And whether you know...
May 11, 2012
Migraine is an illness at which the person suffers from very strong attacks of a headache. The course of migraine, as a rule, very bright and peculiar at each patient. References of this illness reach to us since the oldest times. Migraine attacks periodically overcame many famous people – Caesar, Nietzsche, Napoleon, Tchaikovsky. All of them periodically suffered from an intolerable headache.
The first descriptions of a severe headache at the person reach to us since an ancient Sumer civilization. That is, suffered from migraine of people several millennia ago. Paracelsus, Hippocrates wrote about migraine in the works.
Origin of the word "migraine" — French. In turn it got to French from Ancient Greek language and designated "a half of the head".
It is accepted to allocate a number of factors which can become provocative for approach of an attack of migraine. According to supervision of doctors, the people living in rural areas are less subject to a disease of migraine. Migraine arises at the smoking people more often, and also at women who accept oral contraceptives with high doses of estrogen.
Pain can be shown because of high sensitivity of a human body to some dishes. Rather often attacks of migraine arise after alcohol acceptance. Also sharp fluctuation of weather conditions, strong physical tension, long sleeplessness can cause migraine. At some patients attacks develop after inhalation of smells which irritate respiratory tracts of the person. Also psychological injuries contribute to emergence of pain. Migraine at women is sometimes shown as a result of hormonal fluctuations throughout a menstrual cycle. Very important factor is heredity. At the same time chances to ache with migraine increase at the person whose both parents suffered from this illness.
If the person suffers from migraine, symptoms of this disease first of all, are expressed by very severe headaches which mainly arise in one half of the head. In certain cases at migraine of the patient also suffers from nausea and vomiting, and also acute sensitivity to sounds and light. At such symptoms the person has no stroke, a tumor of a brain, a head injury. Developing of a headache at migraine does not depend on jumps of arterial pressure, the increased intracranial pressure.
This disease is carried to illnesses of vascular type. Initially walls of blood vessels which provide food of a brain of the person extend. These vessels begin to press on nervous cells which are located near them, and migraine as a result is shown. Symptoms of this disease, according to medical supervision, are familiar to about 11% of the population. Most often women suffer from this unpleasant illness. It is accepted to allocate two types of migraine: classical form of a disease and general form. The course of migraine with aura heavier, than displays of migraine without aura.
At a classical form of migraine several hours prior to an attack of the patient feels changes in the general state: the mood changes, covers irritability, concern, drowsiness and fatigue. Manifestation of high sensitivity to a smell, light, noise is possible.
Further at classical migraine from which about 10% of patients suffer the aura provalyatsya. During this period of harbingers focal neurologic symptoms which can proceed no more than one hour take place. The aura can be shown differently at different people. So, some patients note vision disorder symptoms before a migraine attack: before eyes "goosebumps", a veil, periodic bright splashes can appear. Other patients note noticeable disturbances of sense of smell. Sometimes the aura is shown by disturbance of the speech, hearing, correctness of movements. A variety of manifestations of aura is defined by what sites of a brain are subject to blood circulation disturbance. The third period which comes after aura – painful. The pulsing headache covers frontal and orbital and temporal area.
Duration of such attacks can make from several hours to three days. Initially pain is shown in one part of the head then it begins to accrue gradually. Less often at migraine pains from two sides of the head are shown. In development of an attack pain at migraine can find accurate localization in an eye, a temple, an ear, a forehead, sometimes even in a shoulder or a neck. Its intensity can be so high that it seems to the patient that pain covers all body completely. In development of an attack of migraine at the person vomiting, a diarrhea, dizziness, too frequent urination, a fever is often shown. On that side of the head where there was pain, dacryagogue is observed, hypostases of paraorbital fabrics are possible. The temporal artery bulks up and pulses.
Sometimes at migraine there are pronounced vegetative crises at which at the patient extremities grow dumb, the strong fever, heartbeat is felt, to it does not gasp. Jumps of arterial pressure are possible. In development of an attack of migraine the alarm can be shown that does an attack Bol + e heavy. Too sharp sounds and bright light strengthen pain.
At a permission stage pain calms down gradually, vomiting stops, the person falls into a condition of a deep sleep. When the attack recedes, the patient stays in a condition of a starvation, both intellectual, and physical. Therefore following a stage – recovery – several days sometimes proceed. During this period at the patient the feeling of fatigue, a small appetite, gradual normalization of hearing, sight, sense of smell is noted.
Such attacks can arise periodically at the person suffering from migraine for many years. At different people their character can cardinally differ.
