Migraine is a type of unilateral pulsatile headache lasting for hours to days. It often Accompanies with photophobia, phonophobia, etc. Migraine patients often have a family history of migraine.
Calcitonin gene-related peptide (CGRP), Serotonin play a major role in migraine headache. A migraine attack may proceed by aura but in maximum cases, a headache occurs without aura. MIDAS Score or The Migraine Disability Assessment Score is used for clinical evaluation and diagnosis.
SIGN AND SYMPTOMS
- Moderate to severe pulsatile headache.
- Photophobia (light intolerance)
- Phonophobia (Sound intolerance)
- Physical or mental stress.
- Lack of sleep.
- Excessive loud noise.
- Bright light.
- Specific foods.
- Use of oral contraceptive pills.
- LIFESTYLE MODIFICATION – Healthy diet, Avoid alcohol or caffeine, Avoid extra stress, Regular exercise, Uniform sleep pattern.
- SYMPTOMATIC– Taking rest in a dark, noise-free room during attack gives some relief. The use of analgesics like Ibuprofen, Naproxen, Paracetamol is useful during the acute attack of migraine.
- SPECIFIC –
- Ergotamines are often used to control migraine pain. It should be avoided during pregnancy.
- Triptans – These drugs are 5-HT1 agonists. Sumatriptan is available as a subcutaneous injection or oral tablet form or nasal preparation. It gives prompt relief from pain during an acute attack. Other drugs like Rizatriptan, Zolmitriptan, Naratriptan, Almotriptan are also used. Sumatriptan 20mg nasal spray or Zolmitriptan 5mg nasal spray is also available in markets for prompt headache relief. The oral dose of Sumatriptan is 50 – 100mg, Naratriptan 2.5mg Almotrptan 12.5mg, Rizatriptan 10mg are commonly used. These triptans are contraindicated during pregnancy or uncontrolled hypertension or past history of stroke patients.
- Metoclopramide, Chlorpromazine is also used to treat a migraine attack.
- PREVENTIVE – Flunarizine and beta-blocker like propanolol are commonly used for migraine prophylaxis. Valproic acid, Amitryptiline, Verapamil, Topiramate, etc are also used for the same purpose.
- NATURAL REMEDIES – Some of the natural remedies are supposed to reduce migraine symptoms, These are
- Fish Oil
- Flax Seed
- Ginger Root
- Ginkgo Biloba
- Multivitamin including Vitamin B2, Vitamin B6, Vitamin D, and Vitamin C supplements