(1) Migraines without aura.
(2)Migraine with aura:
(1)Migraine with typical aura;
(2)Migraine with persistent aura;
(3)Familial hemiplegic migraine;
(4)Basilar arterial migraine;
(5)Migraine with a migraine aura but without headache;
(6)Migraine with an acute aura attack.
(3) Oculomotor paralytic migraine.
(4) Retinal migraine.
(5) Childhood periodic syndromes that may be migraine precursors or associated with migraine: (1) benign childhood-onset vertigo; (2) childhood-onset alternating hemiparesis.
(6) Comorbidities of migraine: (i) migraine persistence; (ii) migrainous cerebral infarction.
(7) Migraine-like disorders that do not meet the above criteria.
References:
Migraine is a type of episodic headache due to vasodilatory dysfunction. Clinically, there can be repeated cyclic episodic headache, nausea, vomiting, photophobia, dizziness and other symptoms. It is more common in females. It often develops around puberty.
New method of migraine treatment
When a migraine occurs, use a pot of hot water (the temperature of the water is suitable for not scalding the skin), and immerse your hands in the hot water. The water should be enough to cover your wrists. Dip for half an hour at a time. In the process of immersion, the hot water should be constantly to maintain the temperature of the water. Insist on soaking several times, the symptoms can gradually disappear.
Nutritional guidelines:
I. Life should be regular, pay attention to the combination of work and rest, should not be overstressed or fatigue, otherwise it will cause migraine attacks. Appropriate physical activities should be carried out, such as jogging, walking, swimming, tai chi, qigong and so on. Exercise can enhance the toughness and elasticity of blood vessels and improve the function of vascular diastole.
II. Should maintain a good mental state of open-mindedness and relaxation in matters, avoid mental stimulation or tension, depression and so on. Cultivate flowers, goldfish interest, emotional upset when you can look at goldfish, flowers and plants to distraction. To control anger.
three. Be careful to prevent wind and cold invasion, cold weather or sudden changes in climate, should pay attention to cold and warm, go out wearing a good hat or headscarf. Usually do not sleep when the wind or the wind and rain. Women should pay particular attention to prevent menstruation.
Four. Migraine may be related to the consumption of tyrosine-containing foods, such as cheese, chocolate, beer and high-fat foods, should try to eat less or do not eat the above food. Avoid eating spicy food and alcohol and tobacco. It is advisable to eat light and tasty food that is easy to digest and absorb, eat more fresh vegetables and fruits, and keep the bowel movement smooth.
What are the triggers for migraine attacks?
There are many triggers for migraine, which can be divided into two categories:
(l) Common triggers:
1. Mental factors: such as anxiety, anger, nervousness, anxiety, or excessive sadness;
2. Physical stimuli from the outside world: such as bright lights, noises, smells, and patterns.
3. Dietary factors: hunger or eating late, food types (such as containing nitrites, glutamates, aspartate tyramine and other foods), and cochineal, alcoholic beverages, cold beverages, etc., due to partiality resulting in a reduction in the body's magnesium intake can also be induced.
4. Climate change: such as sun exposure, wind, cold stimulation.
Additionally less sleep, head trauma, excessive fatigue, women's menstrual cycle and taking birth control pills are also common causes.
(2) Rare triggers: hyperthermia; excessive sleep; highland areas; excessive vitamin A; drugs: nitroglycerin, histamine, reserpine, hydrazine-phenazine, estrogen; discontinuation of cortisone; cold food; reading and session light abnormalities; irritating odors, fragrances, and organic solvents; fluorescence; and metamorphic reactions.
What are migraines, are they hereditary, and what are their clinical manifestations?
Migraine is a kind of vascular headache, vascular headache is due to the cranial vascular contraction function changes caused by the headache, vascular headache is divided into primary vascular headache and secondary two categories, primary vascular headache is also known as migraine (Migraine), secondary mostly for the two sides of the headache.
Migraine is an ancient disease, as early as 3,000 years ago, this disease has been described, 2,500 years ago by Hippocraets named migraine, used today.
