migraine

Migraine: Description, Forms, Symptoms, Causes

Migraine: description, forms, symptoms, causes

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In migraines, those affected suffer from mostly unilateral (on one side of the head) (Source), often very severe headache attacks (Source). They are often accompanied by nausea, sensitivity to light, and other neurological symptoms (Source). The causes of migraine or cephalalgia have not yet been clearly established (Source). Among other things, a disturbance of the messenger substances in the brain is suspected (Source), combined with reduced blood circulation (Source). Read here which forms of migraine there are, how they manifest themselves and how they can be treated.

ICD codes for this condition are G43 and R51

migraine

Migraine: a short overview

  • Description: recurrent, severe, mostly unilateral headache attacks
  • Shapes: Migraine with and without aura, chronic migraine, migraine sans migraine, vestibular migraine, a hemiplegic migraine, basilar migraine, migraine of the eyes, menstrual migraine
  • Symptoms: Attack-like, mostly unilateral headaches, perception disorders as heralds (aura), nausea, vomiting, sensitivity to light and noise
  • Causes: genetic predisposition, the exact mechanism is not yet clarified (Source), hypotheses: disturbed messenger metabolism in the brain (Source) and reduced blood flow (Source)
  • Trigger: stress, certain foods, lack of sleep, weather changes, hormone fluctuations
  • Diagnosis: on the basis of typical symptoms, exclusion of other diseases by imaging procedures (CT, MRT, angiography), EEG, laboratory values, etc.
  • Treatment: both preventive and acute medication, avoidance of triggers, stress reduction, neurofeedback, behavioral therapy
  • Prognosis: not curable, intensity and frequency of seizures can be reduced, often improves with age, sometimes disappears after menopause

Description

People who suffer from migraines experience repeated headaches at irregular intervals. They are often accompanied by various other symptoms such as nausea, vomiting, or visual disturbances. Usually, the pain only affects one side of the head. It is described by those affected as pulsating, hammering or drilling. With physical exertion, it becomes worse.

A severe migraine can severely restrict the daily life of those affected. The duration of a single attack is between 4 and 72 hours. The attacks occur at different intervals. The duration and intensity can vary from time to time.

The most severe manifestation of the disease is the so-called status migranosus. Doctors speak of it when a seizure lasts longer than 72 hours. This is enormously stressful for those affected and requires medical treatment.

Overall, experts differentiate between various forms of migraine. These include:

  • Migraine without aura
  • Migraine with aura (Migraine accompagnée)
  • Migraine sans migraine (aura without headache)
  • Vestibular Migraine
  • Hemiplegic migraine
  • Basilar migraine
  • Migraine of the eyes
  • Menstrual Migraine
  • Chronic migraine
  • Abdominal migraine

Migraine without aura

Migraine without aura is the most common form of migraine. Typical are attack-like, unilateral headaches of medium to severe intensity. The pulsating pain is intensified by physical activity and is accompanied by nausea but also sensitivity to light and noise. The headache attacks last up to 72 hours.

Migraine with aura (Migraine accompagnée)

About 30 percent of migraine patients experience certain neurological symptoms before the headache phase. Physicians refer to these symptoms collectively as an aura. This form of migraine is also called migraine accompagnée (from French accompagner = to accompany).

Typical aura symptoms are

  • Visual disturbances (flashes of light, flickering, seeing jagged lines),
  • Language difficulties,
  • Skin sensations
  • Fake
  • Indisposition

In most cases, these symptoms last for about half an hour to an hour and then disappear completely. The cause is probably a temporarily reduced blood supply to certain areas of the brain, which is caused by a vascular spasm.

Aura or stroke?

For medical laypersons, the symptoms that occur during the aura phase are hardly distinguishable from those of a stroke. However, an important feature of the aura is that the symptoms start rather insidiously and slowly increase in intensity. In contrast, a stroke usually occurs very suddenly.

In a hospital, however, computer tomography (CT) or magnetic resonance imaging (MRI) can be used to determine exactly whether a stroke or migraine symptoms are involved.

