. How is status migrainosus diagnosed. What treatments are available for status migrainosus. How can status migrainosus be prevented. What are the long-term impacts of status migrainosus.

Defining Status Migrainosus: When Migraines Persist Beyond 72 Hours

Status migrainosus is a severe form of migraine that lasts for more than 72 hours, or 3 days. It is characterized by intense, debilitating symptoms that persist beyond the typical duration of a migraine attack. Unlike regular migraines, status migrainosus often does not respond to usual treatment methods, making it a challenging condition to manage.

Why does status migrainosus occur? While the exact cause is not fully understood, it is believed to be a result of persistent neurological dysfunction and inflammation. Factors such as medication overuse, hormonal changes, stress, and certain medical conditions may contribute to the development of status migrainosus.

Recognizing the Symptoms: Beyond the Typical Migraine Experience

The symptoms of status migrainosus are similar to those of regular migraines but are often more severe and prolonged. They include:

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

Are there any unique symptoms associated with status migrainosus? In addition to the prolonged duration, people experiencing status migrainosus may also suffer from:

• Changes in consciousness, including confusion and sleepiness
• Severe dehydration due to persistent nausea and vomiting
• Neck pain and stiffness
• Heightened anxiety and low mood

The Phases of Status Migrainosus: A Prolonged Migraine Journey

Status migrainosus follows a similar pattern to regular migraines but with extended duration. The phases include:

1. Prodrome Phase

This initial phase can last from a few hours to several days. Symptoms may include:

• Mood changes
• Food cravings
• Difficulty sleeping
• Trouble concentrating
• Increased sensitivity to light and sound

2. Aura Phase

Not all individuals experience aura, but those who do may have:

• Visual disturbances (e.g., flashing lights, zigzag lines)
• Numbness or tingling on one side of the body
• Speech difficulties

The aura phase typically lasts 5 minutes to 1 hour.

3. Headache Phase

In status migrainosus, this phase lasts longer than 72 hours and is characterized by:

• Severe, throbbing headache
• Intense nausea and vomiting
• Extreme sensitivity to light, sound, and sometimes smell
• Difficulty performing daily activities

4. Postdrome Phase

Even after the headache subsides, individuals may experience a “migraine hangover” lasting hours or days, marked by:

• Fatigue
• Difficulty concentrating
• Mild head discomfort
• Mood changes

Diagnosing Status Migrainosus: Challenges and Considerations

Diagnosing status migrainosus can be challenging, as there is no definitive test for the condition. How do healthcare providers diagnose status migrainosus? The process typically involves:

1. Detailed medical history: The doctor will inquire about the frequency, duration, and severity of migraine attacks.
2. Physical examination: This helps rule out other potential causes of prolonged headaches.
3. Neurological assessment: To evaluate cognitive function and rule out other neurological conditions.
4. Imaging studies: In some cases, an MRI or CT scan may be ordered to exclude other causes of persistent headaches.

What criteria are used to diagnose status migrainosus? The International Classification of Headache Disorders (ICHD-3) defines status migrainosus as:

• A debilitating migraine attack lasting for more than 72 hours
• The headache and associated symptoms are continuous throughout this period or are interrupted by remissions of less than 4 hours
• The condition is not attributed to another disorder

Treatment Approaches: Breaking the Cycle of Prolonged Migraine

Managing status migrainosus often requires more aggressive treatment than regular migraines. What are the primary treatment goals for status migrainosus?

• Relieving pain and associated symptoms
• Preventing dehydration
• Breaking the cycle of prolonged migraine
• Minimizing the risk of complications

Treatment options may include:

1. Medications

• Intravenous (IV) medications: These may include NSAIDs, triptans, or ergotamines
• Antiemetics: To control nausea and vomiting
• Corticosteroids: To reduce inflammation and break the migraine cycle
• Dihydroergotamine (DHE): An ergot derivative that can be effective in status migrainosus

2. Hydration Therapy

IV fluids are often necessary to combat dehydration caused by prolonged nausea and vomiting.

3. Nerve Blocks

In some cases, occipital nerve blocks or other regional nerve blocks may provide relief.

4. Hospitalization

Severe cases of status migrainosus may require inpatient treatment to manage symptoms and prevent complications.

