General Medicine

Physicians will look at family medical history and check the patient for the symptoms described above in order to diagnose migraine. The International Headache Society recommends the "5, 4, 3, 2, 1

criteria" to diagnose migraines without aura. This stands for: 5 or more attacks 4 hours to 3 days in duration At least 2 of unilateral location, pulsating quality, moderate to severe pain, aggravation by or avoidance of routine physical activity At least 1 additional symptom such as nausea, vomiting, sensitivity to light, sensitivity to sound. Tests such as electroencephalography (EEG), computed tomography (CT), magnetic resonance imaging(MRI), and spinal tap may also be performed that check for: Bleeding within the skull Blood clot within the membrane that covers the brain STROKE Dilated blood vessel in the brain Too much or too little cerebrospinal fluid Inflammation of the membranes of the brain or spinal cord Nasal sinus blockage Postictal headache (after stroke or seizure) Tumors How is migraine treated and prevented? SOME LIFESTYLE ALTERATIONS CAN HELP REDUCE MIGRAINE HEADACHES.. These include: getting enough sleep reducing stress drinking plenty of water avoiding certain foods regular physical exercise Migraine treatment (abortive therapies) and prevention (prophylactic therapies) focus on avoiding triggers, controlling symptoms, and taking medicines. Medications Over-the-counter medications such as naproxen, ibuprofen, acetaminophen (paracetamol), and other analgesics like EXEDRIN (aspirin with caffeine) are often the first abortive therapies to eliminate the headache or substantially reduce pain. Anti-emetics may also be employed to control symptoms such as nausea and vomiting. Serotonin agonists such as sumatriptan may also be prescribed for severe migraines or for migraines that are not responding to the over-the-counter medications. Similarly, some selective serotonin reuptake inhibitors (SSRIs) – anti-depressants such as tricyclics - are prescribed to reduce migraine symptoms although they are not approved in all countries for this purpose. Another class of abortive treatments are called ergots, which are usually effective if administered at the first sign of migraine. Other drugs have also been used to treat migraine such as combinations of barbituates, paracetamol or aspirin, and caffeine (Fioricet or Fiorinal) and combinations of acetaminophen, dichloralphenazone, and isometheptene (Amidrine, Duadrin, and Midrin). If vomiting makes drugs difficult to ingest, anti-emetics will be prescribed. Prophylactic therapies (prevention) Migraine prevention begins with avoiding things that trigger the condition. The main goals of prophylactic therapies are to reduce the frequency, painfulness, and duration of migraine headaches and to increase the effectiveness of abortive therapies. There are several categories of preventive migraine medicine, ranging from diet changes and exercise to prescription drugs. Some of these include: Prescriptionbeta blockers, anticonvulsants, and antidepressants Botulinum toxin A (Botox) Herbs and vitamins such as butterbur, cannabis, coenzyme Q10, feverfew, magnesium citrate, riboflavin, B12, melatonin Surgery that severs corrugator supercilii muscle and zygomaticotemporal nerve in the brain Spinal cord stimulator implantation Hyperbaric oxygen therapy Vision correction Exercise, sleep, sexual activity Visualization and self-hypnosis Chiropractic care or acupuncture Special diets such as gluten free It is possible for people to get medication overuse headache (MOH), or rebound headache, when taking too many medications in an attempt to prevent migraine. Recent developments on migraine headaches from MNT news Migraine can alter long term structure of the brain.- researchers from the University of Copenhagen in Denmark reported in the journal Neurology that migraines can alter the long-term structure of the brain, and may well cause brain lesions. The scientists looked at MRI brain scans from six population-based studies of people with migraines with and without aura, who were compared to controls (people without migraines). They found that sufferers of migraines with aura had a 68% higher risk of white matter brain lesions, and those with migraines but without aura a 34% higher risk, compared to the controls. Patients with migraines with aura were much more likely to have disruptions in the blood flow to the brain (infarct-like brain abnormalities). When to go to the ER According to Agency for Healthcare Research and Quality 4, part of the US Department of Health and Human Services, if your migraine symptoms become too severe and none of the treatments are working, you may choose to go to the ER (emergency room). If you decide to go to the ER do not drive there, get someone else to take you. The signs and symptoms of migraine can sometimes be confused with those of a stroke. Go straight to hospital if: Your headache is very severe. You have problems with movement, balance, vision or speech, and these symptoms are different or new from those you have experienced before with your migraines. You have a fever with your headache. You have a stiff neck with your headache. Courtesy: Medical News Today