Migraine infarction

A complication of migraine with aura is the so-called migraine infarction. In this case the aura symptoms last for more than 60 minutes. This can lead to a very pronounced reduced blood flow in certain parts of the brain, which can cause permanent damage (ischemic infarction). The reduced blood flow can be made visible with imaging techniques such as CT or MRI.

Migralepsie

Another complication of migraine with aura is the so-called migralepsis. This is an epileptic seizure that occurs during or within one hour of migraine aura.

Aura without headache 

Usually the aura symptoms precede the headaches and do not last longer than about 40 minutes. However, an aura can also occur on its own, without a headache phase following. This is often called “eye migraine” or simply “migraine without a headache” 

Of those who suffer from a “classic” migraine with aura, about ten percent occasionally develop aura without a subsequent headache. This form of migraine is difficult to treat. In principle, it should be clarified particularly thoroughly, as the same symptoms can also be harbingers of a stroke.

Vestibular migraine

In vestibular migraine, the vestibular system is mainly affected by migraines. The patients suffer from dizziness and impaired balance. Headaches are usually also noticeable, but the attack-like disturbances of the vestibular system are in the foreground.

According to experts, vestibular migraine is widespread. It causes similar symptoms to the inner ear disease Meniere’s disease, with which it is sometimes confused.

Hemiplegic migraine

A hemiplegic migraine (also called “complicated migraine”) is a subtype of migraine with aura. It is very rare and most commonly occurs in families.

In addition to the symptoms of migraine accompagnée, patients with hemiplegic migraine also have restricted mobility. For example, they can move certain limbs only with difficulty, not purposefully or not at all. However, these symptoms disappear again after about an hour. Hemiplegic migraine is mainly associated with genetic defects on the 1st, 2nd, and 19th chromosomes.

Basilar migraine

Basilar migraine (basilar migraine or migraine of the basilar type) is also considered a subtype of migraine with aura. It occurs mainly in young adults. The headache is typically located at the back of the head (occipital).

Basilar migraine is named after the basilar artery, which supplies blood to the brain stem and cerebellum. Doctors assume that this artery temporarily cramps in basilar migraine. Then not enough blood reaches the area of the brain that supplies it. Depending on the region affected, typical symptoms of failure occur. These include, for example:

  • Speech disorder (dysarthria)
  • Movement coordination disorders (ataxia)
  • Hearing loss, tinnitus or dizziness
  • Visual disturbances such as double images or visual field failures (black spots in the visual field)
  • Disturbed consciousness
  • mutual sensitive sensations (paresthesia)

Locked-in syndrome (LiS)

In very rare cases, basilar migraine may be accompanied by a temporary locked-in syndrome (LiS). Although the person is fully conscious, he or she is no longer able to move or communicate with the environment. Locked-in syndrome due to basilar migraine can last from two minutes to half an hour.

Migraine of the eyes

There are two forms of migraine of the eyes: retinal and ophthalmoplegic migraine.

Retinal migraine: Retinal migraine is a very rare special form of migraine that mainly affects children and adolescents. About one hour before the headache, retinal migraine begins with visual disturbances such as flickering before the eyes, loss of visual field (scotoma), or temporary blindness. All symptoms are exclusively unilateral and disappear when the headache phase begins.

Opthalmoplegic migraine: This is also an extremely rare form of the disease and affects both eyes. Vision problems are also the most important symptom of ophthalmological migraine.

For both forms, experts discuss whether they are actually forms of migraine. Some researchers believe that they are more a reflection of other diseases.

Menstrual migraine

By a menstrual migraine, doctors understand a migraine that occurs exclusively in connection with menstruation: It occurs between about two days before and two days after menstruation.

A menstrual migraine shows the same symptoms as a “normal” migraine. However, the symptoms are often more intense and last longer. Menstrual migraines can also occur with or without aura or motor difficulties. About seven percent of all women who suffer from migraines have menstrual migraines. The cause is probably the sharp drop in estrogen levels just before menstruation.