Prevention Strategies: Minimizing the Risk of Status Migrainosus

While it may not always be possible to prevent status migrainosus, several strategies can help reduce the frequency and severity of migraine attacks:

1. Prophylactic Medications

• Antihypertensive drugs (e.g., beta-blockers, calcium channel blockers)
• Antidepressants (e.g., tricyclic antidepressants, SNRIs)
• Anti-seizure medications (e.g., topiramate, valproic acid)
• CGRP pathway monoclonal antibodies

2. Botox Injections

Regular Botox injections can be effective in preventing chronic migraines and reducing the risk of status migrainosus.

3. Lifestyle Modifications

• Identifying and avoiding triggers
• Maintaining a regular sleep schedule
• Managing stress through relaxation techniques
• Regular exercise
• Dietary changes (e.g., avoiding known food triggers)

4. Complementary Therapies

Some individuals find relief through alternative approaches such as:

• Acupuncture
• Biofeedback
• Massage therapy
• Mindfulness meditation

Long-term Impact: Living with the Risk of Status Migrainosus

Status migrainosus can have significant long-term effects on an individual’s quality of life. What are the potential consequences of recurrent status migrainosus episodes?

• Social impact: Frequent, prolonged migraine attacks can lead to social isolation and strained relationships.
• Professional challenges: Missed work days and reduced productivity may affect career prospects.
• Psychological effects: Anxiety, depression, and fear of future attacks are common among those who experience status migrainosus.
• Financial burden: The cost of treatment and lost work time can create financial stress.
• Medication overuse: There is a risk of developing medication overuse headaches due to frequent use of pain relievers.

How can individuals cope with the long-term impact of status migrainosus? Strategies include:

• Joining support groups to connect with others facing similar challenges
• Working with a therapist to develop coping mechanisms
• Educating family, friends, and employers about the condition
• Exploring workplace accommodations to manage symptoms
• Maintaining open communication with healthcare providers to optimize treatment

Emerging Research: New Horizons in Status Migrainosus Management

The field of migraine research is continually evolving, offering hope for improved management of status migrainosus. What are some promising areas of research?

1. Neuromodulation Devices

Non-invasive devices that stimulate specific nerves or brain regions are showing promise in migraine treatment. Examples include:

• Transcranial magnetic stimulation (TMS)
• Vagus nerve stimulation
• Supraorbital transcutaneous stimulation

2. Advanced CGRP Therapies

Building on the success of CGRP monoclonal antibodies, researchers are exploring new formulations and delivery methods to enhance their effectiveness in preventing and treating severe migraines.

3. Personalized Medicine Approaches

Genetic and biomarker studies aim to identify individual factors that influence migraine susceptibility and treatment response, paving the way for more targeted therapies.

4. Novel Drug Targets

Researchers are investigating new molecular pathways involved in migraine pathophysiology, which may lead to the development of innovative treatments.

How might these advancements impact the management of status migrainosus? As research progresses, individuals with status migrainosus may benefit from:

• More effective prevention strategies
• Faster-acting and longer-lasting acute treatments
• Reduced side effects and improved tolerability of medications
• Better understanding of individual risk factors and triggers
• Enhanced ability to break the cycle of prolonged migraine attacks

Status migrainosus represents a significant challenge in the field of headache medicine. Its prolonged duration and intense symptoms can have a profound impact on an individual’s life. However, with ongoing research and a multifaceted approach to management, there is hope for improved outcomes. By combining pharmacological treatments, lifestyle modifications, and emerging therapies, individuals with status migrainosus can work towards better control of their condition and an enhanced quality of life.

As our understanding of migraine pathophysiology continues to grow, so too does the potential for more effective and personalized treatments. For those living with the constant threat of status migrainosus, staying informed about the latest developments and maintaining open communication with healthcare providers is crucial. With proper management and support, it is possible to minimize the impact of this challenging condition and look forward to a future with better migraine control.

Status migrainosus: Symptoms and treatment

Status migrainosus is a type of intractable migraine. It is a migraine attack that lasts longer than 72 hours. The symptoms may be more severe than in other types of migraine.

A person’s usual migraine treatments may not relieve status migrainosus. But a number of options are available to help manage it.

The episodes can interfere with everyday life and become debilitating. To break the cycle of symptoms, a person may need treatment in a hospital.

In this article, we look at what causes status migrainosus, how it differs from other types of migraine, and what can relieve symptoms.

Share on PinterestThe symptoms of status migrainosus last longer than those of a typical migraine episode.

Status migrainosus is a severe migraine episode lasting more than 72 hours. A person may experience the same symptoms that characterize their typical migraine episodes, but the symptoms may be more intense.

The main feature of status migrainosus is that the headache and other symptoms are long-lasting. The usual ways of managing symptoms, including rest and medication, often do not work, and hospital treatment may be necessary.

