Migraine is included in the so-called primary headaches, i.e., headaches not caused by other accompanying diseases. A migraine is characterized by a paroxysmal headache, sometimes with additional neurological symptoms. There are many theories about the origins and spread of migraine headaches, and none of them is definitive and clears all doubts.

How common is migraine?

The frequency of migraines in the Polish population is estimated at about 8%, of which 75% are women and 25% men. Migraine may appear at any age (also in children and the elderly), but in almost 90% of patients the first attack of pain occurs before the age of 40. The actual incidence of migraine in Poland may be even higher, as some patients do not see a doctor for this reason.

How is migraine manifested?

Migraine is manifested by recurring, severe headaches. As a rule, the pain covers one side of the head, is throbbing and increases with even slight physical activity. The pain may be accompanied by nausea, sometimes vomiting, and sensitivity to light, sounds or smells.Sometimes migraine pain is immediately preceded by various neurological symptoms known as migraine aura.These symptoms are completely reversible and usually disappear shortly before or at the beginning of the headache. The symptoms of aura include: visual disturbances most often in the form of flickering spots or lines (blurring or deformation of the image is less frequent), numbness of the face or limbs,dizzinessand speech disorders. Rarely, in the course of a migraine aura it results in a temporary, completely reversible weakening of one half of the body.

Dig.Typical headache location in migraine

As a rule, the symptoms of aura last from a few to several minutes, in most cases they disappear after 60 minutes, in exceptional cases they last up to 24 hours.

A migraine attack develops quite quickly (within a dozen or so minutes) and, as a rule, the greatest intensity of pain is achieved during the first two hours of its duration. Migraine pain lasts from 4 to 72 hours, with effective treatment it is shorter.

What to do in the event of migraine symptoms?

Although the first migraine attack in a life can scare a person a lot, migraine is not a life-threatening disease.If you suffer from paroxysmal headaches with the characteristics described above, see your primary care physician. As a rule, migraine does not require urgent medical attention. If, however, the headache is accompanied bydisturbances in consciousnessor consciousness, or increasing paresis of the limbs, an ambulance should be urgently called.

A patient with a diagnosis of migraine should take the painkiller prescribed by a doctor as soon as possible in the event of another headache. The effectiveness of treatment largely depends on the speed of taking the drug and is greatest when theheadachehas not yet reached its maximum intensity.So a person suffering from migraine should not wait, hoping that the headache may “go away”.

How does a doctor make a diagnosis of migraine?

In accordance with the criteria in force in Poland, the diagnosis of migraine is made on the basis of an interview, i.e. headaches with migraine characteristics at least several times. Additional examinations are not necessary for the diagnosis of migraine, although usually brain imaging and possibly EEG examinations are performed to exclude other diseases.

What are the treatments for migraine?

Treatment for migraine can be divided into the acute management of a headache attack and the prophylactic treatment that is expected to reduce the number of migraine attacks.

Emergency treatment

In acute treatment, analgesics (paracetamol, acetylsalicylic acid, non-steroidal anti-inflammatory drugs), ergotamine derivatives or triptans are used. If you develop a migraine headache, take your painkiller as soon as possible. If the patient does not feel better after one type of medication, try a medicine from a different group. Triptans are the treatment of choice for severe migraine headaches. If the headache is accompanied by nausea or vomiting, an emergency treatment with an antiemetic (e.g. metoclopramide) may be necessary, and in the event of severe vomiting, intravenous administration of drugs.

Patients who have frequent headache attacks and require large amounts of pain medication are at risk of developingheadaches from overuse of painkillers. It is a headache that is difficult to treat and makes it very difficult for patients to function. Therefore, every migraine sufferer should monitor the number of painkillers taken each month to prevent the development of drug-induced headache. When migraine attacks are very frequent and / or very troublesome for the patient, prophylactic treatment should be considered.

Prophylactic treatment

Prophylactic treatment for migraine involves taking medications each day to reduce the number of headache attacks. Prophylactic medications do not have an analgesic effect and can be combined with reliever medications. These drugs also do not start working right away and their effect (i.e. reducing the frequency of headaches) can sometimes take several months. Various groups of drugs are used in prophylactic treatment (e.g. cardiological drugs such as propranolol or flunarizine, anti-epileptic drugs such as valproic acid or topiramate, or antidepressants such as amitriptyline). In the case of lack of effectiveness or poor tolerance of one drug, it should be replaced with another drug with a different mechanism of action. Please note

Is it possible to cure migraine completely?

It is not possible to cure a migraine completely, although the frequency of migraine attacks varies greatly between patients (from pain that occurs almost every day to several episodes throughout life).

However, it is not a disease that threatens the patient’s health and life, although it may impair his quality of life. People who suffer from frequent and severe attacks of migraine headache may have a negative impact on professional and social functioning due to migraines.

Complications in migraine are very rare and include the state of migraine (i.e. severe migraine pain lasting more than 72 hours) and migrainestroke, where neurological symptoms of migraine aura (e.g. visual disturbances, sensory disturbances) persist. more than a week and are caused by an ischemic focus in the brain.

What should I do after my migraine treatment is finished?

The frequency of headache attacks varies from person to person and from time to time, but migraine is a lifelong disease.

What to do to avoid getting migraine?

Effective measures to prevent migraines are not known, but many headache triggers are known in migraine patients and, if avoided, reduce the risk of a headache attack. These factors may vary in individual patients, and the most common factors are: emotional stress or, on the contrary, relaxation after stress (so-called weekend/holiday headaches), hormonal changes (e.g. menstruation in women, taking hormonal drugs), some foods ( chocolate, cocoa, alcohol, dairy products, fatty foods), hunger, lack of sleep or too much sleep, fatigue or strenuous physical exertion, rapid changes in weather, staying in the mountains at high altitudes.