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Causes and symptoms of migraine, how to treat?

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What is a migraine?

Migraine is a hereditary neurological disorder that manifests itself growing pulsating headachenot related to trauma, tumor or stroke. According to who statistics migraine – the main cause of spontaneously occurring headache after tension headaches and one of the 19 diseases that were most strongly violates the social adaptation of the person. The loss of performance in migraine can be so palpable that the patient establish a disability.

Cash costs for the treatment and diagnosis of migraine comparable to the financial costs in the treatment of cardiovascular diseases. The task of the doctor in this case, the exact diagnosis, differentiation of pain in migraine attacks from tension-type headaches, the selection of the optimum scheme of drugs, including non-specific analgesics, triptana and beta-blockers. Constant medical supervision helps to develop a plan for the relief of the attack in each individual case. The severity of disease is determined by the frequency of attacks and their intensity. In mild migraine attacks happen several times a year with heavy daily, but the most common form of the disease, in which migraine attacks occur from 2 to 8 times per month.


The symptoms of migraine

According to medical study, migraine often affects women, experiencing an average of 7 seizures per month compared to 6 attacks in men, the duration of attacks is 7.5 hours women and men – 6.5 hours. Causes of asthma in women are changes in atmospheric pressure, air temperature, and other climate change, while men intense exercise. Also differ the symptoms associated with migraine headaches: in women often causes nausea and violations of smell, and men – photophobia and depression.

  • Migraine premonitory or prodrome – weakness, feeling unmotivated fatigue, inability to concentrate, impairment of attention. After seizures sometimes observed postdrop – drowsiness, weakness, pale skin.
  • the Nature of the pain of a migraine differs from other headaches – starting from the head, throbbing and pressing pain gradually covers half of head, extending to the forehead and eyes.
  • Unilateral pain can change from attack to attack, covering the left, the right part of the head or occipital region.

  • Migraine always has one or more accompanying symptoms – photophobia, nausea, vomiting, soukoban, disturbances of smell, vision, or attention.

  • In 10% of cases of migraine in women it occurs during menstruation and lasts one or two days since it started. From menstrual migraines suffers a third of all women who have this disease.

  • Migraines in children usually as a concomitant symptom is drowsiness, attacks of pain occur after sleep. In men migraine develops after strenuous exercise, pain increases when climbing stairs, while running or walking, when lifting weights.
  • Oral contraceptives and other drugs affecting hormonal balance, including means hormone replacement therapy, you can greatly increase the risk of stroke, in 80% of cases reinforces its intensity.
  • Irritability, anxiety, fatigue, drowsiness, paleness or redness of the skin, anxiety and depression – associated migraine symptoms, which may occur or not occur in each case.
  • Artery in the temple, and tense pulse, pain and tension are enhanced by movement, so patients suffer a seizure in bed, in a quiet and dark room to minimize external stimuli.

Nausea and vomiting during a migraine

Nausea is an important symptom that helps to distinguish the pain of a migraine from other types of pain. This symptom is always accompanied by seizures and sometimes expressed so strongly that it comes to gagging. The condition of the patient subjectively easier for a few minutes it becomes easier. If vomiting does not bring relief, but the pain does not subside within a few days, it could be a symptom of migraine status and require hospital treatment.

Signs of migraine with aura

Migraine with aura has a clear structure of the four stages, the duration and intensity of the manifestations of which varies from case to case:

  • Phase precursors. This stage is also called the prodrome phase. Patients can determine the approach of the attack on the complex of symptoms for all different. The most common manifestationsdrowsiness, fatigue, nervousness and inability to concentrate. Some of the prodrome, by contrast, manifests itself by increased activity, insomnia, increased appetite. After this stage begins, the aura if migraine without aura, and the harbingers it usually has.

