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Migraine: symptoms and treatment, signs (aura), how to relieve pain during an attack

This disease has been known since ancient times. It is believed that the procurator of Judea Pontius Pilate, who commanded the crucifixion of Jesus Christ, suffered from migraine. At that time, this disease was called "hemicrania", which means "pain in half of the head."

Of course, such suffering, which has very characteristic complaints, is not infectious, and is characteristic of sufficiently wealthy people (to call not a barber, but a doctor) was described quite early in the literature, and has come down to us unchanged since ancient times.

Half-head pain is not the only, but one of the most characteristic signs of migraine.

Let's say that by “half head” we mean either the left or the right half of it. We are not talking about the "lower" or "upper" half, but only on mirror-symmetrical sides.


Migraine - what is it?


Migraine is a form of primary headache that has a separate coding in the neurological diseases section (G 43). A modern definition says that migraine is a form of a headache with a vascular nature, occurring with characteristic clinical symptoms in the form of pulsating seizures, with or without aura, with the possible presence of nausea or vomiting (see photo).

In this case, the pain is completely reversible, functional, and is not a consequence of a stroke, a volumetric process in the brain or a traumatic lesion of the central nervous system.

Migraine has recently been added to the list of 19 diseases that cause significant socioeconomic losses due to deterioration of working capacity, and also violate the patient's labor adaptation.

About the reasons

The disease is significantly more common in women than in men, and is polyetiological, as there are many causes of migraine. The most famous of them are:

  • Hereditary predisposition, which was proved by the study of identical twins;
  • Stress, physical inactivity, intense mental work in conditions of hypoxia;
  • Physical overstrain;
  • Eating foods containing tyramine (cheese, nuts, chocolate, red wine, beer and champagne);
  • In women, one of the leading factors in the development of migraine is a long-term use of oral hormonal contraceptives;
  • Meteorological dependence in the presence of a change of weather.

Most often, the disease is a manifestation of many of the factors described in their various combinations.

Signs of migraine

Signs of migraine

Migraine headache is distinguished by its nature and associated symptoms. So, the simple form is characterized by the following features:

  • Repeated attacks of headaches, occurring in the form of attacks, from 4 to 72 hours total duration;
  • The pain is localized only to the left or only to the right;
  • The nature of the pain is pulsating, the classic irradiation is in the eyeball;
  • The severity of pain is significant;
  • During exercise, the pain intensifies, which, together with the nature and location, distinguishes it from tension headaches. Therefore, this pain that has arisen during physical exertion may require the cessation of all work, which in some cases in production leads to "rummaging".
  • Migraine symptoms accompany photophobia and phonophobia. This is manifested by photophobia and intolerance not only of loud sounds, but also sounds of medium intensity, which seem loud to the patient. These signs increase with increasing headache. In practice, this is expressed by the fact that the patient has a strong desire to retire, sleep, lie down with his eyes closed in a quiet, dark, and preferably cool room;
  • During an attack, the person's mood changes greatly: the patient becomes depressed, or, conversely, irritable and quick-tempered;
  • Also, there is a special sensitivity to odors (hyperosmia), and even aversion to some of them;
  • When migraine often develops progressive nausea, which is combined with an unbearable headache. Vomiting, as a rule, occurs “at a height” of a headache, and is a quick sign that the pain will subside. Therefore, patients with a long "experience" of migraines perceive vomiting as a sign of rapid relief from suffering;
  • Migraine is a type of headache in which relief is achieved with the help of a tight bandage. Therefore the head bandaged by a suffering aristocrat with a kerchief is a direct indication of a migraine.

Signs of migraines that do not stop within 72 hours are called migraine status. , поскольку такая длительная боль может привести к отеку и набуханию головного мозга, развитию судорожных припадков, или появления очаговой неврологической симптоматики, характерной для ишемического инсульта. This condition requires urgent hospitalization , since such prolonged pain can lead to edema and brain swelling, the development of convulsive seizures, or the appearance of focal neurological symptoms characteristic of ischemic stroke.

Symptoms by type of migraine (photo) - what is an aura?

migraine aura

one of the manifestations of aura photo

Migraine with aura is a slightly more complex disorder than a simple migraine. Aura - these are certain neurological reversible symptoms that build up over a period of time, usually from 5 to 20 minutes, and last in any form for no more than an hour.

As a rule, when an aura occurs, the patient already understands that a migraine attack will follow, and there is time to prepare, or take medicine. Sometimes the aura appears completely out of the blue, and pain appears later.

In some cases, the symptoms of aura in migraine appear on the background of a beginning headache. Morphologically, the aura coincides with the development of insufficient blood circulation in various areas of the brain.

This hypoperfusion of various departments, associated with vasospasm, and manifests itself in the form of symptoms of “stealing” by blood of various structures.

symptoms of aura with migraine photo

symptoms of aura with migraine photo

The typical symptoms of aura , clearly associated with the subsequent headache, include:

  • Visual symptoms (flickering of stripes, spots, "flies" before the eyes, blurring, blurring, the appearance of sparkling "zigzags" and cattle, or temporary loss of sight of the foci and fields);
  • Sensitive disorders in the limbs (feeling of numbness and tingling, feeling of "crawling goosebumps"). These disorders seize one half of the body and extend to the corresponding half of the face;
  • Speech disorders. There are difficulties in the form of speech blurring (dysphasia).

