If your headache occurs in attacks, this pain is called migraine pain. Migraine attacks can be seen 1-2 times a year in some, and many times in a month in others. It can be said that most of the migraine pains are very severe. Apart from being a severe headache, the most important feature that distinguishes migraine pain from other pains is the nausea, sensitivity to sound and light that occurs with the pain. Migraine sufferers find it difficult to complete their daily work due to these disorders accompanying the headache. However, a long process and specialist doctor control is very important for a complete diagnosis of migraine.
The main symptom of migraine is severe headache. Migraine headaches are so severe that; may affect the performance of a function or render the person incapacitated, forcing bed rest. One of the symptoms of migraine is unilateral headache. These unilateral headaches, which can change sides from time to time, generally tend to one half more than the other. In migraine, the headache is often located in the temples and sometimes in the eye or behind the eye. The forehead, the back of the head, and just behind the ear are the most common places for migraine headaches.
In addition to headache, migraine symptoms such as hypersensitivity-reactivity, depressive mood, excessive and unnecessary cheerfulness, stagnation / dullness, decrease in concentration and attention, slowdown in thought, difficulty in finding words, stuttering while talking, increased light-sound-smell sensitivity, yawning, Desire to sleep, hunger, desire to eat sweets, increased appetite or loss of appetite, excessive water drinking, feeling of bloating, constipation or diarrhea are also frequently observed. During migraine pain, increased sensitivity to light and sound can be so severe that; Exposure to them can increase the severity of pain. Another well-known migraine symptom is an increased sensitivity to smell. For this reason, nausea and vomiting may increase even due to pleasant smells such as perfume.
Another symptom of migraine is "aura". Some neurological symptoms that appear just before a severe headache are called "Aura". It can be visual or sensory. Migraine aura occurs before the onset of pain or during the initial development of pain. It is of a fairly short duration; It usually takes 20 minutes between 10 and 30 minutes.
Visual aura: Patients describe flickering twinkling lights.
Sensory aura: The sensory aura of migraine is in the form of numbness and tingling in the hands and tongue or in the mouth and jaw.
WHAT ARE THE CAUSES OF MIGRAINE?
Genetic factors are at the top of the causes of migraine. If there is a family history of migraine, the probability of having migraine is 40%. A person whose mother and father both have migraines may experience migraine complaints at a rate of 75%. One of the causes of migraine pain is hormonal changes. Therefore, migraine is most common in women. Migraine attacks, which are 3 times more common in women than in men, can increase their severity especially during menstrual periods due to hormonal changes. The increase in severe headache during the menstrual period can also be attributed to migraine. Nausea, vomiting, sensitivity to light and sound may occur. It is usually unilateral, intense and throbbing.
HOW IS MIGRAINE DIAGNOSED?
The first step in the treatment of migraine is the clinical diagnosis of the migraine patient after the complaints are evaluated by the doctor. The past history of people with migraine complaints should be examined, and a personalized treatment plan is drawn up for the cause after the head and neck region examination. During the examination, it is necessary to examine the muscle structures. A trigger point in the neck and back, such as muscle contraction, can also cause unilateral eye and facial pain, starting from the neck.
The patient's water consumption, diet, sleep pattern, stress level, environmental conditions, gastrointestinal system health status should be determined. Because physiological disorders can trigger pain as well as cause pain to be perceived too much. Today, many people experience neck and back pain, and headaches that develop in addition to these are often confused with the diagnosis of migraine. A multidisciplinary approach with neurosurgery, neurology, psychiatry and physical therapy departments is required in migraine disease. Studies show that; In fact, 53 percent of patients suffer from pain due to psychogenic factors or a psychological disorder that develops after the illness. For this reason, it is not the right approach to use the same method for every patient.
Migraine types are very important for proper treatment. In order to evaluate migraine correctly, a specialist doctor should be consulted. The most common type of migraine is migraine without aura. Most people with migraine suffer from migraine without aura. Sometimes, attacks without aura can be seen in those who have migraine with aura, which is another type of migraine.
When certain diseases of the brain are suspected, examinations are performed to exclude them. Brain imaging (brain tomography) should be performed in patients with recurrent headaches and diseases that can mimic migraine should be investigated.
How is migraine treated?
Patients can get rid of migraine attacks with correct diagnosis and appropriate treatment planning. In the treatment of migraine, if the pain is infrequent after the diagnosis of migraine; 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, hormone use). Likewise, the drugs used under expert control are also very important in the treatment of migraine. A pain-free life can be provided for years with medications taken only once a day under the control of a doctor.
For an effective headache treatment, medications and changing the daily life routine are very important. If you do not plan your daily life according to migraine, 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
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 with 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 keep the medication with you. It is useful to use migraine medication as soon as you understand the symptoms of attacks. 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 they begin 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 had decreased, 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, 15 or more days a month for more than 3 months. This effect is thought to be due to Botox preventing inflammatory pain by inhibiting the release of certain neurotransmitters at nerve endings.
Botox in the treatment of migraine; It is applied to the forehead, temples, nape and neck area. Botox, which is applied only on the face for cosmetic purposes, is applied by subcutaneous botulinum toxin injection to certain points in the forehead, temples, nape and neck regions, unlike this in migraine treatment. In most cases, the effect of the applications will last for about 3-4 months, so it needs to be repeated for the continuation of the treatment. Botox treatment for migraine should be applied by a neurologist to be reliable.
Migraine vaccine (migraine shot): Migraine vaccine, also known as migraine shot, is one of the 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 to prevent 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 in the world and in Turkey since 2008. neural therapy; It 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 chances 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.