Today, there’s more
hope than ever for a headache free life. Thank to treatments and life style
changes, many migraine sufferers are enjoying more days without pain.
According to Pam
Santamaria, MD, a neurologist at the Nebraska Medical Center, today the
treatment options are greater than they were several years ago, and there aren’t
reasons for people to suffer.
The American Academy of
Neurology, last year published new guidelines on the prevention of episodic
migraines, identifying nearly a dozen effective medications and complementary
treatments.
Experts also have a
deeper understanding of what triggers migraines and how to find faster relief,
because treating a migraine quickly helps medications work better.
First at all, we should identify the different form of
migraine:
v Migraine headache:
Nearly of 30 million Americans suffer from these headaches, which strike three
times more women than men. The pain may interfere with daily activities. It could
appear on 15 or more days a month for at least three months. Pain characterized
by throbbing or pulsating, usually on one side of
head. It may intensify during physical exertion. Escort symptoms can be
appetite loss, nausea or vomiting and/or sensitivity to light, sound, odors or
touch; the pain last anywhere from 4 to 72 hours, sometime even longer. The trigger
may be certain food, hormonal changes, weather and/or stress.
v Tension Headache:
It cause mild to moderate band-like pain, are the most common cause. They may
come and go over a prolonged period, but they don’t usually interfere with
daily life. Pain characterized by a band or vice like sensation in your head or
neck. The dull, aching pain usually takes hold in your forehead, temples or the
back of your neck and/or head. Both sides of your head are affected. The pain
last from 30 minutes to 7 days. It is related with stress, anxiety, fatigue or
anger.
v Sinus headache:
These are often caused by a sinus infection. Sinus related pain and tenderness,
as well as a deep, dull ache that can worsen with head movements. Nasal discharge,
ear fullness and facial swelling, plus fever are accompanied symptoms. In these
cases the trigger may be a sinus infection, allergic reaction or tumor.
v Cluster headache:
One of the least common types of headache, these are almost always one side. Intense
burning or piercing sensation, the pain may be localized behind one of eyes and
may radiate to your forehead, temple, nose, cheek or upper gum. The eyelid on affected
side may become swollen or droop, the nostril may become congested, and you may
experience facial flushing and excessive sweating. The headache are most likely
to occur in the spring or fall.
Treatment:
Preventive:
Antiepileptic (divalproex
sodium, sodium valproate, topiramate) stabilizes nerve cell in the brain,
making them less easily activated.
Antidepressants (amitriptyline,
venlafaxine) increase levels of the brain chemical serotonin, which helps calm
the nervous system.
Beta-blocker
(metoprolol, propranolol, timolol) blocks the release of stress hormones like
epinephrine and adrenaline, which can trigger migraine.
Nonsteroidal
anti-inflammatory drug (fenoprofen, ibuprofen, ketoprofen, naproxen) relieves
inflammation and pain. These medications (NSAID) are often prescribed on a
short-term basis to women with menstrual migraines and patient who are
suffering from other types of pain, such as back and/or neck.
Onabotulinum toxin A (a
purified organic product, for chronic migraine only) quiets hyperactive nerve
cells and blocks the release of inflammatory chemicals involved in migraine
pain.
Triptan (frovatriptan
for short-term prevention of menstrual migraine) prevents nerves on the surface
of the brain from transmitting pain signals.
Acute:
Antinausea
(metoclopramide, prochlorperazine) relieves nausea and migraine pain.
Dihydroergotamine (DHE)
blocks pain, reduces inflammation and shrinks swollen blood vessels
NSAID (acetaminophen,
diclofenac, ibuprofen, naproxen) relieves inflammation and pain.
Triptan/NSAID
combination (sumatriptan and naproxen sodium) relieves inflammation, block pain
and shrinks swollen blood vessels.
Triptan (almotriptan,
frovatriptan, naratriptan, sumatriptan) prevents nerves on surface of the brain
from transmitting pain signals.
Conquering chronic
migraines usually requires a combination of medication and lifestyle changes,
such as getting enough shut-eye, limiting caffeine intake to more than 200 mg (10
ounces of coffee) and monitoring use of pain medications.
Bibliography Consulted:
Escamilla, C. (2007).
Cefaleas. In Cliniguia actualizacion de diagnostico y terapeutica (pp.
684-692). Spain: Eviscience.
National Headache
Foundation. (2013). Migraine .
Palma Lopez, L., Diez
Bermudez, A., Perez Ruiz, D., & Andres Celda, R. (2010). Cefaleas. In M.
Vazquez Lima, & J. Casal Codesino, Guia de Actuacion en Urgencias
(pp. 159-169). Spain: Ofelgama,s.l.