Hormonally induced migraine

In some women, migraine attacks often occur in connection with menstruation, but also in other phases of the cycle. This is called menstrual-associated migraine or hormone-related migraine.

Chronic migraine

Migraine usually only occurs for a few hours or days, with symptom-free intervals in between. In chronic migraine, patients suffer from migraine attacks for more than 15 days a month for more than three months. Patients also have symptoms between attacks.

A migraine without aura is more likely to become chronic than migraine with aura. It should not be confused with painkiller-induced headaches. In the latter case, pain medication taken too frequently causes the headache.

Abdominal migraine

A special form of migraine is an abdominal migraine. It mainly affects children. In abdominal migraine, a dull pain occurs around the navel area. Headaches, however, are usually absent. Loss of appetite, paleness, nausea, and vomiting can be added to this. An attack of abdominal migraine can last from one hour to several days.

The causes of abdominal migraines are not yet fully understood. However, it is possible that classic migraine with headache and abdominal migraine have similar causes. The most important thing for affected children is that they can rest and relax. Abdominal migraine is rarely treated with medication. Children with abdominal migraines have an increased risk of developing classic migraine headaches in adulthood.

Migraine in children

In children, migraine headaches often occur on both sides and mainly affect the forehead and temples. The disease is often overlooked for a long time. In many young patients, the symptoms are atypical because the headaches are less pronounced or completely absent. In addition, dizziness, impaired balance, and olfactory sensitivity are significantly more common in children than in adults as accompanying symptoms of migraine.

Instead, children with migraines more often suffer from symptoms such as lethargy, fatigue, paleness, dizziness, abdominal pain, nausea, or vomiting. In addition, small children are not yet able to express their symptoms adequately.

Main Trigger Stress

The trigger of migraines in children is, very often, stress. This can be physical, e.g. due to overtiredness, exhaustion, too little drinking or eating, but also stimulus satiation. Mental stress such as stress at school, conflicts at home, or arguments with classmates also triggers migraine attacks in children.

Treatment Of Migraines In Children

The treatment of migraine in children also differs somewhat from that of adults. The focus here is on non-drug therapy. It often works very well in children. This includes a regular daily routine, learning a relaxation method, or biofeedback.

When supportive medication is needed, children are often prescribed different drugs than adult patients.

You can find detailed information on this topic in the article Migraine in children.

 

Symptoms

The most important migraine symptom is a severe, usually unilateral headache. In addition, there are other complaints such as photophobia or hypersensitivity to sounds. In addition, various neurological deficits (also known as aura) can herald a migraine.

Migraine symptoms in four phases

A migraine can be divided into up to four different stages with different symptoms. They can manifest themselves to different degrees in each stage. Not everyone affected goes through all phases. The four stages are:

  • Preliminary phase (prodromal stage)
  • Aura phase
  • Headache phase
  • Recovery phase

Symptoms in the migraine preliminary phase (prodromal phase)

In about one-third of migraine patients, migraine signs are announced hours to days before the actual attack by various symptoms. These include

  • Irritability
  • Euphoria
  • severe mood swings
  • Digestive problems
  • Attacks of ravenous appetite or loss of appetite
  • Difficulties with reading and writing
  • noticeably frequent yawning

Migraine symptoms in the aura phase

The symptoms in the aura phase indicate that a migraine attack is approaching. These include

Blurred vision

 The most common aura symptom is blurred vision. These are usually single flashes of light or zigzag lines in the visual field, so-called fortifications. It is assumed that such visual disorders are said to have influenced the style of Vincent van Gogh, who probably suffered from migraine with aura.

Visual field failure (negative scotoma)

In addition, visual field failures can occur, so-called negative scotomas. This manifests itself as a black or grey spot in the middle of the field of vision. Here, a part of the image is “missing”. In rare cases, the affected person may even go completely blind in one eye at times.

Optical hallucinations (positive scotoma)

With a positive scotoma, however, structures are seen that are actually not there. This type of visual disturbance occurs mainly in children with migraines. They then see bright colors or fantastic figures, for example. 

