What are the symptoms of status migrainosus?. What is the treatment for status migrainosus?. How can status migrainosus be prevented?.

Symptoms of Status Migrainosus

Status migrainosus is a type of migraine that lasts for more than 72 hours. The symptoms of status migrainosus are similar to those of a typical migraine, but the condition lasts much longer. Along with severe headache pain, individuals with status migrainosus may experience:

• Aura (sensation of sparkling lights or other vision changes)
• Nausea and vomiting
• Trouble thinking clearly

Because the condition lasts for at least 3 days, individuals with status migrainosus are also at risk of dehydration and sleep loss due to the prolonged vomiting and pain.

Treatment for Status Migrainosus

Doctors may need to treat several issues related to status migrainosus, including dehydration, pain, and other symptoms. Treatment may include:

1. Intravenous (IV) fluids to address dehydration
2. IV medications to control pain, such as dihydroergotamine (DHE-45, Migranal) or sumatriptan (Imitrex, Onzetra, Sumavel DosePro, Zecuity)
3. Anti-nausea medications, such as chlorpromazine, metoclopramide (Metozolv, Reglan), or prochlorperazine (Compro, Procomp)
4. Corticosteroids, such as dexamethasone (Dexamethasone Intensol, Dexpak) or prednisolone, to relieve the migraine

For individuals who do not respond to other treatments and have 4 or more migraine days per month, preventive medications may be recommended. These include seizure medicines, blood pressure medicines, antidepressants, and a new class of drugs called CGRP inhibitors.

Preventing Status Migrainosus

To prevent status migrainosus, it’s important to treat migraines early and effectively. This may involve:

• Seeking treatment as soon as a migraine starts
• Taking the appropriate medication, as prescribed by a healthcare provider
• Avoiding overuse of headache medication, which can lead to status migrainosus

In addition, some devices like transcranial magnetic stimulation (TMS) devices, transcutaneous supraorbital nerve stimulation devices, and vagus nerve stimulators have been approved to help prevent migraine development or recurrence.

Migraine Triggers

Certain factors can trigger or worsen migraines, including:

• Stress
• Hormonal changes
• Certain foods (e.g., aged cheeses, processed meats, alcohol)
• Changes in sleep patterns
• Weather changes

Identifying and avoiding personal migraine triggers can help prevent the development of status migrainosus.

Migraine Types and Frequency

Migraines can be classified into different types, including:

• Migraine with aura
• Migraine without aura
• Chronic migraine (15 or more migraine days per month)
• Episodic migraine (fewer than 15 migraine days per month)

The frequency of migraines can vary greatly from individual to individual, and it’s important for those with frequent or severe migraines to work closely with their healthcare provider to develop an effective treatment plan.

When to Seek Medical Attention

Individuals should seek immediate medical attention if they experience the following signs or symptoms:

• Migraine that lasts more than 72 hours (status migrainosus)
• Severe or worsening headache pain
• Headache accompanied by fever, stiff neck, mental confusion, seizures, double vision, or weakness
• Headache that is the “worst ever” or feels different from previous migraines

Seeking prompt medical care can help prevent complications and ensure appropriate treatment for status migrainosus and other types of severe migraines.

Migraine Prevention and Management

While there is no cure for migraines, there are several effective ways to manage and prevent them, including:

• Identifying and avoiding personal triggers
• Taking preventive medications as prescribed
• Utilizing non-pharmacological interventions, such as stress management techniques, physical therapy, and devices like TMS or vagus nerve stimulators
• Seeking prompt treatment at the first sign of a migraine attack

By working closely with their healthcare provider, individuals with migraines can develop a comprehensive treatment plan to effectively manage their condition and reduce the risk of developing status migrainosus.

Status Migrainosus: Symptoms, Treatment, Prevention

Written by Eric Metcalf, MPH

• Status Migrainosus Symptoms
• Status Migrainosus Treatment
• Status Migrainosus Prevention

Migraines are a type of headache that tend to cause other symptoms, too, such as nausea and vision problems. They can last for a few hours to a few days. But a migraine that lasts for more than 72 hours is called status migrainosus.