Most migraine episodes follow a distinct pattern. This may begin with a warning period, which may feature visual disturbances or other types of aura.

Next, during the attack phase of a migraine episode, a person may experience a headache and:

• nausea and possibly vomiting
• fatigue
• sensitivity to light and noise

As these symptoms start to fade, the person may experience a migraine “hangover,” which can last hours or even days.

The sequence of symptoms can help a person distinguish a migraine episode from other types of headache.

In status migrainosus, the headache phase lasts longer than usual — at least 72 hours, or 3 days.

For some people, the pain and nausea of status migrainosus are so debilitating that they have to spend time in a hospital.

The symptoms are similar to those of other types of migraine, but they last longer and can be more severe.

Also, migraine symptoms can vary from person to person and episode to episode, but they often appear as follows:

Prodrome phase

A person may experience mood changes, food cravings, nausea, difficulty sleeping, trouble concentrating, sensitivity to light and sound, and other issues. These may last a few hours to several days.

Aura

If a person experiences this phase, they may have vision changes — lights or unusual formations may form in the field of vision. A person may also experience numbness and tingling on one side of the body.

This phase may last from 5 minutes to 1 hour.

Headache phase

The headache may be intense and throbbing. It is often on one side of the head but may spread to the other.

For a diagnosis of status migrainosus, the migraine must include:

• a headache that lasts longer than 72 hours
• pain that is debilitating, rather than just troublesome

A person with status migrainosus may also experience:

Changes in consciousness: These may involve difficulty concentrating and communicating, confusion, and sleepiness.

Nausea and vomiting: A person may be unable to take in food or drink, increasing the risk of dehydration and additional symptoms.

Other symptoms: These may include weakness and tingling, nasal congestion, pain and stiffness in the neck, anxiety, and low mood.

The pain may temporarily improve with medication, rest, or both.

There is no definitive test for migraine. Regardless of whether a person sees a doctor during or after an episode, the doctor may:

• ask about symptoms
• take a medical history
• perform a physical examination
• do other tests to rule out, for example, a stroke or brain injury

Status migrainosus only occurs in people who have migraine.

To help decide whether a person has status migrainosus, a doctor may consider whether the person’s medical history includes:

• at least five previous migraine episodes that each lasted 4–72 hours and occurred without an aura
• two previous episodes of migraine with an aura

They may also test neurological performance or request an MRI to rule out other issues.

There are ways to prevent migraine episodes and status migrainosus. There are also ways to reduce the frequency or severity of episodes.

Options include:

• antihypertensive drugs
• antidepressants
• anti-seizure drugs
• Botox injections
• calcitonin gene-related peptide, or CGRP, pathway monoclonal antibodies

Some nondrug options may also help, including acupuncture, biofeedback, and relaxation techniques.

Living with migraine can be difficult, especially for people who are prone to status migrainosus.

Beyond the immediate symptoms, migraine can have long-term social, financial, and psychological effects.

Anxiety about an episode occurring, frustration about unfulfilled plans, and a range of other challenges can make life with migraine difficult.

Support groups may help. They also provide opportunities to share and learn new ways of managing symptoms. One example is the American Migraine Foundation’s Move Against Migraine online community.

Counseling may also help a person manage the effects of pain and anxiety that can accompany a chronic medical condition.

Find more tips for coping with migraine here.

Avoiding triggers

Many people with migraine notice that specific factors can trigger episodes.

A person can learn to identify their triggers by keeping track of what occurred in the lead-up to a migraine episode, including dietary, emotional, and environmental factors. The next step is to find ways to reduce exposure to these triggers.

Common triggers of status migrainosus include:

• hormonal imbalances
• stress
• changes in medication, such as antidepressants or birth control pills
• injuries to the neck or head
• changes in sleeping or eating patterns
• weather changes
• infections, such as a cold or the flu
• surgery on the head or face

Remaining hydrated and getting enough rest may help reduce the frequency of episodes. People should aim to drink at least 60–80 ounces of water per day.

Can changes to the diet help prevent migraine? Find out here.

Status migrainosus can be frightening and painful. Understanding what causes these episodes and taking steps to avoid triggers can help ease any anxiety and prevent the issue from returning.

Also, a specialized treatment plan may help prevent episodes or reduce their severity.

After experiencing status migrainosus, a person may wish to consider seeing a neurologist who specializes in migraine for further assessment and advice.

