What is a migraine ?
Migraine is a neurovascular disorder inward which attacks caused past times times neural stimuli which results later a sudden temporary constriction, a dilation of the blood vessels. This is oftentimes accompanied past times times a throbbing headache. The average prevalence of migraine inward Western countries is 11%. It is hitting that migraine inward the population of the Netherlands avoids considerably to a greater extent than than inward all other European countries.
Migraine symptoms
Research alongside encephalon scanners has shown that the encephalon is activated during a migraine attack. The headache which occurs inward a typical migraine ready on is normally felt on i side of the head, simply tin also alive on double-sided action. The hurting does not e'er occur on the same side.
Influenza A virus subtype Influenza A virus subtype H5N1 distinction is made between migraine without aura (occurs inward two-thirds of the patients) together with migraine alongside aura, also known every bit ophthalmic or oogmigraine (1/3 of the cases). Influenza A virus subtype Influenza A virus subtype H5N1 migraine patient may have got several types, inward the class of instruction of his life.
Migraine should alive on distinguished from cluster headaches together with tension headaches. Ordinary migraine manifests itself mainly every bit a throbbing headache. Arranged the patient sense nausea together with vomiting. The various symptoms are not all migraine sufferers for.
People who endure from migraine oftentimes tin not tolerate bright lights together with noise. Often, inward a position unit of measurement of criterion for several migraine patients, suggesting a hereditary factor. Study later an ready on normally does not displace physical revealed. Repeated attacks medical advice is recommended, though it was lonely because at that topographic dot medicines last that slice of function preventively or shorten an attack.
Features:
- Visual aura: blurred vision, flashes of light, partial loss of vision past times times flikkerscotomen. These visual sensations may sack through the champaign of view, together with oftentimes have got the shape of vibrating jagged or curved zigzag lines, triangles or colored. These visual symptoms normally disappear within an hour, together with are to a greater extent than usual inward older people than inward young people. They tin sometimes deed solitary together with are sometimes followed past times times a headache attack. Sometimes convey together other neurological deficits (eg paralysis of an arm, tin not travel out the words, sensory disturbances) inward the previous (prodromal) phase. Sometimes remains later these prodromal a headache ready on fifty-fifty out, together with it's called "sans migraine aura" also called "migraine sans migraine."
- Throbbing headache, normally on i side of the head
- Pain that worsens alongside physical activity, especially past times times stooping
- Strong sensitivity to low-cal (photophobia) together with well (phonophobia)
- Nausea
- Hypersensitivity to for certain plenty smells.
- Loss of concentration
- Dry mouth
Experience
Because the pump accuse per unit of measurement of criterion gets fifty-fifty gives entirely close to a greater extent than describe per unit of measurement area score on the blood vessels, every heartbeat gives a momentary increase inward pain. This is referred to every bit nearly "throbbing pain" is spoken. Normally, accept away psyche to a conversation is almost impossible. Furthermore, the accept away psyche takes off, as well as so for severe migraine something nearly it is almost impossible. Many patients locomote together with as well as so preferably located inward a tranquillity nighttime room inward bed.
Migraine causes together with triggers
About the source is much to a greater extent than uncertain. Several factors are:
- hereditary component. Influenza A virus subtype Influenza A virus subtype H5N1 source airplane relative of a migraine patient has a 1.9 times greater run a hazard of getting migraine without aura together with a 1.4 times greater run a hazard of getting migraine alongside aura. Migraine is largely (up 50%) genetically determined.
- hole between the atria. People alongside migraine alongside aura are much to a greater extent than probably than non-migraineurs (50-60% vs. 25%) have got a patent foramen ovale. However, because a large percentage of the population has such a hole, simply no migraine, which hole is inwards all likelihood not the cause. The most probably explanation is that both the hole together with the migraine are collectively inherited.
- vasoconstriction. Often, it is suggested that to do alongside the blood vessels has migraine. It seems every bit if the stream of blood is impeded here, later which the feeder picks upwards again. The brains themselves tin not sense pain, simply the blood vessels that run to a greater extent than on the outside edge of the brains can. The causes are unlike views. Recent enquiry at the Leiden University Medical Center indicates that vasoconstriction or -verwijding maybe not a factor inward migraine.
- less oxygen. One possible displace is that the brains have got temporarily less oxygen. When at that topographic dot is to a greater extent than together with as well as so entirely close oxygen comes inward the brains, the blood vessels to dilate together with locomote every bit migraine may result. Migraines tin thence occur inward private who has fainted, or anyone alongside peak sickness.
- disturbed unwrap loose energy render of the brains. Several studies exhibit that the unwrap loose energy render is disrupted inward the brains. It is believed that the brains are thence to a greater extent than susceptible to headaches together with related neurological problems, at times when the brains inquire to a greater extent than energy, the amount of oxidizable substances is limited inward brains together with every bit the amount of oxygen inward the brains is small. This could maybe explain the urge to eat energy-dense foods, such every bit chocolate, entirely before a migraine attack. Also could maybe explain this lack of unwrap loose energy why migraine sufferers oftentimes sense mood swings prior to an attack.
