A migraine headache(1) is a type of vascular throbbing headache. it is brought on by Vassodillation. In it release of chemicals from nerve fibers occurs which coil throughout the large arteries of brain. Sympathetic nervous system is usually triggered by migraine episodes, which controls responses that cause pain and strees. The oral medicine which can be taken up to treat migraine headaces, their impaired absorption is a primary reason for the ineffectivness of medications. Migraine has influenced 28 lack Us citizens, and among them females are troubled more frequently(17%)than guys(6%). Nausea, vomiting, diarrhae, facial pallor, wintry hands and chilly legs and sensitivity to light comonly will be the symptoms of migraine headaches. A typical strike will last b/w 4-72 time. It is estimated that 20% of migraine headaches are associated with an aura(3). Some migraines are associated with neurological dysfunction they are some complicated migraines(4). When symptoms are obvious then migraine headaches are diagnosed. Migraine headaches normally start in early days. Additionally, it may take place in a person beyond the age 50, advancing ages make other types of head pain. Migraine(5) is often remained under diagnosed and under treated. Migraine headache is incurable until now.
- A migraine pain is a type of vascular pain.
- A typical assault can last b/w 4-72 time.
- Migraine attacks switch on the sympethetic anxious system of the body.
INTRODUCTION
Migraine headache is a kind of vascular headache. It is triggered by vassodillation. In it release of substance from nerve fibers(8) occurs, which coil throughout the large arteries of brain. These large sized blood vessels stretch out the nerves that coil across the blood vessels and cause the nerves release a chemicals.
These chemicals cause irritation, pain and more large size of the arteries. (9)
Which cause more serious pain. Sympathetic stressed system is usually activated by migraine attacks(10), which handles responses that distress and stress. A great many other symptoms are also induced by this activation, including the increased activity of sympethetic anxious system in the intestine triggers nausea, vomiting and diarrhea.
The oral drugs which are taken to treat migraine headaces, their impaired absorption is a primary reason behind the ineffectivness of medicines. Ciculation of bloodstream is also reduced due to increased activity of sympathetic nervous system and that leads to chilly hands and foot and pallor of the skin.
The increased activity of sympethetic stressed system activity also triggers the sensitivity of light and sound (11) as well as blurry vissions.
Migraine has affected 28 lack Us citizens, and included in this females are suffering more often (17%) than males (6%). Anyhow migraine is basically under diagnosed and under cured till now.
SYMPTOMS
Most migraine attacks are correlated with head pain. (12)
- sometime the pain is usually in the forehead, near the vision, or at the trunk aspect of head
- Pain is usually using one side of head and sometime it is on the both edges of head
- The one side headache usually differ from one side to some other, in case there is the same aspect headache it should alert the physician to consider a sec. headache caused by a brain tumor.
- It is usually increased by daily activities such as walking upstairs
- Nausea, vomiting, diarrhae, cosmetic pallor, cold side and cold legs and sensitivity to light commonly will be the symptoms of migraines.
A migraine victim usually would like to sit in loneliness
A typical episode continues b/w 4-72 time.
The symptoms may also involve
- sleeping
- irritability(13)
- fatigue(14)
- depression(15)
- yawing(16)
MIGRAINE TRIGGERS
It is one factor associated with environment or physiological conditions which lead to head pain in those folks who are prone to migraine headaches. Just a few migraine sufferers, can plainly identify these triggers. Examples include:
- Stress
- Sleep disturbances
- Fasting
- Hormones
- bright or flickering lights
- Odors,
- Cigarette smoke
- Alcohol
- Aged cheeses
- Chocolate
- Monosodium glutamate
- Nitrites
- Aspartame and caffeine
In some women, the reduction in the amount of estrogen through the onset of puberty is a lead to for migraines which is referred to as menstrual migraine headaches.