  • Phase aura. The aura displays the changes occurring in the brain before the onset of the attack. Manifested only in one third of all cases of migraine, even in the patients aura may occur from attack to attack and not always goes the same way. Its symptoms are not painful but may cause concern patient, especially if it occurs for the first time. So, visual aura, spots before the eyes, zigzag patterns, distorting the picture, the fog and the blurred outlines of objects, the inability to accurately determine their size and ratio – can trigger anxiety in a person, fear for the eyesight. Distortion of tactile, audible, olfactory sensations are also characteristic of the aura stage. You may feel numbness and tingling in the limbs, usually begins with the toes and gradually moving upward to the head affecting the face cheeks. The numbness only applies to one half of the body – that which is opposite to the location of pain. If during a migraine attack, the pain covers the left side of the head, under the aura numbs the right side of the body. There may be a disruption of attention and concentration, which prevents him to do daily chores, work and sometimes even to speak. The duration of stage from 10 minutes to an hour, in some cases, the aura can last even a few hours.

  • Pain phase of migraine is the most difficult for the patient phase, which lasts from several hours to two-three days. The growing pains can be a quick ten minutes and can take place gradually over several hours. To reduce the intensity of the pain and alleviate the condition of the patient at this stage, he needs to remain in a horizontal position, to limit mobility, to wrap your head in a cold towel, to avoid light and loud noises. For the relief of migraine doctor prescribes a medication – analgesics or triptan that should be taken early in the pain phase.

  • The period after a seizure is also called the period of permission – the patient experiences a sensation resembling a phase of the prodrome, nervousness and irritability, fatigue, fatigue, weakness in the limbs. Usually these symptoms disappear within a day, it is best to spend time in the dream.

At high intensity attacks, their continuous following one after the other with short intervals of relief, diagnosed migrainestatus. It is characterized by symptoms such as slow heart rate, irritation of the meninges, constant vomiting without the slightest reduction in pain intensity. In this state, a person completely loses its efficiency and needs to be hospitalized under medical supervision.

Unilateral headache, occurring occasionally or constantly present, not associated with migraine requires immediate examination by a specialist. Such pain is typical for organic brain damage, and early diagnosis will ensure the effectiveness of the treatment.

The causes of migraine

Migraine refers to a neurological disease, so the reason for its occurrence there may be such diseases as:

How is a migraine and what contributes to its development:

  • Migraine pain is the result of vascular disease, which dilate cerebral vessels, the Dura of the brain.
  • Expanding unevenly, these vessels are putting pressure on the nerve cells near which they are located.
  • After a narrowing of blood vessels, blood circulation in the surrounding tissues is disturbed, which can also cause pain.
  • Systemic diseases, metabolic disorders or disease of the Central nervous system can also trigger the development of migraine.
  • 70% of patients with migraine have a genetic predisposition to this disease, parents with similar pathology.

The mechanism of development of migraine pain is not fully understood, in this respect there are some theories.

Serotonin as a cause of migraine

Serotonin is a neurotransmitter that causes constriction of blood vessels and is necessary for proper transmission of nerve impulses. With a sharp increase serotonin levels, there is a spasm of the intracranial vessels at the site where later the pain is felt with a migraine. In these vessels no pain receptors, but the allocationlarge amounts of serotonin, the body produces substances that break down it. As a result, their tone is normal, but expanding superficial artery temporal region, which have pain receptors. During deceleration of the blood flow and expanding the blood vessels are generated pain impulses, which is the cause of the pain.

The attack is once serotonin levels are normalized. According to the serotonin theory of pain, an important role in this process is the activity trigeminovascular system, which is responsible for the allocation of pain neuropeptides. This explains why migraine attacks usually happen in people whose cerebral cortex has high anxiety.

The hypothalamus and migraine

The hypothalamus provides the regulation of the endocrine system in this part of the brain located the centre of hunger, thirst, vascular tone. Therefore, paroxysmal headache with migraines connected with the hypothalamus and comes as a response to external stimuli.

According to recent research, attacks of migraine occur with increased activity level of the hypothalamus. On the basis of this discovery in the future it is possible to develop more effective drugs for the treatment of migraine.