The motherland medicine of migraine disease has long been recognized, that its mechanism is mostly for the three Yang meridian lesions. The cold hut medical words" cloud: "headache is the sun disease, from the back of the brain to the top of the top, the pain is even the neck; belongs to the yangming, even the eye on the beads, in the forehead; belongs to the shao yang, up to the two horns, the pain in the side of the head."
Migraines are hereditary. For nearly a century, neurologists have believed that genetic factors play an important role in the pathogenesis of migraine. Gawers, for example, writes: "Migraine is clearly inherited, and genetic influences can be traced in more than half of the cases, often with other members of the patient's family (at most the parents) having migraineurs."
The mode of inheritance of migraine is not yet conclusively confirmed. From the distribution of family members is different from recessive inheritance, belonging to autosomal dominant inheritance has incomplete epigenetic rate, but some scholars believe that it is recessive inheritance accompanied by incomplete epigenetic rate. In short, the heritability of migraine is certain, but its mode of inheritance is inconclusive.
Headache attacks in migraine patients often occur during the day, but can still occur at night. When the headache attack, usually confined to one side of the head, some patients each attack headache site can be changed, sometimes visible occipital and head pain, some patients show face and neck pain. However, the diagnosis of migraine cannot be made only from the headache site. When the patient has a headache attack, the pain gradually increases, and the headache reaches the peak in a few minutes to 1~2 hours, which may last for a few hours or even a few days, and then the headache gradually decreases or disappears. There are also a few patients, no obvious cause suddenly appeared severe headache, in a few seconds will reach the peak, the pain can last for several hours or even days. The pain is often throbbing, some patients show non-throbbing dull pain, and a few patients show stabbing pain in the head, or a sense of percussion. Compression of the arteries in the headache area or the carotid artery on the diseased side or the eyeball can reduce the headache, and the pain returns to its original state after no compression. Activity can make the headache worse, bed rest can reduce the pain, short-term sleep can make the pain completely disappear.
What are the common gastrointestinal and visual symptoms of a migraine attack?
Nausea is the most common gastrointestinal symptom accompanying migraine patients. More than half of the patients are accompanied by vomiting, a few patients may have diarrhea, and most patients have nausea, vomiting, and diarrhea at the same time. In addition, there are a few patients in the migraine attack mainly gastrointestinal symptoms, and the reverse is accompanied by mild headache, also belongs to a kind of migraine, known as migraine equivalent.
The patient's headache attack may appear monocular or binocular photophobia, dark spots in front of the eyes and flash hallucinations; in severe cases, there may be blackness in front of the eyes, visual field defect, monocular blindness, transient loss of vision, and even visual perception disorders, distortion of vision, diplopia or polydactyly, and change of color of the vision, and other symptoms.
What are the neurological disorders, higher nervous dysfunction, and vegetative symptoms associated with migraine attacks?
Neurological disorders associated with migraine attacks include:
(1) Olfactory disorders: phantom smell, in which the patient complains of smelling a particular odor.
(2) ocular muscle paralysis: mostly on the side of the headache, sometimes also seen bilaterally.
(3) somatosensory disturbances: numbness or tingling sensation, hypesthesia or loss of sensation may occur in the face or at the ends of the limbs.
(4) Motor and reflex disorders: a few patients with migraine attacks can be accompanied by hemiparesis or facial paralysis, hyperreflexia or diminished tendon reflexes, or even impaired consciousness, aphasia, etc., and the paralysis disappeared in a few days to a few weeks. Multiple attacks may produce permanent paralysis.
(5) Brainstem and cerebellar symptoms: dizziness, ****jet disorder, tinnitus and other symptoms.
Migraine attacks are accompanied by the following vegetative symptoms:
Syncope, tachycardia, a few patients may be accompanied by a high fever, individual body temperature can be as high as 41 ℃.
Migraine attacks are often accompanied by the following high-level neurologic dysfunction:
(1) impaired consciousness: blurred or even loss of consciousness.
(2) Mood changes: agitation, irritability, fear and anger, disappointment and inability to concentrate.
(3) Speech disorder: symptoms of aphasia, loss of conversation and writing.
(4) Memory impairment: transient generalized amnesia occurs during the attack and memory returns after the attack.
How is mitral valve prolapse related to the development of migraine?
The relationship between mitral valve prolapse (MVP) and migraine headaches is extremely close and is attracting increasing attention. The incidence of migraine in patients with MVP has been reported by many authors to be around 28%.