Status migrainosus: Symptoms and treatment

Status migrainosus is a type of intractable migraine. It is a migraine attack that lasts longer than 72 hours. The symptoms may be more severe than in other types of migraine.

A person’s usual migraine treatments may not relieve status migrainosus. But a number of options are available to help manage it.

The episodes can interfere with everyday life and become debilitating. To break the cycle of symptoms, a person may need treatment in a hospital.

In this article, we look at what causes status migrainosus, how it differs from other types of migraine, and what can relieve symptoms.

Share on PinterestThe symptoms of status migrainosus last longer than those of a typical migraine episode.

Status migrainosus is a severe migraine episode lasting more than 72 hours. A person may experience the same symptoms that characterize their typical migraine episodes, but the symptoms may be more intense.

The main feature of status migrainosus is that the headache and other symptoms are long-lasting. The usual ways of managing symptoms, including rest and medication, often do not work, and hospital treatment may be necessary.

Most migraine episodes follow a distinct pattern. This may begin with a warning period, which may feature visual disturbances or other types of aura.

Next, during the attack phase of a migraine episode, a person may experience a headache and:

• nausea and possibly vomiting
• fatigue
• sensitivity to light and noise

As these symptoms start to fade, the person may experience a migraine “hangover,” which can last hours or even days.

The sequence of symptoms can help a person distinguish a migraine episode from other types of headache.

In status migrainosus, the headache phase lasts longer than usual — at least 72 hours, or 3 days.

For some people, the pain and nausea of status migrainosus are so debilitating that they have to spend time in a hospital.

The symptoms are similar to those of other types of migraine, but they last longer and can be more severe.

Also, migraine symptoms can vary from person to person and episode to episode, but they often appear as follows:

Prodrome phase

A person may experience mood changes, food cravings, nausea, difficulty sleeping, trouble concentrating, sensitivity to light and sound, and other issues. These may last a few hours to several days.

Aura

If a person experiences this phase, they may have vision changes — lights or unusual formations may form in the field of vision. A person may also experience numbness and tingling on one side of the body.

This phase may last from 5 minutes to 1 hour.

Headache phase

The headache may be intense and throbbing. It is often on one side of the head but may spread to the other.

For a diagnosis of status migrainosus, the migraine must include:

• a headache that lasts longer than 72 hours
• pain that is debilitating, rather than just troublesome

A person with status migrainosus may also experience:

Changes in consciousness: These may involve difficulty concentrating and communicating, confusion, and sleepiness.

Nausea and vomiting: A person may be unable to take in food or drink, increasing the risk of dehydration and additional symptoms.

Other symptoms: These may include weakness and tingling, nasal congestion, pain and stiffness in the neck, anxiety, and low mood.

The pain may temporarily improve with medication, rest, or both.

There is no definitive test for migraine. Regardless of whether a person sees a doctor during or after an episode, the doctor may:

• ask about symptoms
• take a medical history
• perform a physical examination
• do other tests to rule out, for example, a stroke or brain injury

Status migrainosus only occurs in people who have migraine.

To help decide whether a person has status migrainosus, a doctor may consider whether the person’s medical history includes:

• at least five previous migraine episodes that each lasted 4–72 hours and occurred without an aura
• two previous episodes of migraine with an aura

They may also test neurological performance or request an MRI to rule out other issues.

There are ways to prevent migraine episodes and status migrainosus. There are also ways to reduce the frequency or severity of episodes.

Options include:

• antihypertensive drugs
• antidepressants
• anti-seizure drugs
• Botox injections
• calcitonin gene-related peptide, or CGRP, pathway monoclonal antibodies

Some nondrug options may also help, including acupuncture, biofeedback, and relaxation techniques.

Living with migraine can be difficult, especially for people who are prone to status migrainosus.

Beyond the immediate symptoms, migraine can have long-term social, financial, and psychological effects.

Anxiety about an episode occurring, frustration about unfulfilled plans, and a range of other challenges can make life with migraine difficult.

Support groups may help. They also provide opportunities to share and learn new ways of managing symptoms. One example is the American Migraine Foundation’s Move Against Migraine online community.

Counseling may also help a person manage the effects of pain and anxiety that can accompany a chronic medical condition.

Find more tips for coping with migraine here.

Avoiding triggers

Many people with migraine notice that specific factors can trigger episodes.

A person can learn to identify their triggers by keeping track of what occurred in the lead-up to a migraine episode, including dietary, emotional, and environmental factors. The next step is to find ways to reduce exposure to these triggers.