Tingling and paralysis

 In addition to visual disturbances, tingling in arms and legs and paralysis in the aura phase can also occur. Those affected often think of a stroke. In fact, without further examination, it is difficult, even for a doctor, to distinguish these aura symptoms from those of a stroke. Also potentially suspected of having a stroke are complaints such as impaired balance and speech disorders. A brain scan (MRT) will then provide information.

Migraine symptoms in the headache phase

The duration of cephalalgia headaches varies between a few hours and up to three days. The period can vary from attack to attack.

Severe, unilateral headache

 The main symptom of this condition is the recurrent, often severe headache. In two-thirds of those affected, it occurs on one side only. It manifests itself individually in different regions of the head, but usually behind the forehead, temples, or behind the eyes. Those affected often describe it as pulsating, piercing, or hammering. The intensity of the headache typically increases slowly over the course of hours. In the case of a stroke or cerebral hemorrhage, on the other hand, the pain would occur suddenly.

Nausea and vomiting

 Common side effects of migraines are nausea and vomiting. Scientists suspect that the reason for this is the disturbed serotonin balance in many of those affected. Serotonin is a messenger substance (transmitter) in the body, which acts in the brain as well as in the gastrointestinal tract and in many other areas of the body.

Sensitivity to light and noise

During an acute migraine attack, many sufferers are extremely sensitive to loud noises or bright light. How this phenomenon occurs has not yet been clarified with certainty. In any case, those affected should avoid corresponding stimuli during an acute attack. It often relieves the symptoms if the patients withdraw to a quiet and preferably darkened room.

Intensified by exertion

Migraine symptoms can be aggravated by physical exertion, which is not the case with tension headaches. Even with moderate exercises such as climbing stairs or carrying shopping bags, cephalalgia headaches, and discomfort increase.

Migraine symptoms in the regression phase

In the regression phase, the migraine symptoms gradually subside. Those affected feel tired, exhausted, and irritable. Concentration problems, weakness, and loss of appetite can continue for hours after the attack. In rare cases, patients experience a kind of euphoria after this attack. A further 12 to 24 hours may pass before complete recovery.

Stroke or aura?

A characteristic feature of migraine symptoms of an aura is that the symptoms of failure are usually dynamic. This means, for example, that the scotoma moves through the field of vision (the black spot always moves to other places). The tingling in the arm, for example, can also move from the shoulder down to the fingertips.

In addition, such symptoms gradually increase in cephalalgia. In the case of a stroke, they usually start suddenly. Migraine symptoms of the aura are also temporary and, unlike a stroke, do not leave permanent damage.

 

Take migraine symptoms seriously

Basically, if you have frequent migraine symptoms, you should consult your doctor for clarification. He can recommend effective measures for the treatment and prevention of this condition. In some cases, however, supposed symptoms also turn out to be symptoms of other diseases such as a malformation of the blood vessels (aneurysm) or a tumor. These must be treated early on!

Causes Of Migraine

There is still no clear answer to the question “How does migraine develop? Various factors are discussed as the cause. However, it is probably not a single factor alone that is decisive, but rather several factors interact.

Physicians suspect a malfunction in the messenger substance balance in the brain, combined with circulatory disorders. Genetic factors also play a role. Certain trigger factors such as red wine, stress, or lack of sleep can trigger an attack.

Causes of migraine: Disturbances in the serotonin balance

The messenger substance serotonin seems to play a central role in migraine. This neurotransmitter conveys information from nerve cell to nerve cell or to organs. The effect of serotonin on an attack is complex and not yet fully understood.

One theory assumes that serotonin has at least two different sites of action in the body. There is the central serotonin level acting in the brain. But it also acts outside the brain (peripheral serotonin level).

Too much serotonin in the brain, too little in the body

In migraine, the balance between the serotonin level in the body (peripheral serotonin) and that in the brain (central serotonin) shifts. The combination of a low serotonin level in the periphery and a high serotonin level in the brain can trigger an attack, according to some researchers. For example, too high a serotonin level in the brain could cause the brain vessels to contract.