There are no significant differences between migraine patients with MVP and those with migraine alone in terms of headache frequency, duration, triggers, accompanying symptoms, headache location, and attack duration.
The mechanism of migraine attacks caused by MVP is still unclear, and some people believe that it is related to genetic factors, while others believe that migraine is caused by platelet aggregation and the release of 5-HT when the blood flows through the heart valves.
What is the relationship between migraine and ischemic and hemorrhagic stroke?
Migraine-induced ischemic stroke has long been noted. Migraine has been reported to induce stroke, but the incidence of stroke in patients with migraine is still very low in terms of the total number of migraines, with 7% of cerebral infarctions in young adults reported to be caused by migraine.
Migraine patients are more likely to be female and young adults, and therefore, ischemic strokes in migraine patients are more likely to be seen in young adult females. Migraine-induced stroke can involve both the internal carotid artery system and the vertebrobasilar artery system, but occlusion of the posterior cerebral artery is more common.
There are three types of migraine strokes:
(1) Migraine and stroke***:
The same patient suffers from both migraine and stroke, but the onset of stroke occurs some time apart from the migraine.
(2) Stroke with clinical features of migraine:
This kind of patient's brain lesions have nothing to do with the mechanism of migraine, but their clinical manifestations have the typical clinical features of migraine.
(3) Migraine-induced stroke:
The diagnosis of migraine-induced stroke must be based on the following criteria: (1) the patient's neurological signs must be similar to those of a previous migraine attack; (2) the stroke attack must be in the course of a typical attack of migraine; and (3) other possible causes of the stroke must be excluded.
Migraine-induced hemorrhagic stroke is rare in the clinic, but it has been reported in the clinic for a long time. Recently, three cases of lobar hemorrhage due to prolonged migraine attacks were reported, which were confirmed by CT and MRI. Angiography did not show arterio-venous malformations and hemangiomas, and only the corresponding internal and external carotid arteries had extensive spasm, and pathology after surgery in two of these cases proved necrosis of the vascular wall with subacute inflammatory changes. The occurrence of cerebral hemorrhage was estimated to be caused by ischemia of the intracranial vessel walls resulting in necrosis due to more severe cerebral vasospasm during the migraine attack, with secondary vascular rupture leading to hemorrhage when perfusion pressure was restored.
What is the relationship between migraine and hypertension
As early as 1913, it was noted that migraine patients had more hypertension after several years. Later scholars studied that migraine patients are five times more likely to develop hypertension than normal people.
Domestic scholars believe that: where there are intermittent episodes of one or both sides of the headache, accompanied by visual aura attacks, nausea and vomiting with a positive family history of the diagnosis of migraine, diagnosed 473 cases of patients, of which 277 cases of patients in a few years after the occurrence of hypertension or borderline hypertension. After the occurrence of hypertension, the nature of the headache symptoms changed, easily accompanied by dizziness, vertigo, tinnitus, insomnia, heartburn, impatience, numbness of the limbs and so on.
What is a typical migraine and what are its aura symptoms?
Typical migraine, also known as migraine with aura, accounts for 10% of migraine patients, mostly develops in adolescence, and there are more family history. The most significant feature of typical migraine is that there are aura symptoms before the onset of headache:
(1) Visual aura symptoms: patients can have flash hallucinations in bilateral visual field, and the shape of the flash is not certain, such as star, ring, etc. Some patients have dark haze in front of their eyes, and it is common to see dark haze in front of their eyes. Some patients have black haze in front of their eyes, commonly monocular black haze, mostly transient, or see visual distortion, visual objects become larger or smaller, or shape change.
(2) Sensory abnormalities: the most common are tingling and numbness in the hands and forearms, numbness in the hands, limbs, half of the face and around the lips and hemianopsia, and hypesthesia, which lasts from a few seconds to 20 minutes, occasionally for a few hours, and very rarely for a few days to a few weeks.
(3) Other aura symptoms: In addition to the above aura symptoms, migraine patients may also have a motor aura, which is manifested as monoparesis or hemiparesis, and may also show transient aphasia or mental symptoms.
What is common migraine? What are the symptoms?