A typical migraine can sometimes turn into status migrainosus if:

• You don’t get treatment early enough after the attack starts.
• You don’t get the right treatment.
• You use too much headache medicine.

The warning signs of status migrainosus are similar to those of a typical migraine. Along with pain in your head, you might also feel:

• Sensation of sparkling lights or other vision changes (aura)
• Nausea and vomiting
• Trouble thinking clearly

Because the condition lasts for at least 3 days, you’re also at risk for dehydration and sleep loss because of prolonged vomiting and pain.

If you need to seek urgent treatment for status migrainosus, doctors may need to treat other problems the migraine causes as well as the migraine itself. Doctors treat dehydration by giving you fluids through an IV. They may give you drugs through an IV to control pain, as well as medications for other symptoms.

Drugs that stop vomiting include:

• Chlorpromazine
• Metoclopramide (Metozolv, Reglan)
• Prochlorperazine (Compro, Procomp)

A common medicine for halting status migrainosus is dihydroergotamine (DHE-45, Migranal). You can take it as a nasal spray or through a shot. Another drug, sumatriptan (Imitrex, Onzetra, Sumavel DosePro, Zecuity), comes as a shot, nasal spray, pill, or skin patch. Valproate, given by vein, can also be used.

People with certain medical problems should avoid these medicines though.

The corticosteroids dexamethasone (Dexamethasone Intensol, Dexpak) and prednisolone can also relieve status migrainosus.

If you don’t respond to other treatments and you have 4 or more migraine days a month, your doctor may suggest preventive medicines. You take these regularly to make the headaches less frequent or less severe. These include seizure medicines, blood pressure medicines (like beta-blockers and calcium channel blockers), and some antidepressants. CGRP inhibitors are a new class of preventive medicine that your doctor may recommend if other medicines don’t help.

Botox, though better known as a treatment for wrinkles, has also been approved by the FDA to prevent recurring migraines. Natural options such as magnesium may work, but we need more research to know which of these treatments are effective.

There are a couple of devices designed to interrupt abnormal electrical activity in the brain associated with migraine. A device called SpringTMS or eNeura sTMS uses a technique called transcranial magnetic stimulation (TMS). Place it on the back of your head for about a minute, and it releases a pulse of magnetic energy. Similarly, Cefaly uses transcutaneous supraorbital nerve stimulation and is worn as a band on the forehead and turned on daily for 20 minutes to prevent migraine from developing. There is also a noninvasive vagus nerve stimulator called gammaCore. When placed over the vagus nerve in the neck, it releases mild electrical stimulation to the nerve’s fibers to relieve pain. 

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Symptoms, Causes, Diagnosis, Treatment, and Prevention

Written by WebMD Editorial Contributors

Medically Reviewed by Jennifer Robinson, MD on December 13, 2022

• Migraine Symptoms
• Migraine Causes
• Migraine Risk Factors
• Migraine Triggers
• Migraine Types
• Migraine Frequency
• Are Migraines Curable?
• Are Migraines Fatal?
• When to Call Your Doctor
• Migraine Diagnosis
• Migraine Treatment and Home Remedies
• Migraine Prevention
• More

Migraine is a neurologic disorder that often causes a strong headache. The headache comes in episodes and sometimes also comes with nausea, vomiting, and sensitivity to light. 

Migraine is different in everyone. In many people, it happens in stages. These stages may include:

Prodrome

Hours or days before a headache, about 60% of people who have migraine notice symptoms like:

• Being sensitive to light, sound, or smell
• Fatigue
• Food cravings or lack of appetite
• Mood changes
• Severe thirst
• Bloating
• Constipation or diarrhea

Aura

These symptoms stem from your nervous system and often involve your vision. They usually start gradually, over a 5- to 20-minute period, and last less than an hour. You may:

• See black dots, wavy lines, flashes of light, or things that aren’t there (hallucinations)
• Have tunnel vision
• Not be able to see at all
• Have tingling or numbness on one side of your body
• Not be able to speak clearly
• Have a heavy feeling in your arms and legs
• Have ringing in your ears
• Notice changes in smell, taste, or touch

Attack

A migraine headache often begins as a dull ache and grows into throbbing pain. It usually gets worse during physical activity. The pain can move from one side of your head to the other, can be in the front of your head, or can feel like it’s affecting your entire head.