This coincides with observations that scientists have made with a special imaging method, the SPECT examination. This allows the blood flow in the brain vessels to be made visible.

Circulatory disorder in the brain

During an aura, some areas of the brain are demonstrably less well supplied with blood – the brain vessels in these areas are constricted. Gradually, even more blood vessels can become constricted and lead to a local circulatory disorder in the brain. The conclusion suggests that the high serotonin level may be the reason for the local vasoconstriction.

Oversupply Of Blood Is Not A Cause

In the past, it was thought that in response to the narrowed vessels in the aura phase, certain areas of the ear would suddenly become oversupplied with blood. This is believed to trigger the headache. This can happen, but it is not the cause of this condition. In most patients of this disease, the reduced blood supply to brain areas is not only evident during the aura phase, but also in the headache phase.

Other messenger substances as possible causes of migraine

In addition to serotonin, other messenger substances could play an important role, for example, neurokinin A (NKA), substance P (SP), or calcitonin gene-related peptides (CGRP). However, the exact role of these messengers in migraine has not yet been clarified.

Causes of migraine: Genes

Studies have shown that this condition is more common in certain families. Numerous genetic variants have been found that increase the risk thereof. Some are involved in the regulation of neurological circuits in the brain, others are associated with the development of oxidative stress. The exact biological mechanisms by which they act have not yet been clarified.

A special form of hemiplegic migraine (FMH)

In a rare special form of migraine, Familial Hemiplegic Migraine (FMH), a genetic change has been found on chromosome 19. Children of affected persons have a 50 percent risk of also carrying the genetic change in their genome.

In FMH, recurrent attacks with aura occur from about the age of 20. A typical symptom is a temporary hemiplegia, which accompanies the attacks.

 

Migraine triggers

The exact causes of migraines have not been clarified in detail to date. However, various triggers are now known. Such trigger factors can trigger an attack in people who might have a genetic predisposition to this condition.

Which of these are in the individual case is individually different. Typical triggers of an attack include, for example

  • Stress
  • Changes in the sleep-wake rhythm
  • Sensory overload
  • Weather change
  • certain foodstuffs and luxury foods
  • Hormone fluctuations

Migraine Trigger: Stress

A frequent trigger for cephalalgia is stress in private or professional life. For example, a change of job conflicts with colleagues or in the family, and high time pressure can trigger an attack. For schoolchildren, excessive demands at school and conflicts with other pupils are frequent triggers too.

Migraine triggers: Disturbed sleep-wake rhythm

A shift in the sleep-wake rhythm also causes a stress reaction in the body and can become a trigger. People working in shifts or long-distance travelers, for example, are affected, where the “inner clock” gets out of balance due to the time change.

Even after a very restless night, the risk of an attack is increased. However, it is individually different from what a person experiences as stress. One should, therefore, try to identify one’s individual “stressors” in order to avoid them as far as possible.

Migraine triggers: stimulus satiation

An attack can also occur during stimulus satiation. For example, when people with cephalalgia work at home while watching their child and the television is on, the brain is often unable to clearly separate these many impressions. This ultimately also triggers a stress reaction in the body. The brain is overstrained and reacts with cephalalgia.

Weather as A Trigger 

Even when the weather changes, many patients experience an increase in attacks. Even a change in temperature of just ten degrees upwards or downwards can turn into “migraine weather”, i.e. increase the frequency of attacks. An increase in humidity is also considered a trigger.

However, people react differently to changes in the weather. So there is no single “migraine weather” that causes headaches in all patients. Many affected people complain of symptoms of this condition when the air is muggy and warm during thunderstorms or when there is a strong storm or hairdryer. Even very bright light on a cloudless day can trigger an attack.

Cephalalgia attacks are less frequent in winter than in summer. The reason is probably that the weather situation in our latitudes is usually rather stable in winter but often change in summer.

