Migraine – Its Manifestations and Treatment Options

"Migraine is a well-defined chronic disease that manifests itself in repeated attacks of headaches of moderate to severe intensity, throbbing in nature, usually localized on one side of the head, most often behind the eye. It usually lasts between 4 and 72 hours," says MUDr. Markéta Grünermelová, an experienced neurologist at Health+. “It is a complex phenomenon that is sometimes preceded by strange, non-specific sensations called prodromes. They signal to the patient that an attack is likely to develop in the next 24 hours. Prodromes may manifest themselves as feelings of fatigue, malaise, sometimes vague pressure in the head. About 15-18% of patients have a so-called aura, which manifests as blurred vision, dropouts of parts of the visual field, flashes, stars in front of the eyes. Rarer types of aura include unilateral tingling or decreased sensitivity, feelings of numbness, sometimes unilateral impaired mobility, speech impairment where the patient cannot express themselves as they would like, impaired balance or dizziness. Often with increasing pain there is a feeling of nausea, sometimes vomiting, light-headedness, hypersensitivity to noise, smells. Migraine usually makes it impossible to perform normal activities. Between attacks, the patient is quite healthy."

Almost one million people in the Czech Republic suffer from migraine, and it affects women two to three times more often than men. The first attack usually occurs in childhood, with the most intense occurrence between the ages of 25 and 45. The causes of migraine have not yet been fully elucidated by experts, but they assume a certain genetic predisposition. So, what to do if a migraine attack recurs month after month or even week after week? Dr. Grünermelová stresses that the prerequisite for effective treatment is correct diagnosis. According to her, sometimes it is enough to adjust the lifestyle and eliminate the triggers that provoke the attack. These can be, for example, stress at home and at work, changes in pressure, meteorological influences, lack or excess of sleep, smoking, alcohol, fatigue, physical stress and hormonal changes during the menstrual cycle, a drop in blood sugar, etc.

"In most cases, however, medication is unavoidable. So-called acute treatment is aimed at quickly relieving the pain, intervening in an already ongoing attack. For the milder form, as a rule, ordinary analgesics, painkillers are sufficient. However, too frequent use can lead to addiction and the development of chronic daily headaches. For severe attacks, drugs from the group of so-called triptans are effective, which relieve migraine pain but do not relieve pain of other origins. They represent a significant advance in the treatment of acute seizures. Where the number of seizures is higher than 3-4 times a month or where acute treatment is ineffective, we cannot avoid deploying preventive treatment. The aim is to reduce the number and intensity of seizures by at least 50%. For the patient, this means taking medication on a daily basis, which requires patience and some discipline. We have drugs from different groups: beta-blockers, antidepressants, antiepileptics, magnesium-containing drugs and ginkgo biloba extract. We assess the effectiveness of the treatment after two months at the earliest," MUDr. Markéta Grünermelová concludes.

Migraine is a typical disease of civilization, it does not constitute a direct threat to life, but it can be very distressing. Doctors cannot cure it yet, but with the help of medication we can fight it effectively.