About 80% of people have nausea along with a headache, and about half vomit. You may also be pale and clammy or feel faint.

Most migraine headaches last about 4 hours, but severe ones can go for more than 3 days. It’s common to get two to four headaches per month. Some people may get migraine headaches every few days, while others get them once or twice a year.

Postdrome

This stage can last up to a day after a headache. Symptoms include:

• Feeling tired, wiped out, or cranky
• Feeling unusually refreshed or happy
• Muscle pain or weakness
• Food cravings or lack of appetite

Doctors don’t know the exact cause of migraine headaches, although they seem to be related to changes in your brain and to your genes. Your parents can even pass down migraine triggers like fatigue, bright lights, or weather changes.

For many years, scientists thought migraine happened because of changes in blood flow in the brain. Most now think this can contribute to the pain but is not what starts it.

Current thinking is that a migraine likely starts when overactive nerve cells send out signals that trigger your trigeminal nerve, which gives sensation to your head and face. This cues your body to release chemicals like serotonin and calcitonin gene-related peptide (CGRP). CGRP makes blood vessels in the lining of your brain swell. Then, neurotransmitters cause inflammation and pain.

The American Migraine Foundation estimates that more than 38 million Americans get migraines. Some things may make you more likely to get them:

• Sex. Women have migraines three times more often than men.
• Age. Most people start having migraine headaches between ages 10 and 40. But many women find that their migraines get better or go away after age 50.
• Family history.  Four out of five people with migraine have other family members who get them. If one parent has a history of these types of headaches, their child has a 50% chance of getting them. If both parents have them, the risk jumps to 75%.
• Other medical conditions. Depression, anxiety, bipolar disorder, sleep disorders, and epilepsy can raise your odds.

Some common migraine triggers include:

• Hormone changes. Many women notice that they have headaches around their period, while they’re pregnant, or when they’re ovulating. Symptoms may also be tied to menopause, birth control that uses hormones, or hormone replacement therapy.
• Stress. When you’re stressed, your brain releases chemicals that can cause blood vessel changes that might lead to a migraine.
• Foods. Some foods and drinks, such as aged cheese, alcohol, and food additives like nitrates (in pepperoni, hot dogs, and lunch meats) and monosodium glutamate (MSG), may be responsible in some people.
• Skipping meals
• Caffeine. Getting too much or not getting as much as you’re used to can cause headaches. Caffeine itself can be a treatment for acute migraine attacks.
• Changes in weather. Storm fronts, changes in barometric pressure, strong winds, or changes in altitude can all trigger a migraine.
• Senses. Loud noises, bright lights, and strong smells can set off a migraine.
• Medications. Vasodilators, which widen your blood vessels, can trigger them.
• Physical activity. This includes exercise and sex.
• Tobacco
• Changes to your sleep. You might get headaches when you sleep too much or not enough.

There are several kinds of migraines. The most common are migraine with aura (also known as a classic migraine) and migraine without aura (or common migraine).

Other types include:

• Menstrual migraine. This is when the headache is linked to your period. These usually happen 2 days before your period starts and last through 3 days after. You may also have other kinds of migraine headaches at other times of the month, but the migraine around menstruation is usually without aura.
• Silent migraine. This kind is also known as an acephalgic migraine. You have aura symptoms without a headache. In fact, aura is usually the main warning sign of this type of migraine. But you may also have nausea and other migraine symptoms. It usually lasts only about 20-30 minutes.
• Vestibular migraine. You have balance problems, vertigo, nausea, and vomiting, with or without a headache. This kind usually happens in people who have a history of motion sickness.
• Abdominal migraine. Experts don’t know a lot about this type. It causes stomach pain, nausea, and vomiting. It often happens in children and may change into classic migraine headaches over time.
• Hemiplegic migraine. You have a short period of paralysis (hemiplegia) or weakness on one side of your body. You might also feel numbness, dizziness, or vision changes. These symptoms can also be signs of a stroke, so get medical help right away.
• Ocular migraine. This is also known as an ophthalmic or retinal migraine. It causes short-lived, partial, or total loss of vision in one eye, along with a dull ache behind the eye, which may spread to the rest of your head. Get medical help right away if you have any vision changes.
• Migraine with brainstem aura. Dizziness, confusion, or loss of balance can happen before the headache. The pain may affect the back of your head. These symptoms usually start suddenly and can come along with trouble speaking, ringing in your ears, and vomiting. This type of migraine is strongly linked to hormone changes and mainly affects young adult women. Again, get these symptoms checked out by a doctor right away.
• Status migrainosus. This severe type of migraine can last more than 72 hours. The pain and nausea are so intense that you may need to go to the hospital. Sometimes, medicines or medication withdrawal can cause them.
• Ophthalmoplegic migraine. This causes pain around your eye, including paralysis of the muscles around it. This is a medical emergency because the symptoms can also be caused by pressure on the nerves behind the eye or by an aneurysm. Other symptoms include a droopy eyelid, double vision, or other vision changes.

Doctors divide migraine into three levels of frequency.

Episodic migraine means you get migraine now and then. High-frequency episodic migraine means you have eight to 14 migraine headache days per month. This condition also makes you more likely than others to develop chronic migraine.

Chronic migraine means you have migraine headaches on more than 15 days of the month and eight of those days have migraine features such as:

• Moderate to intense head pain
• Pain is on side of head (one or both)
• Pain throbs or pulsates
• Pain gets worse when you move
• You have nausea or vomiting
• You’re sensitive to light and sound

About 12% of Americans get migraine from time to time, but only about a third of those have chronic migraine.

Chronic and even high-frequency episodic migraine can be disabling conditions. And the higher the pain intensity of each headache, the more disabling it can be. That’s why it’s especially important to work closely with your doctor on a treatment plan.

There’s no cure for migraines yet. But medications can help prevent or stop them, or keep your symptoms from getting worse.

You can also avoid things that trigger your migraines. Lifestyle changes like easing stress and having good sleep habits can help, too.

Most migraines don’t cause lasting harm.

Rarely, you can have a complication called migrainous infarction. That’s when you have a stroke while you’re having a migraine. But there’s no evidence migraine can trigger a stroke.

It’s extremely rare, but a hemiplegic migraine can sometimes lead to a coma or other serious complications.

A very intense headache that starts suddenly can be a sign of another, more serious condition, like a stroke or aneurysm. Get medical help right away if this happens.

See your doctor any time a headache doesn’t go away or comes back.

See a doctor right away or go to the emergency room if you have a headache with a stiff neck, fever, vomiting, numbness or weakness in the limbs, or trouble speaking.

Your doctor will ask about your health history and your symptoms. It may help if you have a diary of your symptoms and any triggers you’ve noticed. Write down:

• What symptoms you have, including where it hurts
• How often you have them
• How long they last
• Other family members who have migraine
• All the medicines and supplements you take, even over-the-counter ones
• Other medicines you remember taking in the past

Your doctor may order tests to rule out other things that could cause your symptoms, including:

• Blood tests
• Imaging tests like MRI or CT scans
• Electroencephalogram (EEG)

There’s no cure for migraine headaches. But many drugs can treat or even prevent them. Common migraine treatments include:

• Pain relief. Over-the-counter (OTC) drugs often work well. The main ingredients are acetaminophen, aspirin, caffeine, and ibuprofen. Never give aspirin to anyone under the age of 19 because of the risk of Reye’s syndrome. Be careful when you take OTC pain meds because they might also add to a headache. If you use them too much, you can get rebound headaches or become dependent on them. If you take any OTC pain relievers more than 2 days a week, talk to your doctor about prescription drugs that may work better. They may suggest prescription medicines that may work well to end your migraine pain, including triptans, as well as the newer ditans and gepants. Your doctor can tell you if these are right for you.
• Nausea medicine. Your doctor can prescribe medication if you get nausea with your migraine.
• Triptans. These drugs balance the chemicals in your brain. You might get a pill to swallow, tablets you dissolve on your tongue, a nasal spray, or a shot. Examples include almotriptan (Axert), eletriptan (Relpax), rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig).
• Ergotamine (Cafergot, Ergomar, Migergot). This also works on the chemicals in your brain.
• Lasmiditan (Reyvow). This drug eases pain, nausea, and sensitivity to light or sound.
• CGRP receptor antagonists. Your doctor might give you rimegepant (Nurtec) or ubrogepant (Ubrelvy) if other treatments don’t help.
• Preventive medicines. If other treatments don’t work, your headaches are severe, or you have four or more migraine days a month, your doctor may suggest these. You take them regularly to make your headaches less severe or frequent. They include seizure medicines, blood pressure medicines (like beta-blockers and calcium channel blockers), some antidepressants, and shots of botulinum toxin type A (Botox). CGRP antagonists such as atogepant (Qulipta), eptinezumab (Vyepti), erenumab (Aimovig), fremanezumab (Ajovy), and galcanezumab (Emgality) can also prevent migraines.
• Single-pulse transcranial magnetic stimulation (sTMS). You place this device on the back of your head at the start of a migraine with aura. It sends a pulse of magnetic energy to part of your brain, which may stop or reduce pain.
• Neuromodulation devices. Other devices can affect the vagus nerve and the trigeminal nerve to give relief from or prevent migraines.

Home remedies

You may ease migraine symptoms by:

• Resting with your eyes closed in a dark, quiet room
• Putting a cool compress or ice pack on your forehead
• Drinking plenty of liquids

Complementary and alternative treatments

Some people get relief with therapies they use in addition to or instead of traditional medical treatment. These are called complementary or alternative treatments. For migraine, they include:

• Biofeedback. This helps you take note of stressful situations that could trigger symptoms. If the headache begins slowly, biofeedback can stop the attack before it becomes full-blown.
• Cognitive behavioral therapy (CBT). A specialist can teach you how actions and thoughts affect how you sense pain.
• Supplements. Research has found that some vitamins, minerals, and herbs can prevent or treat migraines. These include riboflavin, coenzyme Q10, and melatonin. Butterbur may head off migraines, but it can also affect your liver enzymes.
• Body work. Physical treatments like chiropractic, massage, acupressure, acupuncture, and craniosacral therapy might ease headache symptoms.

Talk to your doctor before trying any complementary or alternative treatments.

Try these steps to prevent symptoms:

• Identify and avoid triggers. Keep track of your symptom patterns in a diary so you can figure out what’s causing them.
• Manage stress. Relaxation techniques like meditation, yoga, and mindful breathing can help.
• Eat on a regular schedule.
• Drink lots of fluids.
• Get plenty of rest.
• Get regular moderate exercise.
• Ask your doctor about preventive medicines if you get migraines around your period or if lifestyle changes don’t help.

Some new devices can also prevent migraine. Cefaly is a headband-like gadget that sends electrical pulses through the skin of your forehead. It affects your trigeminal nerve, which is linked with migraine headaches. You use Cefaly once a day for 20 minutes. When it’s on, you’ll feel a tingling or massaging sensation. Another stimulator, gammaCore, sends out a mild electrical signal to the fibers of the vagus nerve in your neck to relieve pain and help prevent migraine.

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

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

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

Publication date: September 20, 2019

Updated: May 16, 2022

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

Article content:

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

Phases of migraine

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

Prodromal

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

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

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

Aura

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

Characteristic manifestations:

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

Headache

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

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

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

Postdromal

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

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

Duration depending on the type

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

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

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

Simple appearance

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

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

Classic

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

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

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

Associate

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

Common forms:

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

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

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

References

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risks, causes, triggers and treatments

According to the American Migraine Foundation, migraine is the seventh leading cause of disability. An estimated 10% of people worldwide suffer from migraine.

What is a migraine?

Migraine is one of many headache disorders that can cause severe throbbing pain or a throbbing sensation on one or both sides of the head. The International Headache Society defines migraine by the number of attacks and frequency of pain (at least five migraine attacks lasting 4 to 72 hours if untreated).