Common triggers of status migrainosus include:

• hormonal imbalances
• stress
• changes in medication, such as antidepressants or birth control pills
• injuries to the neck or head
• changes in sleeping or eating patterns
• weather changes
• infections, such as a cold or the flu
• surgery on the head or face

Remaining hydrated and getting enough rest may help reduce the frequency of episodes. People should aim to drink at least 60–80 ounces of water per day.

Can changes to the diet help prevent migraine? Find out here.

Status migrainosus can be frightening and painful. Understanding what causes these episodes and taking steps to avoid triggers can help ease any anxiety and prevent the issue from returning.

Also, a specialized treatment plan may help prevent episodes or reduce their severity.

After experiencing status migrainosus, a person may wish to consider seeing a neurologist who specializes in migraine for further assessment and advice.

Migraine: 7 symptoms you need to know about

Likbez

Health

July 22, 2022

This will help not only to get help on time, but also not to confuse a migraine with a stroke and other dangerous conditions.

Migraine is commonly referred to as an excruciating headache that lasts for hours. But this is not quite the right definition. The disease belongs to neurological disorders, and a splitting head is far from the only symptom.

What are the symptoms of migraine

She has seven characteristic features. Not everyone will need to be present. However, if a person has at least 2-3 symptoms, with a high probability he will have a migraine. In this case, to mitigate new attacks and learn to cope with pain, you will need the help of a specialist.

1. Headache on one side only

The word migraine comes from the Greek word hemicrania, “a headache covering half of the head.” And indeed: in this condition, severe throbbing pain most often manifests itself only on one side.

Only in rare cases does a migraine involve the entire head. Also, pain can occur in the face and neck.

2. You will know about the upcoming attack of pain in 1-2 days

Doctors call this period the prodromal period (from the Greek prodromos – “running ahead”).

Harbingers of an approaching migraine are:

• a sharp increase in appetite;
• constipation;
• frequent urination;
• fluid retention;
• frequent yawning;
• mood swings, from tearfulness and melancholy to euphoria;
• strange sensations in the neck, it seems to become clumsy.

3. Strange sensations occur right before or during an attack

Approximately one in three migraine sufferers experience unusual physical effects – the so-called aura.

Most often, she makes herself felt with visual impairments. So, a person sees flashes of light, bright flashing dots, sparks, zigzag patterns. But other symptoms are also possible:

• numbness or tingling, this sensation usually begins with the fingers of one hand and then gradually rises and may affect the face, lips, tongue;
• dizziness, balance problems;
• ringing in the ears;
• somewhat difficult speech, it may seem as if the tongue is slurred.

In rare cases, before the onset of a migraine, a person may even lose consciousness.

These sensations usually last from 5 minutes to an hour. Some people are lucky, and a distinct aura is not followed by a migraine, but only by a slight headache, or the unpleasant sensations pass without a trace at all. In this case, doctors talk about “silent” (aka – acephalgic) migraine.

4. Headache lasts at least several hours

If migraine is left untreated, attacks usually last from 4 hours to three days.

5. Increased sensitivity to external stimuli

Bright light, loud sound, sharp aromas of flowers, perfumes and food increase migraine pain. Therefore, in this state, a person tries to hide in a quiet and dark room in order to get rid of external stimuli.

6. Pain accompanied by nausea or even vomiting

With migraine, there is often a feeling that is denoted by the word “throbbing”. Strong odors or bright lights can cause nausea and vomiting.

7. After a long headache comes a “hangover”

This is the so-called postdromal phase. After the attack ends, the person feels emptiness, weakness, loss of concentration. Often all this is accompanied by depressive symptoms, although some people experience euphoria.

The “hangover” usually lasts a day or two, but can sometimes last up to a week.

When a severe headache is not associated with a migraine

An acute persistent headache may be a sign of a stroke, cerebral hemorrhage, or inflammation of the brain tissue. Call 103 or 112 urgently if you have any of the following symptoms:

• Sharp, severe headache, like a thunderclap.
• The pain is accompanied by a temperature above 38 °C, immobility of the neck muscles, double vision, confusion, convulsions.
• Numbness, severe weakness or paralysis of one or both arms or one side of the face.
• Speech suddenly became slurred or severely distorted.
• An excruciating headache not only does not subside after 10-20 minutes, but also gets worse with every sudden movement, coughing or simply muscle tension.
• Acute headache following a recent head injury.

Another warning sign is if you are over 50 years old and have had a severe headache for the first time. In this case, it is not necessary to call an ambulance (unless, of course, there are other threatening symptoms), but a visit to the therapist cannot be postponed. This may be a sign of giant cell arteritis, a disease that affects the arteries in the neck and head.

