Migraine

What is migraine?

Migraine (usually) affects only half of the head. Migraine affects about 8% of the population (women suffer much more often). It occurs with attacks of pain, sometimes on the right and sometimes on the left, from a young age and usually at least one of the parents has the same condition. Sometimes the pain is accompanied by nausea.

Symptoms of migraine

Precursor stage
The precursor stage of migraine occurs with symptoms a day or two before aura or, in cases of migraine without aura, before the onset of headache. The patient often experiences some of the following symptoms:

• Constipation
• Increased thirst and frequent urination
• Changes in mood
• Frequent yawning
• Stiffness in the neck
• Craving for food

Aura

Migraine often alerts the patient, who feels weak, has no appetite for anything and wants to go to a quiet and dark room to lie down. If the patient manages to sleep, there is a good chance that when he or she wakes up, the migraine attack has been avoided. If he does not make it, then he realizes that he does not see well. That is, he sees black circles that prevent him from reading or seeing what is behind them, or he sees zigzag lines that go off to the side but come back again and again. Other disturbances that signal the beginning of a migraine episode may include tingling that is localised on one side of the face or one of the limbs, as well as difficulties in speaking.

Headache

Usually the pain is strong and beats rhythmically with the same intensity as the pulse, or with increasing intensity and rhythm, as if a drill is piercing the head. The patient wants to vomit, and the slightest noise or light makes the migraine pain even more excruciating. If he does not vomit automatically, he often induces it himself. With vomiting comes some relief and the patient regains some time to try to sleep. But if he thinks the crisis is over and tries to work, then the pain comes back even stronger and more unbearable. Without medication, it lasts from a few hours to a day or, at most, two days and slowly goes away.

Retreat stage

Usually the patient is pleasantly surprised to realise that the headache is gone, but cannot determine when. Many patients report that after a migraine episode they have low energy levels or feel confused. Others report feeling an indeterminate euphoria. However, sudden movements of the head may bring back the pain for a short time.

Other types of migraine are the following:

• Migraine with complications. If the patient feels numb or weak to paralysed on the arm or leg on the other side (from the side of the head that hurts), or if they cannot speak properly or understand the words they hear or pronounce the words they want, then this is migraine with complications.
• Migraine of the period. If the migraine occurs a few days before, during, immediately after the end of the period or around the middle of the cycle (i.e. when ovulation occurs), then it is a menstrual migraine (or trigeminal migraine).
• Childhood migraine. There is even a childhood migraine, which usually starts with pain in the middle of the abdomen, vomiting or dizziness a few hours before the headache starts.

What is the cause of migraine?

The cause of the migraine has not yet been found. There are many factors such as:

• Hormonal
• Psychics
• Nutritional
• Environmental
• Toxic

These factors cause contraction, which reflexively causes vasodilation in the meninges and cephalopoma occurs.

Treatment of migraine

Drug treatment of the most common forms of migraine is currently based on triptans. Triptans are effective drugs, without the serious side effects of older drugs. It is of enormous importance that the patient takes the medication as soon as the attack begins. For patients who suffer from frequent and severe migraine attacks, monoclonal antibodies will soon be available in Greece, which, with one injection per month, quarter or half a year (depending on the active substance), will protect the patient from these attacks.

Text:
Dimitrios Vlaikidis, Neurologist

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