Common symptoms associated with migraine headache include vomiting, nausea, and increased sensitivity to light and sound. Other symptoms include difficulty speaking, auras, food cravings, or lack of appetite. In people with migraine with aura, the aura may appear as flashing lights before or after the migraine. A migraine with aura is also known as classic migraine, when there are warning signs before the onset of a migraine.

The most common migraine is migraine without aura. Some people also experience migraine pain in the neck, where it can be mistaken for muscle spasm or arthritis, or in the face, where it can be mistaken for a sinus headache. Migraine headaches can also be associated with sinus-like symptoms, including facial pressure, watery eyes, and nasal congestion. In some patients, migraines can be severe and prolonged, affecting daily activities.

Risk factors for migraine

Common risk factors for migraine include age, sex, and medical history. Although migraine can occur at any point in life, it most commonly affects people in their 20s and 50s. Headaches can peak at age 30 and decrease in intensity with age. Gender also plays a role: Women are three times more likely to get migraines than men. Genes contribute to the prevalence of migraine; A person is much more likely to have migraine headaches if one or both parents have migraines.

Causes of migraine

Although the exact causes of migraine are not known, environmental, lifestyle and genetic factors may play a role. Migraines are thought to be caused by abnormal brain activity that temporarily affects chemicals, nerve signals, and blood vessels in the brain. Research shows that overactive nerve cells send signals to the trigeminal nerve, which causes the body to release calcitonin gene-related peptides (C.G.R.P.) and serotonin. C.G.R.P. causes swelling of the blood vessels in the brain, leading to inflammation and migraine pain. A headache on one side of the head may move to the other side of the head and affect the entire head.

Episodic and chronic migraine

Episodic migraine means that migraine occurs less than fifteen days per month. A migraine that occurs for three or more consecutive months or more than fifteen days a month is chronic. Episodic migraine can become chronic due to triggers such as excessive caffeine intake or overuse of medications including N.S.A.I.D.S., opioids, and barbiturates. The pain intensifies if the person is sensitive to light and sound. Symptoms of chronic migraine include double vision, slurred speech, loss of balance, and dizziness.

Types of migraine

How people experience migraine depends on the type of migraine they experience. For example, vestibular migraine is common in people who suffer from motion sickness. Common symptoms of vestibular migraine include nausea and vomiting with or without headache.

A common type of migraine that affects children is abdominal migraine, which causes nausea and vomiting. Abdominal migraine is characterized by abdominal pain and loss of appetite in children. Over time, it can develop into a classic migraine headache. Retinal migraine is another type of migraine that occurs due to narrowing of the blood vessels in the eye, resulting in reduced blood flow to the eye. Ocular or retinal migraine causes recurring attacks of temporary or partial blindness or decreased vision in one eye.

Migraine phases

Prodrome phase

Migraine attacks include more than just the time when a person has a headache. Most people have seizures in three phases. Approximately 60% of people experience prodrome symptoms at the onset of a migraine attack. These subtle signs include mood changes, lack of appetite, food cravings, constipation, diarrhea, frequent urination, and frequent yawning. However, some people do not recognize these signs as indicators of a migraine attack.

Aura phase

One third of people with migraine may experience an aura before or during a migraine attack. Aura refers to reversible and temporary visual impairment and neurological symptoms originating in the central nervous system. Symptoms usually begin gradually, over 5 to 20 minutes, and last less than an hour. A migraine with aura may appear as flashes of light, black dots, wavy lines, hallucinations, or tunnel vision. Some people may experience complete loss of vision, numbness, or tingling in one side of the body.

Migraine without aura is the most common type of migraine that occurs without any warning signs. Another type is migraine with aura without headache, also known as silent migraine, in which aura and migraine symptoms occur without migraine headaches. Silent migraine, also known as acephalgic migraine, can cause debilitating symptoms that include blurred vision, loss of vision, changes in color vision, and sensitivity to light, sound, and smell.

During an attack, a migraine headache begins as a dull ache and develops into a throbbing or throbbing pain that occurs on one side of the head. About 80% of people experience nausea and vomiting along with a migraine headache. In addition, the person may be pale, lethargic, or dizzy. Most migraine headaches last about four hours, but severe migraines can last more than three days.