As a rule, visual disturbances appear first, as the most subtle, then sensory sensory and speech disorders appear.

Patients need to know their type of aura, since in some cases it is difficult to distinguish it from a transient ischemic attack, which may itself be a manifestation of a stroke.

Therefore, patients suffering from migraine need to keep a diary, which would reflect the specificity of the signs of aura and the relationship with various environmental factors.

In some cases, patients may have a developed aura, but there is no headache, or be of a minor nature. This type of "headless migraine" is common in men.

More rare types of migraine

In addition to the classic pain and a set of precursors, called an aura, there are atypical forms of migraine, for example:

  • Basilar migraine. Its signs are the aura, which comes from the brain stem: speech disorders, dizziness, tinnitus, double vision, hearing loss, impaired consciousness, as well as bilateral sensory disturbances in the limbs of the paresthesia type;
  • Hemiplegic migraine. This form is very similar to stroke, since there are impairments of movements of the type of motor weakness in the limbs.

It should be added that even before the aura, sometimes a day or two before the migraine attack, there are prodromal symptoms - tension in the neck muscles, impaired concentration, yawning or pale skin, and blurred vision or weakness.

As a rule, then they are replaced by an aura or a classic attack of migraine pain.

Migraine Treatment

Migraine Treatment

The treatment of this disease presents known difficulties, especially the treatment of migraine in women. According to modern data, a predisposition to this type of headache in the beautiful half of humanity is due to the influence of estrogen.

Migraine treatment is reduced to the recognition and timely relief of seizures, the reduction of their frequency of occurrence, reducing the time of seizures.

In the case of a radical cure, the attacks completely disappear, and the patient is not disturbed for a year. However, the main task has always been and remains to relieve an attack.

Sometimes, with a good relationship between the doctor and the patient, the correct treatment tactics, a radical lifestyle change, stopping the attack becomes simply unnecessary, as they become very rare and can disappear altogether.

How to remove a migraine attack?

Most often, migraine is explained by the alternation of vascular spasm with subsequent expansion. If you describe the development of migraine in simple language, then first develops a spasm of cerebral vessels and dura mater, which is asymptomatic. The spasm is triggered by the factors described above.

Then, as a compensatory reaction, the resolution of the spasm occurs, and the over-expansion of the vessels is more usual. This stretching causes a reaction of pain receptors, which leads to the appearance of characteristic pain.

To relieve a migraine attack, it is necessary to increase the vascular tone again or, more simply, to achieve their spasm. This can be done with the help of many drugs: from coffee and brandy to drugs from the class of triptans.

Serious drugs for the relief of an attack come in the form of a nasal spray or rectal suppositories, since continuing vomiting may interfere with the absorption of the drug in the body.

How to treat an easy migraine attack?

treat a migraine attack with medication In that case, if the attack is of low intensity, and the patient's condition is satisfactory, you can use non-drug methods of treatment: an ice bubble or dry heat.

The medications help "light" funds from the group of nonsteroidal anti-inflammatory drugs: from "Analgin" and "Paracetamol" to "Nurofen", "Tempalgin" or "Ketanov", which is the most powerful analgesic.

Of course, when treating an easy migraine attack with these drugs, one should be aware of the dangers to the gastric mucosa, and together with them give omeprazole to reduce the ulcerogenic risk.

How to remove the pain of migraine moderate and severe intensity?

In the event that a patient has a typical attack and nonsteroidal drugs do not help to relieve migraine pain, it is better to take analgesics sold by prescription, containing codeine or caffeine. These drugs include Caffetine, Solpadein, Pentalgin.

If a person has a severe headache, accompanied by nausea and repeated vomiting, then you can use a prescription drug such as "Zaldiar" containing tramadol. This drug is a prescription, but not narcotic, and any doctor can prescribe it.

Also used are triptans, which are introduced as a spray into the corresponding nasal passage on the side of appearance of the headache.

  • From triptans are shown sumatriptan (Imigran). These drugs stop the slowly growing headache better. In tablet form, the drug is produced under the name "Amigrenin", "Sumamigren", as well as in the candlelight - "Triigren".
  • The next generation of triptans (“Namig”, “Zomig”) are characterized by better tolerability.

It is important that taking triptans in any form is necessary only after the headache has begun. Their reception without pain, on the background of the aura is contraindicated. You also can not use them for prevention, because they cause vasospasm, and, conversely, can provoke a migraine attack.

You can also take antiemetic drugs ("TSerukal", "Motilium"). In case of severe vomiting, intramuscular administration of drugs is advisable.

Modern preparations for migraine can also belong to ergot alkaloids. In some cases, antidepressants and anticonvulsants are also used, but for prevention.

Migraine Prevention

Migraine and the problem of "how to relieve pain" is not the only one, but it begins with a long road to recovery. To prevent seizures, completely different drugs are used, which are used between seizures.

These drugs include beta - adrenergic blockers ("Anaprilin", "Obzidan"), anticonvulsants ("Topamax"). But, before you begin to use them, you need to modify all the risk factors that can be changed: body weight, avoiding bad habits, a healthy lifestyle, proper nutrition.

Migraine, the symptoms and treatment of which we have disassembled, refers to functional disorders. But, under certain conditions, it can bring a person to a stroke and swelling of the brain, and severe migraine status can be a cause of death.

Therefore, it is necessary to take timely measures to diagnose and treat this well-known vascular dysfunction in the earliest terms.


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