Migraine is a primary episodic form of headache manifested by intense, attack-like headaches (often unilateral) with a combination of neurological, autonomic, and gastrointestinal manifestations. It first manifests itself usually at the age of 12 to 22 years. In terms of frequency, it ranks second after tension headaches. Often a migraine attack occurs after some aura and ends with a feeling of general weakness and brokenness. During diagnosis of migraine it is necessary to rule out organic brain pathology and deal with the possible causes of migraine. Treatment consists of remedies to stop the arisen attack and to prevent the occurrence of a new migraine episode. One of the remedies: https://pillintrip.com/medicine/apireks.
Migraine is the primary episodic form of headache, manifested by intense, attack-like headaches (often unilateral) with a combination of neurological, autonomic and gastrointestinal manifestations. It first manifests itself usually at the age of 12 to 22 years. It ranks second in frequency after tension headache.
Etiology and pathogenesis
Previously, migraine was considered as a vascular pathology, since during a migraine attack there is a dilation of the vessels of the dura mater, in the innervation of which the trigeminovascular fibers are involved. However, pain sensations during a migraine attack are secondary; they result from the release of pain neuropeptide vasodilators, the most important of which are neurokinin A and peptide, from the endings of the trigeminovascular fibers.
Thus, a migraine attack is caused by activation of the trigeminovascular system. Such activation occurs in patients with hypersensitivity of trigeminovascular fibers and increased cortical excitability. Emotional stress (a migraine attack occurs immediately after a stressful situation), menstruation, physical tension, hunger, as well as some products containing phenylethylamine and tyramine (citrus fruits, chocolate, champagne, red wine) are the most frequent “provocateurs” of migraine attack.
Migraines are characterized by a pressing, throbbing headache affecting half of the head and localized in the forehead/fork/eye area. In some cases, migraine headaches occur in the occipital region and then move to one half of the head. From time to time, the localization of the headache may change from one half of the head to the other. Moreover, persistent (or periodic) unilateral headaches are not characteristic of migraine, but are considered an absolute indication for examination in order to rule out organic brain damage.
In some cases, there is a prodrome (precursors of a migraine attack), manifested by weakness, decreased concentration, and a postdrome (condition immediately after a migraine attack) as general weakness, pallor and yawning. As a rule, a migraine attack is accompanied by nausea, photo- and phonophobia, deterioration of appetite. The headache worsens when climbing stairs and walking. In childhood, a migraine attack is accompanied by drowsiness, and after sleep, the pain usually goes away. Migraine is closely connected with female reproductive organs, therefore in 35 % of cases a migraine attack is provoked by menstruation, and the so-called menstrual migraine (a migraine attack occurs within two days of the beginning of menses) in 8-10 % of cases. Taking hormonal contraceptives and hormone replacement therapy worsens the course of migraines in 70-80% of cases.
There are several clinical types of migraine:
vegetative or panic migraine – the attack is accompanied by vegetative symptoms (chills, increased heart rate, lacrimation, a feeling of suffocation, facial swelling);
migraine with aura: transient, visual, speech, sensory, motor disorders appear before the attack; its variant is basilar migraine;
associative migraine – the paroxysm of headache is accompanied by a transient neurological deficit; its varieties are aphasic, cerebellar, hemiplegic, and ophthalmoplegic migraine.
sleep migraine – an attack occurs during sleep or in the morning, upon awakening;
Cathemenal (menstrual) migraine – a type of migraine associated with the menstrual cycle. It has been proven that an attack of this migraine is caused by a decrease in estrogen levels in the late luteal phase of the normal menstrual cycle;
chronic migraine – attacks occur more frequently than 15 days/month for three months or longer. The number of attacks increases every year up to the appearance of daily headaches. The intensity of headache in chronic migraine increases with each attack.