Migraine - Diagnosis, Prevention and Treatment
60Migraine is felt as an headache, generally unilateral and frequently pulsatile. It changes the pain side with eache crisis. The pain episodes could be as short as a couple hours or as long as 3 days.
Symptoms
It is often associated with nausea, vomiting, excessive light sensitivity/aversion, excessive sound sensitivity or even water intolerance. Usully, two of these symptoms are present. Visual auras occur in about 10% of patients. Mostly of cases are in women eith more than half the patients presenting the symptoms until late 20s. A family history of migraine is present in most cases.
Precipitating Factors
Migraine attacks can be precipitated by certain factors that should be avoided:
- Certain thyramine-rich foods - Some cheeses, meat (hot dogs and bacon), or chocholate.
- Fasting
- Emotions
- Menses
- Drugs (as Nitroglycerin)
- Bright lights
- Sleep excess/deprivation
Treatment
Acute attacks may respond to simple analgesics (aspirin, acetaminophen). If not they usually respond to sumatriptan (Imitrex, Imigran). These drugs must be taken immediately at the onset of symptoms to be maximally effective. A antiemetic - metoclopramide - could be usefull to prevent vomit.
Prevention
Some drugs have proven effective preventing migraine. Preventive medication has to be taken on a daily basis, usually for weeks. Theis side effects should be taken in account while talking to the patient.
- Tryciclic antidepressants - Amitriptyline, Doxepin, etc
- Beta-Blockers - Propanolol (Inderal), Atenolol, Timolol, etc
- Anticonvulsants - Valproic acid
Some herbanl and nutritional supplements had been shown to reduce the number or intensity of migraines, if taked in a regular basis. (Magnesium, Riboflavin, Vitamin B12)
Visual Aura
