Pain relief

Migraine is a vascular headache, occurring periodically, and the pain principally affects one side of the head. The pain is often accompanied by nausea, vomiting and visual impairment. The characteristic of migraine headache is so-called aura which usually occurs before the attack.

Migraines are divided into:

• migraine without aura
• migraine with aura
• migraine with prolonged aura

It is believed that migraine affects 10% of the total population, while women are affected more often than men. Migraine headaches are often related to the menstrual cycle or menopause, and they rarely occur during pregnancy. They can be caused by mental stress, physical exertion, weather conditions or sudden weather changes, consumption of certain foods, alcohol, etc.

Headaches are extremely common ailments in humans. We divide them into four groups:

• Vascular
• Tension
• Neuralgia
• Symptomatic headaches

Clinical picture

Aura is a portent of the migraine pain and manifests itself in the form of appearance of a dot in the visual field, disturbance of the visual field, feeling or motor control disorder that is usually one-sided, impaired speech. It can last for several minutes up to an hour. It also causes change of mood in the form of depression or euphoria, impaired concentration, restlessness. It can cause pathological hunger, especially the need for sweets.

After aura, the throbbing headache develops, but the pain may be dull or stabbing. In more than 90% of patients the pain is accompanied by nausea and vomiting. A large number of patients complain of so-called, photophobia (sensitivity to light), loud noise, or strong odor. At the end of the attacks, some patients experience polyuria (production of greater amount of urine). Migraine attack usually lasts a few hours, but in most cases it ends within 24 hours.

Treatment

Besides the change of lifestyle and diet, psychotherapy, acupuncture, etc., the treatment of migraine includes drug treatment (treatment of acute migraine attacks and prevention of attacks):

• In the treatment of acute migraine are used sumatriptan, naratriptan, zolmitriptan, rizatriptan, alnitidan, ergotamine.
• Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin), diclofenac (Cataflam, Voltaren) and naproxen sodium (Naprosyn), which can be effective if taken at the first sign of the headache. Simple painkillers including aspirin, acetaminophen (Tylenol), or aspirin / acetaminophen / caffeine combination (Panadol Extra, Topirin, Kofan Instant).
• In the prophylaxis can be applied topiramate (Topamax), amytriptyline (Elavil), methysergide, pizotifen, cyproheptadine, propranolol (Inderal) and similar drugs.
• The treatment of migraine symptoms such as nausea can be treated with metoclopramide (Reglan) and thiethylperazine.