health
Suffering from migraines?
These are the treatment options available to you
Over ten percent of the population suffers from migraines, which impair their function and quality of life.
How are they diagnosed, and what are the most effective treatments available today to deal with these pains?
We asked an expert
Tags
Headache
migraine
In collaboration with Madison
Sunday, 11 April 2021, 10:34
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Brain disease is very common.
Woman suffers from migraine (Photo: ShutterStock)
Headaches are a problem that many people suffer from, with varying frequencies and degrees of severity.
When is this pain defined as migraine and how is migraine diagnosed and treated?
"Headaches are usually divided into two types, primary and secondary," explains Prof. Gal Ifergan, director of the Department of Neurology and Chairman of the Division of Brain Medicine at Soroka Medical Center. , Abnormal blood vessels in the brain and the like.
In these cases, the disease is the first and the headache is the second, and therefore secondary. "
"But most people suffer from primary pain - these are people for whom all the tests done will be normal, and the pain itself is the problem."
According to Prof. Ifergan, migraines are a very common type of primary headache.
"Migraine is a very common brain disease in which the brain has a tendency to produce seizures, which we call migraine attacks - their core is usually a headache (with a tendency to unilateral pain of a throbbing nature and moderate-high intensity) and often accompanied by pain, nausea, vomiting and sensitivity to light. "Or a voice. A seizure typically lasts between 4 hours and 72 hours."
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"It is important to understand that suffering from a migraine is a disease," emphasizes Prof. Ifergan. "It does not cause death, but it severely impairs functioning - work, school, family and social functioning, and of course it greatly impairs the quality of life of those who suffer from it."
According to him, people who suffer from migraines are people who have a tendency to develop recurrent bouts of such pain.
The frequency may vary: it can be once every few months, once a month, or once a week, and the extreme condition, he says, is chronic migraine - a condition in which there are at least 15 days of headache a month.
That is, more days with a headache than without it.
Men also suffer from migraines, but less.
Man holding his face (Photo: ShutterStock)
Over ten percent of the population suffers from migraine, making it a very common disease, and it affects men, women and even children.
However, it affects women 3 times more than men.
According to Prof. Ifergan, until puberty, migraines affect boys and girls to a fairly equal extent, but after puberty and the onset of menstruation, this balance is disturbed.
Is the difference between women and men in migraine vulnerability fundamentally hormonal?
According to Prof. Ifergan, the hormonal differences are part of the story - "In general, pain behaves differently in men and women. But it is probably not the only part responsible for the difference. The hormonal cycle greatly affects the frequency and intensity of migraines. To be aggravated around. "
How is migraine diagnosed and treated?
"A diagnosis of migraine is made according to the patient's description of the seizures and their pattern, and on the other hand by ruling out other problems. Sometimes it is enough for the doctor to hear a description of the pain and perform only a clinical examination, and sometimes imaging tests are needed to rule out other causes of pain."
"Treatment of migraines is divided into two channels," explains Prof. Ifergan. "Acute treatment - how to stop an attack while it occurs. And preventive treatment - how to reduce the number of attacks. These are two completely separate channels, and most people with migraines need at least one, if not both. ".
Acute treatment includes - various painkillers and also combination drugs that contain a combination of painkiller with caffeine, for example.
All of these are non-migraine-specific treatments, and alongside them there are also migraine-specific medications - which activate specific receptors for serotonin, which bring about a cessation of the attack or relief.
Sometimes the migraine develops due to overuse of acute medications.
Woman taking pill (Photo: ShutterStock)
Alongside these drugs have in recent years also entered into techniques of non-drug nerve stimulation by instrumentation, which are also intended for cessation of the attack in its early stages.
These techniques work on the pain pathways in the central nervous system and are supposed to alleviate a migraine attack in its early stages - that is, when the pain is not yet very strong.
Today, there are also new devices that, in addition to their effectiveness in reducing pain, also allow control of the intensity of treatment by the patient himself.
For people who suffer from four or more days of migraine a month, Prof. Ifergan recommends that you also use preventive treatments when there are pharmacological and non-pharmacological ones here as well.
"Non-medication includes the identification and prevention of triggers, certain supplements, behavioral techniques, relaxation techniques with / without bio-feedback, exercise, lifestyle changes, etc. Medication prevention includes oral medications taken on a daily basis, or treatment with a relapse. "Muscles are injected with a certain technique that is done once every 3 months at different points on the scalp. Recently, biological preventive treatments have also been introduced that consist of antibodies that work against a small protein that is involved in the mechanism of development of the migraine attack," he explains.
"It is important to note that many times people develop medication overuse headache, which is a condition in which migraine develops due to overuse of acute medications. Using ten days or more of specific migraine medications or combination medications, or using 15 days or more per month of simple painkillers, is an overuse of painkillers. "Pain and can worsen the frequency of migraines."
According to Prof. Ifergan, in these cases, withdrawal from these drugs also constitutes a type of preventive treatment for migraine, when it is accompanied by overuse of sedatives.
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