Migraine: definition and treatment

The migraine or migraine is one of the headaches ( headaches) more frequent in the population without a doubt, the strongest impact, both on the patient and the suffering and social and work scope.

affects approximately 12% of the population, with a preference for female and generally working age, leading to a major economic impact and quality of life.

types of migraine more frequent are migraine without aura, migraine with aura or without aura with mixture of the two.

Usually migraine causes severe pain on one side of the head (though not always) with characteristics of“hammering or pounding”. It is accompanied by nausea, vomiting, especially in light and noise sensitivity, which requires the patient to lie down in a dark, quiet room, interfering activities. Sometimes pain precedes or accompanies visual disturbances ( light flashes, spots, decreased visual acuity, etc.),&ldquo sensations, numbness” or loss of strength in the face or extremities, dizziness and even language disorders, which are known by the name of migraine aura. They are usually transient, disappearing in less than 60 minutes due to electrical and circulatory disturbances affecting certain areas of the brain, due to migraine.

The origin of migraine is in the Nervous System, due to a genetically determined abnormal response of certain nuclei of the brain to various stimuli. These can be internal, such as hormonal changes, or environmental, starting a cascade of events involving changes in chemical substances called“neurotransmitters&rdquo ;, finally going to induce alterations in the blood vessels with dilated and inflammation of the wall thereof, thus generating the pain and associated symptoms.

At the beginning the pain should avoid taking alcohol, stress and physical or intellectual efforts. It is convenient to relax in a quiet, dark place, take an anti-inflammatory or triptan early on ( if possible in the first hour of onset) and try to sleep. The dream has a beneficial effect on migraine.

We can not act on the genetic predisposition of the person suffering from migraine, but in any case you can prevent and treat pain, if this occurs, so getting it appropriately.

There preventive treatments that try to reduce the frequency and severity of crises, when they are frequent or severe and prolonged. The most used drugs are called beta-blockers (propranolol, nadolol ), calcium antagonists ( flunarizine ), neuromodulators ( topiramate, sodium valproate) and some antidepressants ( amitriptyline).

Special mention deserves the call chronic migraine, where the pain manifests least 15 days a month for more than 3 months. Many patients suffer daily and represents a serious problem for the sufferer, both suffering from the pain and lost workdays or quality of life and leisure. In these cases, the indicated pericranial and cervical infiltration of botulinum toxin A (Botox ).

In crises used drugs for alleviating or eliminating pain when it starts. It is important to use the appropriate drug as pain intensity, at an early stage and take effective doses. The drugs most commonly used for moderate pain are nonsteroidal anti-inflammatory drugs (NSAIDs ), the most useful being ibuprofen, naproxen, or diclofenac Dexketoprofen, among other. In case of severe pain, the recommended drugs are called triptans, selective and more effective than previous. When the pain is accompanied by vomiting, it is advisable to supply the medicines through inhalers or injectable to ensure its absorption.

We must emphasize the importance of limit the use of analgesic, antiinflammatory and triptans to avoid the call analgesic overuse headache, and excessive consumption leads to chronicity of pain and poorer response to preventive treatment. In general you should not use painkillers, anti-inflammatory or triptans, over 8-10 days per month.