Migraine is a serious condition that can disrupt a person's usual life. It most often manifests with an aura and is accompanied by intense headaches. What else is important to know about migraines, how to recognize them, and who is at risk, explained Irina Tsoi, a candidate of medical sciences and neurologist.
Migraine is a fairly common issue that neurologists encounter in outpatient settings. Accurate diagnosis of this condition is a complex and responsible process. It should be noted that a correctly established diagnosis accounts for 90% of the success in treatment.
Women suffer from migraines twice as often as men, who are also familiar with this problem. This is related to hormonal background characteristics. The peak incidence is usually observed around the age of 30. In 40% of migraine patients, the condition is severe. The basis of migraine pain is neurogenic inflammation and secondary persistent vasodilation. There is also a hereditary predisposition to migraines.
How is the diagnosis made?
Neurologists typically rely on the following main criteria for diagnosing “migraine”:
Unilateral pain (may switch sides).
Pulsating nature of the pain.
Moderate or high intensity of pain.
Worsening of pain with physical activity (e.g., running, bending, or climbing stairs).
If such symptoms appear, it is advisable not to delay a visit to the doctor — it is better to undergo an examination and start treatment as soon as possible.
What can trigger a migraine?
Triggers that can provoke a migraine include:
food factors (hunger, dehydration, alcohol, food additives, chocolate, cheese, nuts, citrus fruits, etc.);
hormonal changes (menstruation, pregnancy, menopause);
environmental factors (bright light, odors, altitude, weather changes, air travel);
physical exertion (exercise, sex);
psychogenic factors (stress, anxiety, depression, fatigue);
sleep disturbances (lack or excess of sleep).
Chronic migraine is becoming an increasingly relevant problem due to the rising incidence among the working population and often leads to disability.
The primary task of a neurologist is to prevent the disease from transitioning to a chronic form by reducing the frequency and intensity of attacks. Modern medicine has made significant progress in treating migraines based on scientific data about the mechanisms of attack development.
What treatment methods are available?
For many years, in addition to the traditional approach (taking triptans and analgesics), specific migraine therapy using monoclonal antibodies targeting CGRP receptors has been actively applied. Research has shown that CGRP is released during a migraine attack, highlighting the importance of this therapy in preventing attacks. Thus, monoclonal antibodies have become a full-fledged alternative to medications used for migraine prevention.
When discussing modern methods for treating chronic migraines, one cannot overlook the effectiveness of therapy with botulinum toxin type A. The therapeutic properties of this drug were discovered accidentally over 20 years ago. Plastic surgeon William Binder, while injecting into the forehead and glabellar area to smooth wrinkles, noticed significant improvement in women with migraines. This discovery prompted the study of the mechanisms of action of botulinum toxin type A. Ten major double-blind placebo-controlled studies have been conducted, resulting in the approval of botulinum toxin type A for the treatment of chronic migraines in 2011 with a level of evidence A. Currently, botulinum therapy is conducted according to the PREEMPT paradigm, based on clinical research confirming the efficacy and safety of botulinum toxin type A in treating chronic migraines.
There are also non-drug methods for preventing migraines, such as mindfulness therapy aimed at increasing the patient's awareness and concentration on current events, as well as acupuncture, cognitive-behavioral therapy, and many other approaches.
Modern treatment and prevention methods significantly improve the quality of life for people suffering from migraines.
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