Migraine and Feminine hormones
Some women have problems with migraine headaches around enough time with their menstrual cycles. And some other women suffer from migraines only at the time of menstrual cycle. "Menstrual migraine" is a term whish can be used mainly to describe migraines that happen in those women who've all their head pain before two days and nights and after 1 day of these menstrual cycles. Lowering degrees of estrogen at the starting point of menses is the key cause of menstrual migraine headaches.
MIGRAINE AURA
It is believed that 20% of migraines are associated with an aura, frequently the aura causes the head pain, even though sometimes it could occur at exactly the same time with the throbbing headache.
The most frequent auras are;
- Flashing, bright lighting in zigzag structure, starting in the centre and moving outward,
- A gap in the visual field which is actually a blind area.
Some old migraine anguish patients may practice only the visible aura, minus the throbbing headache. A less common aura contains pins-and-needle experience in the hand and on the arm and also around oral cavity and near nasal area.
Other types of auras include aural abnormalities and irregular likes and smell.
Approximately after a day of migraine problems the sufferer may feel lack of energy and may practice a low grade headaches.
Retinal or aesthetic migraines are unusual (17) types of attacks and are seen as a repetitive cases of sightlessness on one side lasting 1 hour that can be linked with headache.
SOME VARIANTS OF HEADACHE
Some migraines are combined with neurological dysfunction these are some complicated migraine headaches. The brain decides the part of the body that is influenced by dysfunction, and it is responsible for headache.
Verterobasilor migraines
These are involved in the dysfunction of the lower brain that regulates the automatic activities like consciousness and sense of balance.
The symptoms include
- fainting as an aura
- giddiness (wooziness in which the environment seems to be rotating)
- double visualization
Hemiplegics migraines
These include paralysis or mistake of one part of the body,
Mimicking a stroke.
The paralysis or mistake is typically momentary, but every once in awhile it can last for many days.
MIGRAINE Throbbing headache DIAGNOSE
When symptoms are clear then migraine headaches are dignosed. Migraine headaches normally initiate in start. (19)Additionally, it may arise in a person beyond this 50, but as the age increases it creates other styles of head pain.
In this a family history is also involved, this disease may be transfered from parents to their children geneticaly.
Patients who have the first pain ever, a substantial change in their chracteristics of headach or an interconnection of the frustration with anxious system symptoms, like visible or hearing or sensory reduction may need extra tests to obtain the diseases apart from migraine.
There are some tests which are used to identify the headaches such as blood tests and scanning that is CT or MRI.
TREATMENT OF MIGRAINES
There are two types of treatment. (20)
- Non-medication treatments for migraine
- Medication for migraine
Non-medication therapy for migraine
The remedy can be considered a precautionary or non medicated therapy that will not entail medication.
a - by using glaciers, biofeedback, and soothing techniques headaches can be ceased.
b - sleeping can be the best medicine.
c - by keeping away from smoking the result of migraine can be minimized.
d - by steering clear of confident foods specially those that are high in thyramine like razor-sharp cheese or those that contain sulfites (wines) or nitrates (nuts, pressed meats) migraine headaches can be halted.
Commonly, a wholesome life-style with healthy diet, an sufficient ingestion of fluids, adequate rest and exercise can be useful therapy. Acupuncture has been advised as a good therapy.
Medication for migraine
Some individuals experiencing migraine generally treat themselves with over-the-counter (OTC) or non prescription pain relievers. Various kinds of OTC analgesics(21) or pain relievers are accessible. They are efficient for brief interval of energy only. When used according to informations on brands.
Two types of analgesics are:
- Acetaminophen(22)
- Non-steroidal anti-inflammatory drugs(NSAIDS)(23)
Acetaminophen
It acts on the pain centers in the mind and reduces pain and fever. It really is well tolerated by the abdomen and normally is known as easier on the tummy than NSAIDS, when it's used large doses additionally, it may damage kidney, and additionally, it may effect liver organ.
NSAIDS
There are two types of NSAIDS
- aspirin
- non aspirin
Ibuprofen and naproxen will be the types of non aspirin NSAIDS. Some NSAIDS are accessible by only prescription. To treat arthritis and other inflammatory conditions prescription NSAIDS are usually approved. The amount of active ingredient in each pill is the key difference between OTC NSAIDS and prescription NSAIDS.