Ordinary migraine, also known as migraine without aura, is the most common type of migraine, and its aura period is not obvious. A few hours or days before the onset of headache, there may be some non-specific precursor symptoms, including mental disorders, gastrointestinal symptoms and fluid balance changes. The headache may manifest as unilateral or bilateral frontal and temporal episodic, throbbing pain of longer duration than typical, with completely normal intervals.
What is hemiplegic migraine and what are its symptoms?
Hemiplegic migraines are rare in the clinic and can be sporadic or familial. Familial hemiplegic migraines are inherited in an autosomal dominant manner, and may be accompanied by tremor and nystagmus, retinal degeneration, deafness, and ****typhosis.
Hemiplegia can be one of the aura symptoms of a headache attack, which lasts 20 to 30 minutes, and hemiplegia resumes with the headache attack. Hemiplegia may also last for hours, days, or weeks after the headache disappears.
Headaches usually follow hemiplegia, and in about one-third of patients they occur on the same side as the hemiplegia, often accompanied by nausea and vomiting. About 50% of hemiplegic episodes are associated with dysarthria or aphasia, and sensory centers are involved in about one-third of patients, although hemiplegia is accompanied by hemiplegia in almost every case. Most hemiplegic attacks begin in childhood, and in many patients the hemiplegic attacks cease when they reach the age of 20 to 30 years and hemiplegic migraine is replaced by other types of migraine.
What is ophthalmoplegic migraine and what are its symptoms?
Ophthalmoplegic migraine is rare. The patient has fewer headache episodes, non-pulsatile orbital or periorbital pain radiating to the lateral side of the face, often accompanied by nausea, vomiting, the symptoms last for 1 to 4 days, ophthalmoplegia and headache coexist, or in the relief of the headache is still continued for a long period of time, usually lasts for a few days, usually within 45 days to 2 months time. The first ptosis appears on one side, and within a few hours may present complete paralysis of the third cranial nerve, sometimes with dilated pupils, and occasionally involving the fourth and sixth pairs and the ophthalmic branch of the trigeminal nerve. The paralysis of the ocular muscles usually recovers completely, but some paralysis of the extraocular muscles may persist after several episodes, and occasionally ophthalmoplegic headaches alternate between the two sides of the head.
The age of onset of this form of the disease is similar to that of the common type of migraine, with most patients having their first attack before the age of 12 years.
What are basilar migraines and what are their symptoms?
Basilar migraine is a brainstem neurologic dysfunction that occurs during a migraine attack, often accompanied by total blindness and changes in consciousness.
The disease is most common in adolescent girls, and the majority of patients are under 35 years of age, and most attacks are related to menstruation. The onset of the attack is characterized by sharp, disembodied visual hallucinations or blurred vision, involving the entire visual field, or even total blindness, with concomitant or subsequent onset of vertigo, dysarthria, dysarthria, tinnitus, and sensory abnormalities in the distal or extremities. In some of these patients there is a progressive impairment of consciousness, and in some cases the loss of consciousness is preceded by an incomprehensible dream-like state, a state of delirium, and the loss of consciousness is not too profound, and strong stimuli may awaken it. These episodes of neurologic symptoms occur within 2 to 45 days, mostly for 10 to 30 minutes. This is followed by a throbbing headache in the occipital region, often accompanied by vomiting, which may last for several hours or until the patient goes to sleep. In the majority of patients, there are only a few dramatic attacks, which are preceded by or interspersed with a typical attack, and the patient presents with a common type of migraine headache. The basilar migraine attacks stop and are often replaced by common migraine.
What is psychotic migraine and what are its symptoms?
Migraine with psychiatric symptoms is called psychogenic migraine. The age of onset of this type is mostly between 5 and 16 years old, accompanied by acute migraine attacks, but never due to severe headache caused by mental disorders. Clinical manifestations of excitement, agitation, fidgeting, fear, disorientation, memory impairment retrograde amnesia, unresponsiveness, impaired consciousness, occasionally migraine rigidity, sometimes showing automatisms and so on.
What is abdominal migraine and what are its symptoms?
