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What is it about ?
Migraine is a form of headache recurrent with intermediate attacks lasting from a few hours to a maximum of three days. The cause is not entirely clear. Hereditary factors certainly play a role. There are two types of migraine: headache with and without aura.
In migraine with aura, a number of symptoms occur before the onset of headache, for example :
- from vision disturbances ;
- bright spots in the field of vision (scotomas);
- language disorders;
- tingling;
- from nausea and vomiting ;
- difficulty in tolerating (natural) light or noise.
In migraine without aura, the headache are not preceded by symptoms.
What is its frequency?
Migraine affects around 15% of the population, mostly people in the workforce. Women suffer from migraines more often than men. Of all migraine attacks, the aura-free form is the most common (70-80%). Migraine with aura occurs in 20-30% of patients.
How to recognize it?
In the case of a migraine, the headache are headache pulsatile on one side of the head. Stress makes the pain worse. The headache are often accompanied by nausea or sensitivity to light or noise.
Certain factors can trigger a migraine attack: sleeping troubles, a too low blood sugar (blood sugar), the rules, the stress, coffee, flavor enhancers, strong odors and alcohol.
If you answer “yes” to two of the following questions, you are probably suffering from a migraine:
- Are you bothered by light or noise when you have headache ?
- Are you nauseous or do you have stomach problems when you have headache ?
- Your headache have they limited your daily activities for at least one day in the past three months?
How is the diagnosis made?
The doctor will ask you about the history of the disease, the triggers, the medication taken and the family history. Based on your answers, the doctor will or will not make the diagnosis of migraine; there are indeed many forms of headache.
Your doctor may ask you to keep an headache for a month, on the one hand, to be able to diagnose migraine, on the other hand, to better understand the triggering factors. He will be able to check, for example, if the migraine is the consequence of an excess of painkillers. If so, the doctor will help you break this vicious cycle.
Physical examination and imaging are not normally necessary except in the presence of warning signs, such as:
- headache appearing after the age of 50;
- headache appearing during pregnancy;
- headache of increasing intensity after an accident;
- reduced work performance;
- aura for the first time in a patient who has recently started taking the pill.
Although it is not essential, the doctor can also measure blood pressure. This can help her determine the best treatment for migraine.
What can you do ?
During a migraine attack, it is best to rest quietly in a dark room. An ice pack on the head or on the temples can relieve the pain a little. Relaxation techniques can be helpful. If a medicine has been prescribed by the doctor, you can take it according to his instructions in case of an acute attack.
What can your doctor do?
Acute migraine treatment
The doctor can explain what is best to do in the event of a migraine attack (calm down, rest in a dark environment).
As a drug, paracetamol or an anti-inflammatory drug (NSAID), possibly combined with an antiemetic, are recommended. If you cannot keep these medicines because of vomiting, you can take them as effervescent tablets or suppositories.
During pregnancy, you can only take paracetamol.
If you have a severe migraine attack that the medicines do not relieve enough, your doctor may prescribe a special medicine for migraine (triptan). Ergotamine derivatives are not indicated due to their side effects. Both of these drugs can only be obtained with a prescription.
Preventive treatment
By keeping a diary of headache, you and the doctor can find out what factors trigger a seizure. Your doctor can also provide you with a list of the main triggers to avoid.
If you have two or more migraine attacks per month, your doctor may consider preventive treatment (beta blockers, topiramate). Medicines can also prevent migraines caused by hormonal changes, such as the menstrual cycle.
Although not yet scientifically substantiated, acupuncture and relaxation techniques may also be considered. If this is not effective enough, there are certainly other treatment options. For this, the doctor will refer you to a neurologist.
Want to know more?
www.mongeneraliste.be/maladies/migraine-un-mal-de-tete-pas-comme-les-autres
www.mongeneraliste.be/fiches-patients/migraine-avec-sans-aura
Sources
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