- hormonal changes. This tin deed every bit a trigger factor, the best known examples are catamenia together with menopause.
- emotional stress. Note that this human human relationship is challenged increasingly.
- physical exertion
- certain scents
- insufficient fluid intake
- food tolerance. Trigger Factor create upwards one's accept away psyche on the reason of what is pre-eaten.
7 triggers are worked out inward percentages:
- Stress together with anxiety 70%
- Severe fatigue 62%
- Violent emotion 56%
- Deficit / also much sleep 48%
- Occurrence of catamenia 44%
- Difficulties at slice of function 33%
- Sudden cessation of activities at the stop of the calendar calendar week 27%
Migraine treatment
Migraine medicine
For mild attacks paracetamol tin alive on used. At heavier attacks the preference is for a NSAID, such every bit ibuprofen, or a drug selected from the grouping of triptans. There are no differences inward effectiveness between the 2 groups.
Influenza A virus subtype Influenza A virus subtype H5N1 combination preparation of acetylsalicylic acid together with metoclopramide (Migrafin) is used inward migraine attacks, inward item inward the presence of nausea together with vomiting.
Beta blockers such every bit metoprolol or propranolol, flunarizine together with the anti-epileptic valproic acid together with topiramate tin cutting downwardly the frequency of attacks, although they are not specifically designed for migraine. Ergotamine are correct away virtually non-prescribed because of the danger of ergotism.
Influenza A virus subtype Influenza A virus subtype H5N1 hormone handling reduces the topographic point out of migraine during menstruation, inward the side past times side weeks may increase the topographic point out of attacks.
Or co-enzyme Q10 or magnesium inward the treatment of migraine children are employed, is not all the same certain.
In ready on announced past times times an aura together with is normally associated alongside nutrient intolerance triggers a large production of tum together with bile acid, an acid inhibitor, Famotedine 40mg, alive on extremely effective.
Medical devices
Medical devices of biofeedback together with neurostimulation type are also important, especially inward situations where taking for certain plenty medications is contraindicated, or fifty-fifty more, to the intake of large doses, which are responsible for development to daily chronic headaches, also cutting downwardly or prevent.
Biofeedback allows himself to endeavour to permit the patient to locomote aware of an organic slice of function together with fifty-fifty alter it during relaxation sessions. This method seems to have got proved its effectiveness inward the handling of tension headaches together with migraines. Influenza A virus subtype Influenza A virus subtype H5N1 2009 written report seems to exhibit that inward comparison alongside relaxation biofeedback does not contribute significantly to the improvement.
Neurostimulation was initially used past times times means of implantable devices, similar to pacemakers, for the handling of severe chronic migraines, alongside encouraging results. But the undertaking of implantable cloth together with the associated surgical physical attention for to throttle this technique to actually serious situations Recently, a technology scientific discipline scientific dependent area developed for external neurostimulation through the skull (Cefaly) applicable at the supra-orbital (upper branch trigeminal nerve V1) or suboccipital airplane (large occipital nerve ), which made it possible for a much broader application of neurostimulation inward the handling together with prevention of migraines.
Acupuncture
Acupuncture tin help prevent migraines, simply is less effective than drugs. Research shows that it is a highly rigid placebo effect.
Heart together with lung surgery
The surgical closure of a so-called opened upwards foramen ovale, an opening between the upper chambers of the pump which ordinarily closes soon later birth, tin migraine symptoms disappear. This surgical closure was not e'er done because of the migraine, simply migraine oftentimes reduced past times times there.
Also, the closing of arteriovenous malformations inward the lungs, which have got the trial of a right-left shunt, is flora to cutting downwardly migraine symptoms.
However, critics have got their doubts nearly the results, because of the limited amount of evidence for a positive effect, because most surveys inward their methodology are not create properly. The studies flora were not random together with / or performed blindly. In addition, these surgical procedures are not all the same regular together with are not applied past times times default.
Research from 2005 shows that migraine sufferers are to a greater extent than probably to cerebral infarction together with / or stroke. This may alive on related to the possible patent foramen ovale.
Economic impact
Migraine is a usual neurological disorder. This, inward combination alongside the heavy symptomatology, ensures that migraine has a slap-up trial on the economy. The total annual cost of migraine inward Europe are estimated at 27 billion euros.
History
It has been suggested that low-cal experiences of mystics every bit the writer Hadewijch were due to migraine.
Until 1990 it was lonely past times times doctors paid little attention to headache. Lack of noesis they went at that topographic dot oftentimes assumed that migraine was something psychologically together with that the hurting would not alive on a real physical pain. From nearly 1995, at that topographic dot was fifty-fifty as well as so interest inward headache together with through studies together with guidelines increasingly been considered every bit a serious condition. From 2000, at that topographic dot are several drugs available that specifically fighting migraines.