Typical or common migraine attacks accompanied by abdominal cramps are called abdominal migraine. The pain is mostly around the umbilicus, accompanied by nausea, vomiting, some patients may have no headache, only episodes of abdominal pain, accompanied by nausea, vomiting and vegetative symptoms such as pallor, sweating, calf muscle spasms, etc., at this time the diagnosis is more difficult. The following are needed for diagnosis:
(1) the syndrome can have a variety of strange medical history;
(2) accompanied by vegetative symptoms such as pallor, excessive sweating, dizziness, etc.
(3) abdominal tenderness on palpation;
(4) mental tension can make the pain worse;
(5) recurrent abdominal pain;
( 6) negative various laboratory and X-ray examinations;
(7) no specific findings on proctoscopy.
What are the clinical features of periodic migraine and what is the treatment?
This type of patient's migraine headache is mostly periodic, so it is called cyclic migraine. This type of patient headache each attack lasts about 25 hours on average, the duration of the cycle for the duration of 2 to 20 weeks (average 6 weeks), 1 to 12 times a year (average 5 times / year), in the headache cycle, 1 to 7 times a week, an average of 5 times / week. Fixed, mild one- or two-sided headaches remained in the headache cycle between headaches.
The diagnostic criteria for this type should be the following:
(1) the patient should have typical or atypical migraine headaches;
(2) cyclic attacks of headache lasting for more than 2 weeks;
(3) in the cycle of attacks, there is still a distinct, mild headache in the headache interval;
(4) cyclic migraine headache is often confined to frontal and temporal sides. Most of them are accompanied by nausea and shyness, with continuous attacks, and are easily confused with cluster migraine, which should be noted during diagnosis.
Periodic migraine is mainly treated with lithium carbonate. According to foreign scholars reported, lithium carbonate treatment of this disease efficacy, and thus all cyclic migraine should try to use lithium carbonate treatment for 2 weeks, if the effect is good, at least apply the medicine for more than 1 month, serious cases should be served for 1 year.
Acupuncture treatment: acupuncture can relieve pain, mostly temporary. Acupuncture points: Hegu, sun, head Wei, leave the needle for 30 to 60 minutes, can be used according to the effect of twisting and lifting insertion and other techniques to improve the pain relief effect.
What is the significance of EEG in the diagnosis of migraine?
It is generally believed that the incidence of EEG abnormalities in migraine patients is higher than that in normal controls, both during attacks and intermittent periods. However, the EEG changes in migraine patients are not specific, as they may include normal waveforms, ordinary slow waves, spike-wave discharges, focal spike-waves, analogous waves, and abnormal responses to hyperventilation, flash stimulation, and other waveforms. An EEG study of 11 cases of ordinary and 10 cases of typical migraine proved that, when observed in the episodic period, intermittent period, hyperventilation, flash stimulation, etc., the results were that all ordinary migraine and 8 cases of typical migraine had no abnormality, and that a small number of slow waves in the frontal region could be seen in the episodic period and intermittent period of the 2 cases of typical migraine.
Electroencephalographic abnormalities in pediatric migraine were higher, ranging from 9% to 70%, and could be characterized by spikes, paroxysmal slow waves, fast wave activity, and diffuse chronic diffuse waves.
What tests should be performed in patients with migraine?
(1) Electroencephalogram:
It is generally believed that the incidence of abnormalities in the electroencephalogram of migraine patients is higher than that of normal controls, whether in the onset or intermittent period, but the electroencephalogram changes in migraine patients are not specific, because it can have normal waveforms. There are various waveforms such as normal slow waves, spike discharges, focal spikes, analogous waves, and abnormal responses to hyperventilation and flash stimuli. The pediatric migraine EEG has a high rate of abnormality, ranging from 9% to 70%, and can have spike waves, paroxysmal slow waves, fast wave activity, and diffuse slow waves.
(2) Cerebral hemogram:
The main change of cerebral hemogram in the patient during the attack period and intermittent period is asymmetry of wave amplitude on both sides, with one side being high or the other side being low.
(3)Cerebral angiography:
In principle, patients with migraine do not need to undergo cerebral angiography, but only in severe headache attacks, highly suspicious of subarachnoid hemorrhage patients to undergo cerebral angiography, in order to exclude intracranial aneurysms, arteriovenous malformations and other disorders. Undoubtedly, cerebral angiography is normal in the vast majority of patients with migraine.