Some people also get cephalalgia when they travel to a country with a tropical climate. The change in climate and the strain of the trip can trigger an attack. However, people usually get used to the changing climate within a few days, and the symptoms subside as quickly as they came.

Migraine triggers: Food and drink

Certain foods and beverages can also trigger a cephalalgia. This applies among other things to:

  • Citrus fruits
  • Alcohol
  • Nicotine
  • tyramine containing food (bananas, chocolate, red wine)

Tyramine and also histamine are degradation products of protein building blocks (amino acids) and are called biogenic amines. Among other things, tyramine stimulates the release of the messenger substance norepinephrine. This has a strong vasoconstrictive effect – even locally in the brain. This could be the reason for a migraine attack after the consumption of tyramine-containing food.

Cephalalgia attacks often start even if one has eaten too little (“hypoglycemia”).

Migraine triggers: Hormone fluctuations

It has been known for some time that sex hormones have a strong influence on cephalalgia attacks. For example, in childhood, girls and boys are still affected by this condition about equally often. With puberty, however, the ratio shifts. Women then suffer from this disease three times as often as men.

Cephalalgia attacks occur remarkably often during menstruation. The symptoms often improve with the intake of hormones. Such a menstrual cephalalgia clearly loses the intensity and frequency of attacks with menopause.

According to researchers, a falling blood level of the female sex hormone estrogen (also known as oestradiol) is probably the main reason for this. However, it is not yet clear exactly how the falling estrogen level ultimately triggers a cephalalgia attack.

However, a cephalalgia attack during menstruation could also be the result of a stress reaction of the body due to pain and mental tension.

Contraceptive Pills As The Cause For Migraine

With most hormonal contraceptives, women take one pill for 21 days and then take a seven-day pill break. During this break, the levels of female sex hormones in the blood fall rapidly. A hormone withdrawal bleeding begins. This can trigger a cephalalgia attack. Continued use of the pill can then reduce the frequency of such attacks.

Migraine diary unmasks trigger factors

To find out your personal trigger factors, you should keep a cephalalgia diary. Sometimes a pattern can be seen in these entries, for example, that cephalalgias tend to occur after a long working day or after eating certain foods. You can then try to avoid these triggers. You should document the following things in your daily notes:

  • Time of day, duration and severity of the headache
  • Was the headache preceded by an aura, or did you sense the beginning of the headache in some other way?
  • Did nausea, photophobia or visual disturbances occur simultaneously?
  • Did you have any other accompanying symptoms?
  • What did you eat before the seizure?
  • Did you make any physical exertion or did you feel stressed before?
  • Did you have your menstruation or do you take hormones?
  • What medicine did you take and in what doses? Did this medicine help?
  • What events preceded the attack?
  • Do the attacks occur more often in connection with your period?

Diagnosis Of Migraine

If you suspect that you are suffering from cephalalgia, your family doctor is the first port of call. He may refer you to a neurologist or a doctor who specializes in headaches.

Taking a medical history (anamnesis)

The doctor will first ask you about your current symptoms and any previous illnesses. It is important that you describe your symptoms and their course in detail. The doctor may ask you questions such as:

  • Where exactly do you feel the pain?
  • What does the pain feel like?
  • Does physical exertion make the headache worse?
  • Does the pain occur after certain events (lack of sleep, alcohol consumption, during menstruation, etc.)?
  • Did or do other members of your family also suffer from headaches on a regular basis?
  • Are you taking any medication, for example for headaches or for other reasons? If so, which ones?

If you keep a calendar for some time before you see your doctor, you will be particularly good at answering his questions.

Medication-induced headache

Especially the question about taking medication should be answered precisely. Sometimes headaches are the result of taking medication too often or for too long. Doctors speak of a drug-induced headache. It can be caused by taking too many painkillers (analgesics), but also by taking other drugs such as nitrate-containing drugs or calcium antagonists for a long time.