Read also 🤯

• 5 causes of a headache in the back of the head and how to deal with it
• Why does your head hurt and what to do about it
• Why pregnant women have a headache and what to do about it
• Why a headache in the morning: 5 common causes
• Types of headaches: how they differ and how to get rid of each of them

For a sore head

03/25/2022

For a sore head

Many patients note that the head starts to hurt more often in the spring. The reason for this may be: exacerbation of chronic diseases, depression, anxiety disorders, weather changes and vitamin D deficiency. The neurologist of the pain treatment clinic of the hospital named after Vinogradova Pyotr Sokov in an interview for the newspaper Arguments and Facts.

How is a migraine different from a headache? Many people think they are one and the same.

– Migraine has clear criteria. This is a headache that lasts from 4 to 72 hours, has a high intensity and throbbing character, may be accompanied by nausea, vomiting, fear of light and sound. Most often it hurts on one side of the head. But there is also a bilateral migraine – it is more typical for children. Another indicator is that the pain intensifies at the time of physical activity. 5 or more recurring, similar cases are enough to make a diagnosis.

Distinguish between migraine with and without aura . Migraine with aura is less common but more severe. Aura is a variety of visual phenomena (flashes before the eyes, spots), a feeling of discomfort, numbness of the face or hand. However, there is also an aura that is pleasant for a person, followed by pain.

There is also a special kind of aura called “Alice in Wonderland Syndrome”. A person’s body sensations change. He can see and feel arms as huge, legs as small. The sense of time and space may be distorted. Time speeds up or slows down, sounds louder or quieter than they really are. All this precedes a migraine attack.

It is said that the causes of migraine are still unclear, although many suffer from it.

– Research on migraine is carried out by many scientific institutions both here and in the world. The fact is that it is in 3rd place among non-communicable diseases that lead to temporary disability. This is the cause of great economic losses, since we are talking about the unproductive state of the active sections of the population. Recently, scientists have made some progress. The concepts of treatment and prevention have been revised. But there are still many unknown areas.

Would an injection help?

There is a version that migraine triggers one “bad” molecule.

– This is a calcitonin-gene-related peptide molecule involved in the formation of a migraine attack at the chemical level. It was opened 30 years ago. And recently, drugs have been invented that, like a key to a lock, fit the receptors of the molecule and can block the transmission of a nerve impulse to the brain just at the moment when an attack is just beginning to develop.

This therapy is based on the principle of monoclonal antibodies that are synthesized in vitro. The drug is administered subcutaneously once a month. Treatment cannot solve the problem once and for all. But patients have a real hope for a normal life, because usually chronic migraine eats almost half of life for a headache. There is evidence that you can increase the dosage of the drug and make injections once every 3 months. 4 injections are enough to get a year almost without a headache.

These drugs have few side effects, but there is one significant disadvantage – the high price. In Russia, they are not yet available within the framework of compulsory medical insurance. Although these drugs are fully included in international clinical practice, and in many countries patients can receive them under medical insurance.

The current standard therapy is triptans, anticonvulsants and antidepressants.

It is often said that a headache is associated with osteochondrosis in the neck, compression of muscles and nerves.

– These types of headaches are very rare and account for less than 1%. More often, neck pain is a consequence of a beginning migraine attack, and not its cause. Therefore, to make a diagnosis of migraine, you do not need expensive studies such as MRI of the head, ultrasound of the vessels of the neck, electroencephalography, laboratory tests, etc. In most cases, such appointments are a waste of time and money for the patient or the state. It makes sense to conduct such examinations only if there are so-called “red flags”. These are patient complaints that allow the doctor to suspect another serious disease that gives a symptom in the form of a headache. For example, it can be a tumor, aneurysm, meningitis, etc. These are factors that require an unambiguous referral for additional research.

If your head hurts a lot, how many tablets can you take?

– It is recommended to take no more than two tablets per day, no more than 10 per month. Why? There is a special type of headaches – abuse, or drug-induced. They develop with excessive use of non-steroidal anti-inflammatory drugs and some other analgesics. A person drinks a pill for a headache, but the pain does not subside, but, on the contrary, intensifies. Particularly dangerous in this regard are combined analgesics, which contain not one, but several active substances. For example, paracetamol, caffeine and others. Say, if a conventional analgesic is needed to cause abuse pain, you need 10-15 tablets per month, then a combination drug is enough 5-10.