Provocateurs migraine

  • Food factors. To provoke a migraine attack can substance contained in food or the diet. Alcohol, even weak as wine, champagne or beer, can cause migraines. It is also recommended to avoid foods with flavorings, monosodium glutamate, aspartame and caffeine. Caffeine or the lack of it is a risk factor for migraine. So, a person who used to drink a lot of coffee or caffeinated products, and a sharp decline in the quantities of caffeine that enters the body may develop a migraine attack. Cheeses, chocolate, citrus, cocoa, nuts in the menu can cause a similar reaction because of the content phenylethamine and tyramine.

    Other agents-provocateurs entering the body from food:

    1. Gluten – wheat, barley, oats, rye and their products (cereals, cakes, pastries, beer);

    2. Salicylates – black and green tea, mint, spices;

    3. Nitrate – greenhouse vegetables and fruits, greens (lettuce, spinach, parsley,celery).

    More often, however, the mechanism of development of migraine is not affected by food, and the frequency and quantity of intake. So, an attack may occur on the background of a strict diet or if you skip taking food, for example Breakfast.

  • Hormonal factors. First of all it concerns menstrual migraine, which is common among women. On the development of asthma is affected by fluctuations in the level of estrogen in your blood. Trigger can medications hormone replacement therapy used to treat diseases of the reproductive system, oral contraceptives, and ovulation or my period.
  • The environmental factors. The change of seasons, fluctuations in temperature, pressure, humidity, heat or cold, dry air in the room can act as provocateurs. The same applies to noise, unexpected loud noises, bright flashing lights or fluorescent lighting, the irritating visual receptors.
  • Sleep mode. This applies in particular to migraine sleep attack may develop on the background of lack of sleep and oversleeping. Late bedtime and late awakening, jet lag, sleepless nights – all these factors can contribute to migraines.
  • The internal factors. Migraine attacks may occur due to chronic pain in the spine as a result of cervical degenerative disc disease. In addition, the internal provocateurs there may be a lack of magnesium and iron in the body, sudden changes in the level of glucose in the blood, anemia.
  • Medication. In addition to hormonal drugs that cause migraine can reserpine, nitroglycerin, ranitidine, hydralazine, histamine in the composition of drugs.
  • Psychological and physiological factors. Emotional overload, long-term stress, sudden relaxation after a stressful situation, nervous breakdowns, anxiety and panic attacks, suppression of emotions, both negative and positive. Psychophysiological provocateurs cause of migraine in ambitious people who are perfectionists with high expectations to yourself.
  • Other factors. Injuries of the skull, excessive physical activity, including sexual, fatigue, sharp change of scenery from moving.

Types of migraines

In clinical practice, the known types of migraine:

  • Panic – for this migrainecharacteristic symptoms, such as choking, vomiting, palpitations, swelling of the face.
  • Chronic migraine is characterized by regular bouts of increasing pain intensity with each subsequent one. To diagnose chronic migraine if attacks are repeated for three months, 15 times a month.
  • Menstrual migraine – attacks of migraine dependent on the level of estrogen in the blood, therefore appear, depending on the cycle.
  • Migraine sleep – its manifestation depends on the mode of human sleep, usually upon waking or in sleep.

Aura symptoms in migraine:

  • Speech disorders (reversible) – it is impossible to say the proposal to formulate a thought;
  • Visual aura – spots, dots, stripes, fog before the eyes, blurred outlines of objects;
  • Numbness, tingling in the extremities, disturbance of tactile sensations.

Headache occurs after an hour or less after the aura or together with it, increases with walking and other physical activities, is one-sided and accompanied by nausea, phonophobia, photophobia. The attack can last from four hours to three days.


Diagnosis of migraine

Migraine treatment should be carried out only after diagnosis, as without the correct diagnosis of self-medication can be dangerous, causing complications in the form of drug-induced pain.

Diagnosis technician requires data on the frequency and duration of attack, anamnesis and clinical picture of the disease. In severe cases the doctor may require an MRI of the cervical spine and brain, reoentsefalografii.

At diagnosis should be distinguished episodic pain stress from bouts of throbbing headaches sovremennyh attacks.