Physical and neurological examination

The medical history interview is followed by a physical examination. During this, the doctor will check the function of your nervous system externally. For example, he will test the sensitivity of your skin or muscle strength. He will also check whether your sense of balance is normal and whether there are any abnormalities in your eyes. Signs of this are, for example, a changed pupil reaction or a movement disorder of the eye muscles.

Normally, this neurological examination is completely inconspicuous outside of an acute seizure. If the doctor finds neurological abnormalities, however, this is more likely to be an indication of cephalalgia and possibly another cause of the headache.

Distinguishing Migraine From Other Conditions 

It is particularly important to distinguish cephalalgia from other types of headaches and other disorders, as these must be treated differently. Symptoms similar to cephalalgia occur, for example, in tension headache and cluster headache. The doctor must also rule out disorders such as tumors, inflammation, or injuries in the head area. This usually requires imaging procedures such as computer tomography (CT) or magnetic resonance imaging (MRI) of the head. For example, an MRI is useful if:

  • the neurological examination has so far been inconspicuous
  • cephalalgia occurs for the first time after the age of 40
  • the frequency and/or intensity of seizures increases continuously
  • in short intervals, many auras (especially with psychological abnormalities) occur
  • the accompanying symptoms of cephalalgia suddenly change

 

Electroencephalography (EEG), Doppler sonography

Electroencephalography (EEG) – a measurement of electrical brain activity – and a special ultrasound examination of the blood vessels supplying the brain (Doppler sonography) are also frequently performed to rule out other diseases.

Laboratory examinations

Before treatment with medication, blood values should also be used to check whether the kidney and liver are healthy. It may be necessary to adjust the drug dose if organ function is impaired.

Treatment

Even if a cephalalgia cannot be cured, the frequency and intensity of pain attacks can be significantly reduced through an adequate treatment

Preventive measures

A combination of different preventive measures can if applied consistently, more than halve the frequency of attacks. Their intensity can also be significantly reduced. Possibilities for this are

  • Avoidance of trigger factors
  • Behavioral therapy (discarding stressful thought patterns such as negative thoughts and performance thinking that generate stress)
  • Neurofeedback, in which patients learn to actively create certain states of relaxation in their heads. This works by using electrodes to transmit brain waves to a computer program that converts them into images.
  • Stress reduction
  • Endurance sports
  • Learning a relaxation technique, e.g. progressive muscle relaxation.
  • In more severe cases, preventive drugs are prescribed, especially beta-blockers, flunarizine, valproate, and topiramate

Measures in acute cases

Medicines are the main remedy for an acute cephalalgia attack.

  • against the pain: painkillers from the class of non-steroidal anti-inflammatory drugs (NSAIDs) such as acetylsalicylic acid (ASA), paracetamol, ibuprofen, diclofenac, metamizole, and naproxen
  • for severe migraine: triptans
  • against nausea: antiemetics
  • In addition, rest in a darkened room often helps.

The text tells you how you can prevent and treat cephalalgia: What helps against it.

Prognosis And Course Of the Disease

Migraine is the most common form of headache after tension headaches. Researchers estimate that 12 to 14 percent of all women and about 8 percent of all men suffer from this condition. Children can also get the disease. In 5 out of 100 children, it occurs before puberty. However, this type of headache usually occurs in the 35 to 45-year-old age group. cephalalgia is a chronic disease. Its exact causes are not yet known. Therefore only the symptoms can be treated.

Considerable strain

Severe cephalalgia attacks can be extremely stressful for those affected and considerably restrict their everyday life. Some are even completely incapacitated for several days. However, the intensity and frequency of the attacks can be favorably influenced by adequate treatment and the right lifestyle.

In a few cases, the attacks increase despite the preventive use of medication. This is usually the result of too frequent use of painkillers, including cephalalgia medications such as triptans.

Weakening with increasing age

In some people, the frequency of seizures decreases after the age of 40 without any apparent cause. However, while the severity of the headache decreases, the intensity of the symptoms often increases.

In women who suffer from menstrual or hormone-related cephalalgia, the seizures largely stop after the menopause. In general, however, you should be aware that they can occur again and again.

 

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