Migraine is a type of headache that can start at any age, decrease in frequency with advancing age, and tend to be persistent or recurrent. Migraine, which can be seen in one out of every 20 men and one in every 5 women, ranks second on the list of diseases that limit people's work force. Although migraine can have a childhood onset, it usually begins in adolescence. In more than 80% of patients, the onset of attacks occurs before the age of 30. Between the ages of 35 and 39, there is a decrease in the incidence of migraine.
There are two main types of migraine: migraine with aura and migraine without aura. Aura refers to a set of symptoms that some people experience before the onset of a migraine attack. These symptoms can include visual disturbances such as seeing flashing lights or zigzag lines, as well as other sensory symptoms like tingling or numbness in the face or hands. Not all people with migraines experience an aura, but for those who do, it can be a warning sign that a migraine attack is imminent.
Causes of Migraines
Migraine symptoms cause mood changes such as irritability, depression, and unhappiness. Rarely, it can turn into a disease that causes pain every day, which we call a chronic daily headache. Since this condition affects the quality of life very negatively, it should be treated immediately. Some of the symptoms of migraine pain can be listed as follows;
- Severe headache
- Hypersensitivity and reactivity
- Excessive and unnecessary cheerfulness
- Stagnation and dullness
- Slowing of thoughts
- Increased appetite or loss of appetite
- Hypersensitivity to smell
- Hypersensitivity to light
- Difficulty finding words while speaking
The reasons listed above vary from person to person. Although these reasons are triggered by different types of migraine, they can have symptoms in different diseases. Therefore, if the diagnosis of migraine or any of the migraine types has not been made, it is necessary to consult a specialist.
Triggers of Migraine
There are many factors that can trigger migraine attacks, including:
Migraine attacks become easier due to hormonal changes experienced by women. Estrogen fluctuations can trigger headaches for many women. Women with a history of migraine headaches may experience premenstrual or postmenstrual headaches when there is a decrease in estrogen levels. Pregnancy or the period of menopause can cause migraines as well as change the course of existing migraine attacks.
- Hormone medications such as oral contraceptives (birth control pills) and hormone replacement therapy can also worsen the course of migraines.
- Some foodstuffs, such as processed meats, stale cheese, and salty and processed foods, can trigger migraines. It is known that the sweetener aspartame and the preservative monosodium glutamate found in many foods can trigger migraines.
- For example, a change in the eating pattern—skipping meals or overeating—can also facilitate the occurrence of a migraine attack.
- Beverages; Alcohol, especially wine and high-caffeine drinks, can trigger migraines.
- Stress plays an important role in migraine attacks. Stress at work or in home life may be the cause of frequent migraine attacks.
- Loud noises, bright lights, or exposure to sunlight can trigger a migraine attack. Some types of fragrances and some odors, including perfume, thinner, and cigarette smoke, can trigger a migraine attack.
- Changes in sleep and wakefulness patterns are also known triggers of migraine. Conditions such as insomnia, excessive sleep, deterioration in sleep quality, and jet lag can cause migraine attacks to become more frequent or occur.
- Migraine attacks may occur with sexual activity or intense physical exertion.
- Medicines called vasodilators, such as nitroglycerin or oral contraceptives (birth control pills), can worsen migraines.
- Wind, storms, extremely bright sunlight, high humidity, and high pressure are the main known meteorological triggers.
- Weather changes can trigger migraine attacks. It is stated by migraine patients that migraine attacks become more frequent, especially in cold weather.
What Is Good For Migraine Pain?
It is not easy to be protected from meteorological and hormonal triggers. Rain, wind, variable air pressure, and sunlight may be unavoidable. For this reason, some of the methods that migraine patients can apply to prevent migraine attacks or to have migraine attacks more easily are as follows:
- Keeping a pain diary so that you can determine under what conditions the pain is triggered
- Eating healthy, avoiding prolonged starvation
- drinking lots of water.
- do regular exercise
- Regular and adequate sleep, if possible, of 7-9 hours per night for adults
- Avoiding stressful situations
- Wearing a hat and glasses if exposed to sunlight
- Not to delay the recommendations and treatments created by the physician for migraine.
Sometimes, pain may develop when more than one trigger, not a single trigger, overlaps. For example, a windy day, prolonged hunger, and high stress levels increase the likelihood of having a migraine attack.
If the pain becomes more frequent, a neurologist should be consulted for treatment. Long and intense use of painkillers may lose their effect in preventing pain, and may cause deterioration of health, especially in the stomach and kidneys.
Undesirable Consequences That Migraine Can Cause
Trying to control migraine pain on their own without physician control can sometimes cause different problems.
Stomach and intestinal diseases: Some high-dose or long-term painkillers can cause stomach or intestinal diseases, especially abdominal pain, bleeding, gastritis, and ulcers.
Headache as a result of drug overuse: Taking high-dose prescription or over-the-counter drugs more than ten days a month in the last three months can cause severe, never-ending, and persistent drug-overuse headaches. Medication-overuse Headaches occur when drugs lose their pain-relieving properties and begin to cause headaches themselves. This vicious cycle may require the use of more painkillers. However, this will not relieve the pain, but will only cause the headache to become more chronic.