How to distinguish the pain of tension headache migraines:

  • Low intensity
  • The character of the pain is crushing and squeezing the head like a Hoop, and not pulsating
  • Bipartite
  • Is not increased during exercise

A tension headache is provoked by such factors as a constant emotional burden, stress, spending long periods in an uncomfortable position, in which the blood circulation of the head. For this type of headache is also characterized by light - and photobase, nausea as migraine.


In the treatment of migraine using two approaches – the first is aimed at relief of an attack and alleviate the condition of the patient, the second approach aims to prevent recurrence.

Analgesic for the relief of the attack appointed by the neurologist depending on the intensity of their manifestations and duration. Migraines average and weak forms of severity with duration of attack no more than two days are assigned analgesics:

  • Ibuprofenas non-steroidal anti-inflammatory prescribed to relief the condition during the attack; paracetamol is not recommended if the patient has liver disease or renal insufficiency; aspirin is contraindicated in blood clotting disorders and diseases of the digestive tract.
  • Codeine, phenobarbital, paracetamol, Metamizole is included in the composition of the combined drugs from migraines and have many contraindications. Uncontrolled use can cause drug pain.

  • When the duration of the attack from two daysto relief of use triptan. (Read the article: Triptan — effective remedy for migraine)

  • The auxiliary drugs with psychotropic effects as domperidone and chlorpromazine.

Most modern drugs against migraine synthesized 20 years ago, they are a derivative of serotonin and have a complex effect:

  • Trigeminal nerve – desensitization, analgesic effect;
  • Cerebral blood vessels – reduce a pulsation of brain vessels, which causes pain without affecting other vessels;
  • The pain receptors and neuropeptides reduce the number of neuropeptides thereby removing the pain.

Migraine with aura can be removed immediately taking Papazol. To alleviate the patient's condition helps the pressure chamber, hot or cold bath, individually for each case.

How to remove a migraine attack?

During an acute attack of migraine is recommended:

  • A combination of analgesics, antiemetics and nonsteroidal anti-inflammatory drugs allows to stop the seizure in 40% of cases.
  • Zolmitriptan – taking at a dosage of 2.5 mg has a high rate of analgesic action.
  • Sumatriptan acts through four hours after administration, and is efficient in 80% of cases. In severe attacks, accompanied by vomiting, is administered subcutaneously. For rapid onset of effect is applied in the form of a spray.
  • Naratriptan in a dosage of 2.5 mg reduces the likelihood of relapse and has few side effects.
  • Ergotamine is rarely used, usually use triptan.

Learn more: How to reduce the frequency of migraine attacks? All the necessary information for the treatment of migraine


Prevention of migraine

  • Metoprolol, timolol and other beta blockers are used to prevent attacks of restriction for patients with heart failure or bronchial asthma.
  • Sodium valproate and pizotifen can cause drowsiness and weight gain, so their use is limited.
  • Aspirin is rarely used to prevent migraine headaches, since there is no approved dosage.

  • Amitriptyline helps to relieve pain during a migraine attack caused by stress.

General rules for migraine

  • The damaging effects of alcohol and nicotine on the vascular system can provoke a migraine attack, increase the intensity of the pain. Therefore, an important condition for the prevention of migraine is the rejection of bad habits.
  • Energy drinks, coffee and other products with a high content of caffeine should be excluded from the diet. Caffeine has a stimulating effect on the body that provokes a person to a larger load than he's capable of in a normal state.
  • Use sleep mode to the processes of relaxation and regeneration of the body took place more intensively. The most important is the period from 20:00 until midnight, it is necessary to spend in sleep. If the person is awake until 3:00 and longer, the consumption of energy resources significantly increases, and the body is not only recovering, but also exhausted.

  • Eliminate foods that are contributing to the development of atherosclerosis – fast food, smoked food, food with preservatives, flavors and other flavors. Their use not only provokes the disease of cardiovascular system, but also can cause seizure.

  • Gentle exercise, walks in the fresh air trained by the body, making it more resistant to stress and reduce the likelihood of attack.

  • Adjust the intensity of mental activity, not perezagruzite the body and avoid emotional stress and nervous breakdowns, to minimize the probability of attack.