(4)Cerebrospinal fluid examination:
The routine examination of cerebrospinal fluid in migraine patients is usually normal, and the lymphocytes of cerebrospinal fluid can be increased in general.
(5) Immunologic examination:
Immunoglobulin IgG, IgA, C?3, and E wreath formation are generally considered to be higher in migraine patients than in normal subjects.
(6) Platelet function test:
Platelet aggregation may be elevated in migraine patients.
What is the pathogenesis of migraine?
The pathogenesis of migraine is still not clear, since Wolff proposed the vascular hypothesis of migraine attacks in 1938, has ruled the medical profession for decades, this theory has not been confirmed by strong experiments, but also has not been disproved. But since people have been able to measure localized blood flow in the brain, it has shaken conviction in the vasculogenic hypothesis and revalued the previously proposed neurogenic hypothesis, which has gained general support.
(1) The vascular origin hypothesis:
Wolff was the first to carry out clinical and experimental studies of migraine in a scientific way. He came to the conclusion that headache attacks are preceded by constriction of the intracranial arteries, which produces cortical ischemia, visual disturbances, and other aura symptoms, followed by dilation of the external carotid arterial system, which produces the headache attack, which is exacerbated by perivascular vasoactive polypeptides in the tissues and irritating aseptic inflammation. Support for the vasogenic hypothesis is based on the following: the pulsatile and throbbing nature of the pain in clinical migraine; and the diversity of pain sites, with the location of the pain not coinciding with the anatomical distribution of the trigeminal nerve but with the branches of the external carotid arteries in the face and head, which suggests that the pain is of vasogenic origin.
Compression of the carotid artery provides temporary relief from migraine attacks.
Application of alpha-adrenergic blocking agents (e.g., ergotamine) relieves the pain, and use of vasodilators (e.g., alcohol, nitrites, etc.) worsens their headache symptoms.
Phenomena unexplained by the vasogenic hypothesis:
①Common migraine: it is difficult to explain common migraine with Wolff's typical migraine hypothesis. The latter does not start with focal symptoms in the brain, but occasionally with obscure general sensory symptoms, such as fatigue, yawning and emotional instability. Many scholars have reported an increase in cerebral blood flow during an attack of common migraine, which lasts up to 48 hours after the onset of the attack. However, the increase in cerebral blood flow was moderate, and no focal hypoperfusion was seen at the beginning of the attack.
②Typical migraine: Initial cerebral blood flow (rCBF) measurement techniques lent support to Wolff's classic hypothesis, which found that rCBF was reduced in the aura phase of typical migraine, essentially at a site consistent with the symptoms. However, with the application of highly spatially resolved equipment and repeated measurements in a large number of patients, the results were different. Tomographic determination of rCBF during a typical migraine attack showed that the occipital lobe had reduced blood flow, which also involved the more anterior portion of the brain, and that the blood flow abnormality was confined to the cerebral cortex, whereas blood flow to the deeper structures of the brain was normal. In addition, underperfusion persists for several hours after the disappearance of aura symptoms and continues into the seizure phase. Delayed hyperperfusion (reactive congestion) occurs late. There appears to be no association between hypoperfusion and headache. There is more evidence to reject the cerebral artery spasm hypothesis.
(2) Neurogenic hypothesis:
This theory was proposed by Liveing more than a hundred years ago, and in recent years many people have supported the neurogenic point of view in the clinic, and put forward the hypothesis that migraine is a primary neurogenic disorder with secondary vasomotor changes. In summary, it can be discussed from three aspects:
① In the migraine attack stage, all of its symptoms are produced by the brain, such as pre-symptomatic behavioral changes, changes in state of mind, food fetish and so on. Some of the patients in the headache phase have throbbing pain and the rest have constant headache. Even the throbbing pain is not vascular in origin. Neurologic symptoms during the headache phase include shyness, acoustic terror, generalized euphoria, hypersensitivity to vibration and smell, loss of concentration, insomnia, yawning, and temperature instability, which are not symptoms caused by extracranial vasodilatation. Mood and mental changes, yawning, and fatigue during recovery from symptoms are neurogenic.
