MIGRAINE

Today, there’s more hope than ever for a headache free life. Thank to treatments and life style changes, many migraine sufferers are enjoying more days without pain.

According to Pam Santamaria, MD, a neurologist at the Nebraska Medical Center, today the treatment options are greater than they were several years ago, and there aren’t reasons for people to suffer.

The American Academy of Neurology, last year published new guidelines on the prevention of episodic migraines, identifying nearly a dozen effective medications and complementary treatments.

Experts also have a deeper understanding of what triggers migraines and how to find faster relief, because treating a migraine quickly helps medications work better.

First at all, we should identify the different form of migraine:

v Migraine headache: Nearly of 30 million Americans suffer from these headaches, which strike three times more women than men. The pain may interfere with daily activities. It could appear on 15 or more days a month for at least three months. Pain characterized by   throbbing or pulsating, usually on one side of head. It may intensify during physical exertion. Escort symptoms can be appetite loss, nausea or vomiting and/or sensitivity to light, sound, odors or touch; the pain last anywhere from 4 to 72 hours, sometime even longer. The trigger may be certain food, hormonal changes, weather and/or stress.

v Tension Headache: It cause mild to moderate band-like pain, are the most common cause. They may come and go over a prolonged period, but they don’t usually interfere with daily life. Pain characterized by a band or vice like sensation in your head or neck. The dull, aching pain usually takes hold in your forehead, temples or the back of your neck and/or head. Both sides of your head are affected. The pain last from 30 minutes to 7 days. It is related with stress, anxiety, fatigue or anger.

v Sinus headache: These are often caused by a sinus infection. Sinus related pain and tenderness, as well as a deep, dull ache that can worsen with head movements. Nasal discharge, ear fullness and facial swelling, plus fever are accompanied symptoms. In these cases the trigger may be a sinus infection, allergic reaction or tumor.

v Cluster headache: One of the least common types of headache, these are almost always one side. Intense burning or piercing sensation, the pain may be localized behind one of eyes and may radiate to your forehead, temple, nose, cheek or upper gum. The eyelid on affected side may become swollen or droop, the nostril may become congested, and you may experience facial flushing and excessive sweating. The headache are most likely to occur in the spring or fall.

 

Treatment:

Preventive:

Antiepileptic (divalproex sodium, sodium valproate, topiramate) stabilizes nerve cell in the brain, making them less easily activated.

Antidepressants (amitriptyline, venlafaxine) increase levels of the brain chemical serotonin, which helps calm the nervous system.

Beta-blocker (metoprolol, propranolol, timolol) blocks the release of stress hormones like epinephrine and adrenaline, which can trigger migraine.

Nonsteroidal anti-inflammatory drug (fenoprofen, ibuprofen, ketoprofen, naproxen) relieves inflammation and pain. These medications (NSAID) are often prescribed on a short-term basis to women with menstrual migraines and patient who are suffering from other types of pain, such as back and/or neck.

Onabotulinum toxin A (a purified organic product, for chronic migraine only) quiets hyperactive nerve cells and blocks the release of inflammatory chemicals involved in migraine pain.

Triptan (frovatriptan for short-term prevention of menstrual migraine) prevents nerves on the surface of the brain from transmitting pain signals.

 

 

Acute:

Antinausea (metoclopramide, prochlorperazine) relieves nausea and migraine pain.

Dihydroergotamine (DHE) blocks pain, reduces inflammation and shrinks swollen blood vessels

NSAID (acetaminophen, diclofenac, ibuprofen, naproxen) relieves inflammation and pain.

Triptan/NSAID combination (sumatriptan and naproxen sodium) relieves inflammation, block pain and shrinks swollen blood vessels.

Triptan (almotriptan, frovatriptan, naratriptan, sumatriptan) prevents nerves on surface of the brain from transmitting pain signals.

Conquering chronic migraines usually requires a combination of medication and lifestyle changes, such as getting enough shut-eye, limiting caffeine intake to more than 200 mg (10 ounces of coffee) and monitoring use of pain medications.

 

Bibliography Consulted

American Academy of Neurology. (2012, April 21). aan.com. Retrieved from New Guidelines on Treating Migraine Press Kit: http://www.aan.com/globals/axon/assets/9774.pd

Escamilla, C. (2007). Cefaleas. In Cliniguia actualizacion de diagnostico y terapeutica (pp. 684-692). Spain: Eviscience.

National Headache Foundation. (2013). Migraine .

Palma Lopez, L., Diez Bermudez, A., Perez Ruiz, D., & Andres Celda, R. (2010). Cefaleas. In M. Vazquez Lima, & J. Casal Codesino, Guia de Actuacion en Urgencias (pp. 159-169). Spain: Ofelgama,s.l.