Serotonin syndrome: Serotonin syndrome is a rare but potentially life-threatening exposure of the body to excess serotonin. Care should be taken in terms of serotonin syndrome, and drugs should be used under the supervision of a physician.
Chronic migraine: migraine attacks can become chronic. It is recommended that people who have had 15 or more painful days a month in the last three months consult a neurologist in terms of chronic migraine.
Migraine status: A migraine attack can last from 4 to 72 hours if untreated or inadequately treated. Severe migraine attacks lasting longer than three days are called "migraine status".
Persistent aura without infarction: Temporary neurological disorders, usually called auras, go away after the headache begins. However, sometimes the aura persists after the pain has resolved and may last for more than a week. In the case of persistent aura, the brain must be imaged radiologically with an MRI, and it must be confirmed that there is no tissue damage or any other problem in the brain.
Migraineous infarct (cerebral vascular occlusion): In cases of aura lasting longer than one hour, it is recommended to consult a neurologist in terms of possible cerebral vascular occlusion. Your doctor may order brain imaging to rule out possible cerebral vascular occlusion or bleeding.
Patients can get rid of migraine attacks with a correct diagnosis and appropriate treatment planning. In the treatment of migraine, if the pain is infrequent after the diagnosis, crisis treatment is planned to relieve pain attacks. Preventive treatment should be applied when attacks occur 1-2 times a week or more.
In the treatment of migraine, pain attacks can disappear or their frequency and severity can be reduced by eliminating the factors that trigger migraine (such as hunger, insomnia, and hormone use). Likewise, the drugs used under expert control are also very important in the treatment of migraine. A pain-free life for years can be achieved with medications taken only once a day under the control of a doctor.
For effective headache treatment, medications and changing the daily routine are very important. If you do not plan your daily life according to migraines, only using migraine drugs will not be beneficial.
Be sure to pay attention to these issues in your daily life;
- Keeping a headache calendar or headache diary
- Not sleeping too little or too much
- Do regular exercise
- Learning ways to cope with stress
- Reach an appropriate weight
- Avoiding alcohol
Migraine medications: Although using medication in the treatment of migraine is one of the first preventive methods that comes to mind, it should be taken with the advice of a specialist doctor. The right migraine medications can end migraine attacks. If you have nausea accompanying your migraine pain, it may be beneficial to use drugs that prevent nausea and migraine pain together. However, migraine medication should not be used without the advice of a spouse or friend. A migraine medicine that is good for your friend may not be good for you.
If you are using migraine medication, the first thing you should pay attention to is that you should always have the medication with you. It is useful to use migraine medication as soon as you understand the symptoms of an attack. The sooner it is taken, the more effective it will be. In the same way, using migraine medication 2-3 days a week will develop tolerance in the body after a while, so it begins to become the cause of your migraine pain. This can make migraine treatment more difficult.
If migraine drugs do not work and attacks progress very often and severely, you should try "preventive treatment." Medications taken during preventive treatment are different from pain relievers and are more aimed at raising the migraine threshold.
"Botox" treatment against migraine: Another approach in migraine treatment is botox, which is used to eliminate facial wrinkles. The realization that the headaches of migraine patients who had Botox were reduced, paved the way for the use of botox in the treatment of migraine. Studies have shown that botox application is effective in the treatment of chronic migraine, defined as a migraine headache occurring 15 or more days a month for more than 3 months. This effect is thought to be due to botox's ability to prevent inflammatory pain by inhibiting the release of certain neurotransmitters at nerve endings.
Botox is used in the treatment of migraines. It is applied to the forehead, temples, nape, and neck area. Botox, which is applied only to the face for cosmetic purposes, is applied by subcutaneous botulinum toxin injection to certain points in the forehead, temples, nape, and neck regions, unlike in migraine treatment. In most cases, the effect of the applications will last for about 3–4 months, so they need to be repeated for the continuation of the treatment. Botox treatment for migraines should be applied by a neurologist to be reliable.
Migraine vaccine (migraine shot): Migraine vaccine, also known as migraine shot, is one of the most prominent methods in the treatment of migraine in recent years. It has been determined that the molecule called CGRP in the body is effective in the formation of migraine pain and attacks. In chronic migraine and migraine with aura, it is aimed at preventing attacks with the migraine vaccine, which is based on the injection of antibodies developed against the pain-causing substance called CGRP into the body.
Neuraltherapy: Discovered during the treatment of a patient with migraine in 1926, neuraltherapy treatment is a method applied around the world and in Turkey since 2008. Neural therapy is a needle treatment with short-acting local anesthetics. It is based on the reorganization of the autonomic nervous system. It has almost no complications and can be applied to all age groups, including pregnant women. Neural therapy and a holistic approach have increased the chance of success in migraine treatment. Depending on the degree of migraine, neural therapy can be supported by combined treatments such as trigger point injections, manual therapy, ganglion blockades, medication, and chelation.