②Migraine-promoting factors: mental stimulation, hunger, too much or too little sleep, menstruation in women, irritation of the sense organs, and other triggers of migraine attacks are all neurologically related.
③The neurogenic theory can be strongly supported by the findings of EEG, cerebral blood flow and cerebral metabolism.
What are the clinical manifestations of chronic recurrent carotid artery pain, what diseases should be differentiated from it, and what is the treatment?
This disease may be a variant of migraine. Patients are mostly female, aged 10 to 75 years, but mainly aged 40 to 50 years, and many have a family history of migraine or have migraine themselves. Carotid artery tenderness is often accompanied during a generalized migraine attack, with the main site of pain in the mandible or neck, and individually in the periorbital and maxillary regions. The nature of the pain is dull, accompanied by paroxysmal, throbbing, or knocking pain, with attacks occurring one or more times per week, lasting from a few minutes to several hours each time, and with individual patients complaining of sharp, pins and needles-like pain. Examination reveals carotid artery tenderness, increased pulsation and swelling of the surrounding soft tissues.
The disease can be diagnosed by pain in the face and neck with carotid artery tenderness and soft tissue swelling. The disease can be induced by dental trauma. It should be differentiated from giant cell arteritis and unruptured carotid tumors.
The pathogenesis of chronic recurrent carotid artery pain is similar to that of migraine, and therefore, anti-migraine medications can be used to treat this disease, such as lysergic acid, methylergotamine, and cardioplegia.
What is the mechanism of Phenothiazide in the prevention and treatment of migraine?
The chemical structure of phenothiazine is very similar to that of some anti-allergy drugs, so it has a good anti-allergy effect. It is ineffective in controlling migraine attacks with short-term use, and can prevent migraine attacks with long-term use. Because of the relatively more side effects of methylergotamine, benzphenazone has become a more commonly used migraine prevention and treatment drug.
Mechanisms of phenothiazide in the prevention and treatment of migraine:
(1) Promote or enhance the contraction of extracranial blood vessels by 5-hydroxytryptamine. Benzothiazide can compete with 5-hydroxytryptamine for special receptors, presenting an anti-5-hydroxytryptamine effect. At the same time, it can feedback activate tryptophan hydroxylase and 5-hydroxytryptamine decarboxylase, compensating to accelerate the formation of 5-hydroxytryptamine and its release from the gastrointestinal tract, platelets, and brain system tissues, so that there is no significant reduction of 5-hydroxytryptamine in plasma concentration, thus overcoming its blocking effect. This compensatory promotion of 5-hydroxytryptamine formation and release of the process requires a certain period of time, so need a longer period of time to take the drug to be effective.
(2) Enhancing the susceptibility of other vasoconstrictor drugs to extracranial vascularization. Even when the plasma level of 5-hydroxytryptamine suddenly drops during the migraine attack, it can still be sensitive to the control of other vasoconstrictor drugs to maintain vasoconstriction, so that migraine does not attack.
(3) It competes with histamine for the H1 receptor, presenting a strong anti-histamine vasodilator effect, keeping the blood vessels in a constricted state and inhibiting 5-hydroxytryptophan and histamine to enhance the permeability of blood vessels.
(4) Blocking the formation of inflammatory factors in the body, reducing the triggering factors of migraine. (5) Reduce sympathetic nervous tension.
(6) Participates in analgesia by reducing the production of substance P and preventing the decrease of nociceptive trapping value of the vascular wall through anti-5-hydroxytryptamine action. It also has central sedative and antidepressant effects.
The old medicine against migraine
Migraine is one of the common cerebrovascular diseases. It is especially common in female patients and occurs periodically before the onset of menstruation. When the attack is often two eyes suddenly black, or eyes, see a lot of strange geometric patterns shining, then one side of the head began to pain, and gradually developed to the top of the head, was throbbing or cut-like pain. At the same time, pale, nausea and vomiting, as long as the vomit one or two times, the symptoms will be alleviated, but the whole body is weak, need to rest for a few days to recover, can be described as stubborn. However, clinical research found that a variety of old medicines can prevent and cure migraine. The following is a brief description.