Migraine headache phase

During the headache phase, the pain may move from one side of the head to the other, possibly affecting the front of the head. You may also feel like your whole head hurts. Symptoms specific to this phase include sensitivity to light and noise, nausea, and vomiting.

Postdromic

Finally, after a person has experienced a migraine headache, the postdromic may last up to one day and be accompanied by symptoms such as fatigue, body aches, muscle pain/weakness, dizziness, trouble concentrating, sensitivity to light and sound.

Differences between childhood and adult migraines

According to the American Migraine Foundation, there are some critical differences in how children experience migraine attacks. These differences include less frequent migraine attacks and more bilateral pain compared to unilateral, shorter migraine attacks. Bilateral pain occurs over the entire forehead as opposed to unilateral pain on one side of the head.

Common migraine triggers

Endogenous or exogenous elements that increase the likelihood of a migraine attack in a short time are known as migraine triggers. Some triggers include stress, foods and drinks such as dietary supplements, aged cheese, alcohol, and monosodium glutamate. Hormonal changes are also common migraine triggers in women. Many women notice that migraine attacks occur due to fluctuations in estrogen levels during pregnancy, menopause, or the menstrual cycle. A migraine that occurs three days after your period or two days before your period starts is called a menstrual migraine.

Symptoms may include migraine without aura, throbbing pain on one side of the head, nausea, vomiting, and increased sensitivity to light. Menstrual migraine occurs due to a decrease in estrogen levels and can be triggered by stress, caffeine, or skipping meals. Hormonal and birth control medications, such as birth control pills, can also make migraine headaches worse.

Other migraine triggers include skipping meals, caffeine intake, dehydration, and sudden changes in weather or sensory stimuli. Some weather changes associated with migraine headache include high humidity, excessive heat, storms, barometric pressure changes, and thunderstorms.

Although weather changes cannot be controlled, people should do what is good for their migraines. In addition, strong odors such as smoke, perfume, and paint thinners cause migraines in some people. Identifying and understanding a person’s triggers is critical to migraine prevention.

Not all common triggers are present in all people, and people with migraine perceive triggers differently. Tracking triggers can be more complex and needs careful consideration. For migraine sufferers, it is important to identify and understand their triggers.

How is migraine diagnosed?

There are no standard tests to diagnose migraine. However, some ways a doctor can diagnose a migraine include using the person’s described symptoms, or the doctor may ask the person about their family history. In addition, doctors may do a physical exam to determine the cause of headaches. The doctor may also order a brain test, such as a CT scan and an MRI of the brain, or a blood test. They may also ask the patient to keep a migraine diary and look for factors that may trigger migraines.

Migraine treatment

Conventional migraine treatment is preventive medication to reduce the severity and frequency of migraine attacks. Doctors use different types of medications to prevent migraines. Preventive treatments include drugs originally developed to treat high blood pressure. Such prophylactic drugs include angiotensin receptor blockers, beta-blockers, calcium channel blockers, antidepressants such as tricyclic antidepressants, serotonin-norpinephrine drugs and anticonvulsants, and valproic acids.

Health care providers recommend that people with migraine take one or more prophylactic medications for 2-3 months to evaluate their effectiveness if they do not have side effects. Prophylactic or abortive drugs are aimed at relieving the headache and preventing it from getting worse.

More modern and expensive drugs for the treatment of migraine headache include antibodies to the calcitonin gene-related peptide or its receptors and antagonists. C.G.R.P inhibitors block a gene-related peptide that increases during a migraine attack, which may help prevent migraine headaches. Preventive treatments for chronic migraine include topiramate and botulinum toxin type A. Other medical devices that can help treat migraine include noninvasive vagus nerve stimulation, external trigeminal nerve stimulator, and transcranial magnetic stimulation.

For the treatment of frequent migraines, physical treatments such as massage, acupressure, acupuncture, chiropractic and craniosacral therapy can be used to help relieve headache symptoms. However, before trying alternative treatments, you should consult your doctor. It is very important for the person to describe the symptoms of the headache, including the severity and frequency of the symptoms, to determine the treatment.