At the general form of migraine the aura is not shown: the patient at once feels development of an attack of migraine. This form of a disease is considered the most eurysynusic. Symptoms of the general form of migraine are similar described above. However in this case the person often has so-called refractory periods at which after an attack very long time repeated displays of migraine do not come. In such time the patient considers that he is completely healthy. Often during research at the most part of such patients the neurangiosis syndrome is defined. More often at the same time the person is inclined to arterial hypotonia. Besides, patients with migraine have tendency to manifestation of emotional lability, alarming depressions.
Diagnosis of migraine
At manifestations of the symptoms similar to symptoms of migraine, the patient independently the diagnosis should not attribute itself "migraine" at all. For establishment of such diagnosis it is necessary to pass comprehensive inspection at the specialist. The doctor, first of all, carries out a detailed survey of the patient, finding out whether the following features of a headache take place: the pulsing character, localization of one party, strengthening of pain at an exercise stress. Existence at least of one of the accompanying symptoms allows to suspect migraine at the patient at a headache: vomitings, nausea, sacred and shumoboyazn, duration of an attack from 4 to 72 hours. If similar attacks at the patient more than five were observed, the doctor can suspect migraine. At diagnosis of migraine studying of the hereditary anamnesis of the patient is important.
In the course of diagnosis researches for an exception of symptoms of an organic illness are conducted. Migraine should be differentiated, first of all, from a headache at vascular diseases of a brain. So, it is necessary to exclude a neurangiosis, an idiopathic hypertensia, vasculites, hemorrhagic and ischemic strokes with the small centers, etc. Vvazhno to conduct researches for an exception of existence of tumors and infectious damages of a brain and covers.
Migraine needs to be differentiated from a number of primary forms of cephalalgias: cluster headache, incidental pain of tension, chronic paroxysmal hemicrany.
In the course of diagnosis it is necessary to consider also the fact that migraine at children is shown without acute pain and is followed only by benign paroxysmal dizziness.
Treatment of migraine
At treatment of migraine of the most effective there will be a therapy which is carried out at the very beginning of development of a disease that is on phases which precede painful. As drug treatment of migraine the funds allocated for stopping of an attack, and also abortal treatment which prevents manifestation of migrenozny paroxysms are applied.
As migraine medicine which warns attacks use beta-blockers, blockers of calcium channels, and also drugs-antidespressanty.
The migraine medicine stopping a migrenozny paroxysm are three different groups of medicamentous means. It is aspirin and combinations of aspirin with caffeine; triptanes (serotonin receptor agonists) and drugs which contain ergotamine. The important condition of effective treatment consists in that the patient took medicine surely in the beginning of an attack. In certain cases individually attending physician in addition can appoint tranquilizers and dehydrating means.
If at the patient the migraine attack develops, it needs to provide at once a condition of absolute rest and a bed rest. For this purpose sources of noise and bright light are eliminated. There is also a number of medicines against migraine which can be accepted both in the form of tablets, and in the form of candles already in development of an attack of pain. However such means have many contraindications, and efficiency of these drugs can be shown not at all patients.
If at the patient severe vomiting, perhaps additional use of antiemetics is observed. In this case apply cerucal or motilium.
Widespread methods of treatment of migraine are also some non-drug techniques. Often the acupuncture is for this purpose used. In this case cardinally different approach to treatment between attacks of migraine and in the period of a paroxysm is used. Besides, the psychotherapy, a psychomotor relaxation, manual therapy is applied to the prevention of attacks of migraine. At migraine often appoint physiotherapeutic treatment, apply a girudoterapiya, treatment by means of massage sessions.
It is important to consider that all drugs which are used for treatment of migraine and for prevention of emergence of attacks of illness should be accepted only after appointment of the doctor. Independent treatment of migraine is inadmissible. Among a number of drugs which are used for stopping of attacks of migraine it is necessary to pick up that means which will suit the specific patient. Those drugs which help one patient can even increase intensity of an attack at other patient.
Prevention of migraine
As the preventive measures directed to reducing the frequency of emergence and duration of attacks of migraine some methods allowing to improve quality of human life are used. The most important task is elimination of those factors which provoke emergence of attacks of migraine. Therefore, it is important to provide regular food with absence in a diet of the products provoking manifestation of attacks of migraine. Chocolate, cheese, caffeine, alcohol, smoked products concern to those. Exercise stresses have to be moderate, it is impossible to allow a strong overstrain.
As measures of prevention it is recommended to women who suffer from menstrual migraine to take migraine medicine three days before expected monthly.
As measures of prevention the healthy lifestyle, reasonable alternation of work and rest is important as much as possible. To the people inclined to migraine, it is important to be as much as possible on fresh and clean air.
Section: Diseases of vessels