The pain can be relieved by the action of NSAIDS on the inflammation that causes the pain. Although carticosteroids are valuable in infection but when used for long period of time these have very toxic side effects.
Aspirin, aleve, motrin and advil all are NSAIDS and have similar effects in relieving pain and fever.
Their influence on platelets is the primary difference between aspirin and non aspirin NSAIDS, platelets are the small allergens in blood that result in blood clots, and aspirin inhibit the action of platelets. The non aspirin NSAIDS also inhibit the action of platelets but their action is not as long as aspirin.
Precautions when using OTC analgesics
Following safeguards should be observed with OTC analgesics;
- Children and teens should avoid aspirin for the cure of headache due to its dangerous side effects of developing Reye's syndrome that can lead to comma or even loss of life.
- People who are battling with balance disorder should not use aspirin.
- Because of the increased risk of bleeding individuals who are experiencing ulcers of abdominal and duodenoum shouldn't use aspirin and non aspirin NSAIDS.
- People who are battling with liver diseases should also not take aspirin since it may impact the kidney and liver's functions.
OTC and prescription analgesic shouldn't be overused, because their overuse can cause development of tolerance of these analgesics means increasing ineffectiveness of the analgesics.
TREATMENT FOR Average TO SEVERE ATTACK
Specific migraine futile medications are used for the treating moderate to severe attackBecause they not only relief the headache but also terminate the headache.
Examples include Triptans and Ergot preprations.
Triptans
The triptans (24) constricts the arteries and reduce the swelling by attaching to the serotonin receptors which surround the arteries. This aborts the headaches, in past it was used with the name of somatript, the new form of it is zolimtriptan that are available as tablets in market.
Side ramifications of triptans
Facial flushing, tingling of skin area and a sense of tightness around chest and neck are the most common side effects of triptans. Other aspect effects that are not more prevalent are drowsiness, fatigue and dizziness. The best serious side effects are heart attacks and strokes, because these can thin arteries in brain as well as in the heart.
Ergots
The effect of ergots is similar to triptans that terminate migraines. They are in the combined form with caffeine and other pain reliefers. Ergotaminepreprations(ergomar, wigraine, cafergot) and dihydroergotamine preprations(DHE45, Migranal) will be the types of ergots. Ergots constrict the blood vessels which is more dangerous for center.
Midrin
It can be used to terminate migraine and stress causing headaches. It is a mixed product of isometheptene (a blood vessels vessel constrictor), acetaminophen (a pain reliever), and dichloralphenazone (a moderate sedative). It acts more effectively if it is employed early throughout a headache.
PREVENTIONS
There are two ways to avoid migraine headaches, (14)
- By avoiding the headache causing factors
- By preventing problems by taking medicines
PROPHYLACTIC MEDICATIONS FOR MIGRAINE HEADACHES
These are medications which are taken daily to mininmize the period of headaches. When a headache has begun then these are not taken simultaneously. Several types of prophylactic medications are there
- beta blockers
- calcium channel blocker
- tricyclic anti depresants
- anti serotonin agents
- anti convulsants
The doctor should take into account the side effects of the drug, drug-drug relationships and co-existing conditions such as diabetes, heart and soul diseases and high blood circulation pressure while choosing prophylactic medication for a patient.
PROPER WAY TO MAKE USE OF PREVNTIVE MEDICATIONS
- The medications should be recommended by the doctor who is acquainted with treatment.
- Decisions about to take medicines based on their area effects
- Propranolal is used first, but it is not provided to the individuals who have asthma or cardiovascular disease.
- These begin at low doses and steadily increase to raised doses.
CONCLUSIONS
Migraine is often continued to be underdiagnosed and under cured. There is no get rid of for migraine, there are many steps for the better life of migraine sufferers(25). Pharmacists try their finest to invent a new medicine for the remedy of migraine. Individulizing treatment is vital for greater results.