For women who have migraine symptoms associated with the menstrual cycle and who experience migraine associated with menstruation, hormone therapy may help manage other symptoms.

Complications after taking pain medications

People who take pain medications too often can experience severe headaches when taking medications too much. The risk of overuse headaches is highest when a person takes a combination of caffeine, acetaminophen, and aspirin. Taking ibuprofen or aspirin for more than 14 days and triptans for more than nine days a month can also trigger headaches when overused. Medication overuse headaches occur when a medication is no longer effective in relieving migraine pain and causes a headache. The cycle continues as the person uses more and more drugs.

Some migraine medicines can also constrict blood vessels, so people at risk for heart disease or a heart attack should consult a healthcare professional before use. In addition, pregnant women and patients with other comorbidities should consult their physician before use and evaluate side effects.

How to prevent migraines?

Migraine prevention involves using the natural S.E.E.D.S. method. A person can prevent migraine by using the five effective steps of S.E.E.D.S., which means sleep hygiene, regular and healthy eating, regular exercise, migraine diary and stress management.

Sleep

Lack of sleep or irregular sleep can trigger migraine or migraine attacks. According to the American Migraine Foundation, people with migraines are 8 times more likely to have trouble sleeping than others. Some ways to improve sleep hygiene include following a regular and regular sleep schedule, keeping the room cool and dark, avoiding electronics in the bedroom, and practicing relaxation techniques before bed.

Regular meals

Regular and healthy eating can make a big difference, especially for people who are hungry. Foods high in protein and low in carbohydrates are usually preferred by migraine sufferers to avoid fluctuations in blood sugar levels. The main difficulty is to determine whether certain foods trigger migraines or headaches, since this can vary significantly from person to person.

Therefore, it is very important to understand which diet or foods cause headaches. However, some general strategies that can be adopted include eating at least three meals a day, stopping or limiting your caffeine intake, and staying hydrated by drinking 7-8 glasses of water daily.

Exercise

Moderate and regular exercise can be an effective way to prevent migraines. You should be careful, as intense exercise and physical activity can aggravate the attack. Some of the benefits of exercise include improved overall health and better sleep. Recommended exercise for people with migraines includes regular aerobic exercise for at least 30 minutes 3 times a week and about 30 minutes of cardio several times a week.

Choose an exercise and activity you like; Start by gradually setting exercise duration and frequency goals, and gradually increase exercise frequency and duration. This gradual process will help a person refrain from intense physical activity that can trigger a migraine.

Migraine Diary

Headache/Migraine Diary is a handy tool for managing triggers, diagnosing, determining the effectiveness of medications, and the effectiveness of current treatments, allowing a person to better understand the disorder. For example, to keep track of migraine/headaches, you can use several applications in addition to the diary.

Some of the benefits of a diary include helping your doctor diagnose migraines, showing you a pattern of attacks, helping you recognize warning signs and triggers, and assessing acute or prophylactic medications. Always keep a simple diary and write down basic information that may be helpful for migraine management and prevention.

Stress management

Stress can make migraine symptoms worse. Therefore, stress management should be an integral part of natural migraine prevention and control plans. Establish a daily routine that includes periods of relaxation. Relaxation periods should consist of relaxation strategies. Some of these include taking slow, deep breaths, soft relaxing sounds and lights, or focusing on a soothing image or scene.

Other recommended stress management strategies include CBT, biofeedback, breathing techniques, gratitude, guided meditation and mindfulness, and positive mantras.

Migraine prognosis

Migraine headaches are a risk factor for stroke in some people. People at increased risk of stroke include people who smoke, women who have migraines with aura or take birth control pills, and people who eat unhealthy foods that raise blood pressure or cholesterol levels.

Professional help

Call 911 or go to the emergency room if the person is experiencing the worst headache of their life, neurological symptoms that have not been experienced before, such as problems with balance, vision or speech, tingling sensations, paralysis , weakness, convulsions, or if the headache occurs after a head injury or comes on suddenly. To learn more about migraine, see the resources of the National Headache Foundation, the American Headache Society, and the Migraine Research Foundation.

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Resources

What is a migraine? | Headache | JAMA

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