Fluoroquinolizine (flunitrazine, cipro) It can inhibit spasmodic vasoconstriction caused by calcium ions, increase blood flow, reduce vascular viscosity, reduce the release of platelets, improve peripheral vascular circulation, enhance the supply of oxygen to the brain, reduce tissue edema. Flunarizine 10 mg every night before bedtime, a month for a course of treatment, the efficiency can reach 96%. However, those who have a sense of sleepiness, pregnant women and lactating mothers are prohibited.
Verapamil hydrochloride (ibogaine) has the effect of inhibiting platelet aggregation. Each time to take 80 mg, three times a day, the frequency of migraine attacks significantly reduced. It should be used with caution in patients with bronchial asthma and hepatic and renal impairment, and is contraindicated in patients with hypotension, heart failure, conduction block and cardiogenic shock.
Isosorbide nitrate (cardiac pain) can inhibit platelet aggregation, reduce the release of 5-hydroxytryptamine and thromboxane. Each time to take 10 mg, three times a day, a month for a course of treatment. After taking the drug, the frequency of attacks decreased significantly and was relieved, with an effective rate of 90%. Hypotensive patients should be used with caution, pregnant women are contraindicated.
Chlorpromazine hydrochloride can dilate blood vessels, relieve spasm, improve microcirculation, and have sedative and anti-5-hydroxytryptamine effect. Application of 1 mg of chlorpromazine per kilogram of body weight (each extreme amount of 100 mg) for intramuscular injection, the effectiveness rate of 90%. If relapse occurs, repeat applications remain effective.
Sodium valproate, originally an antiepileptic, is now used to prevent and treat migraine headaches with good efficacy. Take 1200 milligrams per day, divided into morning and evening once a dose, for three to twelve months, the effective rate of 77%. Pregnant women, hepatic insufficiency, thrombocytopenia should be used with caution.
Disodium alginate can reduce blood viscosity, improve microcirculation, especially for arterial nerve paralysis migraine patients. The drug 100 mg added to 5% dextrose solution for intravenous drip, thirty drops per minute, once a day, 20 days for the medical city. Clinical observation, after taking the drug rarely relapse. Cerebral hemorrhage and severe hepatic and renal insufficiency is contraindicated.
Scopolamine hydrobromide (654-2) can relieve vasospasm, improve microcirculation, and have analgesic effect. Take its 10 mg added to 5% sodium bicarbonate solution 60 ml for intravenous drip, once a day, 7 days for a course of treatment, the effect is better.
Stimulation of the cerebellar parietal nucleus can cure migraine Health News
Migraine incidence of nearly 200 million people in China, an annual upward trend, and can not be cured. Liu Yan, a postdoctoral fellow at Chongqing Medical University's Institute of Neurology, under the guidance of his mentor, Professor Dong Weiwei, has discovered and proved that a series of neural circuits generated by electrical stimulation of the parietal nucleus of the cerebellum can protect blood vessels in the brain, thereby curing migraines and preventing and treating ischemic strokes and Alzheimer's disease.
The animal experiments of this study proved that there exists an intrinsic neural pathway from the parietal nucleus of the cerebellum to the cerebral cortex in the brain, and when they are stimulated, they can protect the ischemia of the brain organs, so that ischemic damage is reduced or does not occur. Because the realization of this effect is achieved through the action of a series of neural circuits, it has been termed neurogenic neuroprotection. More convincing evidence is that, according to the principle of the design of the cerebral circulation therapeutic instrument, in the treatment of the clinical control group also found that the treatment group daily cerebellar energization for 1 hour plus conventional drug therapy, 30 days later, the patient's neurological dysfunction score compared with the control group (only drug therapy) significantly lower, suggesting that the patient's neurological rehabilitation effect is significantly raised? /td>
Taking the right amount of aspirin
For tension headaches that occur once or twice a month, aspirin or other common anti-inflammatory drugs can come in handy. But overuse of such drugs will cause more pain." It's like scratching a rash, it will get itchier and itchier." Dr. Cyber said.
Don't delay
If you decide to use aspirin for a headache, "it should be taken as soon as the headache starts; otherwise it's not as effective." Dr. Sobak says. Exercise "Exercise is one of the effective ways to prevent headaches because it helps you de-stress and de-stress." Dr. Solomon says.
Exercise as usual