Headache is one of the most invisible and often trivialized diseases. Migraine is its most common variant, but few people know how hard it is to live with it. This headache causes a greater number of visits to the specialist doctor and is among the twenty most disabling diseases, according to the World Health Organization. Dr. Víctor Obach, Neurologist at the Hospital Clinic Barcelonaexplains that “when someone has a headache that makes them go to the emergency room, the vast majority of times they are usually migraines.”
Migraine or migraine is characterized by recurrent episodes of headache that usually start on one side and then spread to other areas. The pain, typically throbbing, may be accompanied by nausea, vomiting, and sensitivity to light, noise, or smells. This process is divided into four phases. The first, prodromes, can appear up to 24 hours before and include food cravings, mood swings, uncontrollable yawning, fluid retention or increased urination.
A migraine with aura is not more serious; It’s different
Another phase, present in only 20% of migraines, is the aura. Its symptoms may be visual, such as blind spots, losses in the visual field, flashes or distortions; or sensitive, such as tingling in the tips of the fingers that ascends to the face. Dr. Neus Fabregat, neurologist at Hospital Clínic Barcelona, clarifies: “A migraine with aura is not more serious; It’s different.” The main phase is headache, although in some cases, and infrequently, it can occur without pain. The last phase is the postdrome, which affects 80% of patients. It is characterized by fatigue, confusion and problems concentrating, and can last up to a day.
To prevent a serious attack, it is essential to initiate treatment sharp as soon as possible. In mild or moderate crises, the most common thing is to take anti-inflammatories and, if there is no response, resort to triptans. In cases of moderate or severe crises, both medications can be combined. Additionally, preventive treatment may be chosen if three or more attacks are experienced per month, if symptomatic treatment is required two or more days per week, if the attacks are severe and do not respond to treatment, or if they are accompanied by a prolonged aura. or severe neurological focality.
For preventive treatment to be effective, it should last between 3 and 6 months, reaching the optimal dose before discarding. Migraines can be very frustrating, but it is important to keep in mind that this treatment usually takes between 10 days and 4 weeks to take effect. It is considered successful when it reduces the frequency or intensity of headache days by 50%. When discontinuing it, it should be done gradually.
Anyone can suffer from migraine, although it generally begins after the age of 20, and is more common in women than in men. The main causes They include disturbances in sleep patterns, menstruation, weather changes, fasting or starvation, and certain foods. Furthermore, “stress is one of the most powerful triggers of migraine,” emphasizes Teresa Marco, nurse at the Hospital Clínic Barcelona. However, there is one factor that cannot be controlled: hereditary. In most cases, there is a family history.
Stress is one of the most powerful triggers of migraine
When a migraine occurs 15 days or more per month, it is considered chronic. Among the factors that favor the chronicification of the disease are advanced age, genetic factors, low socioeconomic status, anxiety or depression, sleep disorders, drug abuse, obesity, excessive caffeine consumption and history of head trauma. Approximately 2.5% of patients go from an episodic migraine to a chronic migraine each year. The good news is that it also happens the other way around, which shows that the disease can improve.
One of the best techniques to manage chronic migraine is therapeutic educationa continuous process that empowers patients and their families to optimize disease control, prevent complications and improve quality of life. In a recent study by the Hospital Clínic Barcelona, a positive impact of this strategy was observed: on average, four days of headache and two days of migraine per month were reduced, in addition to improvements in quality of life and a decrease in the impact of disease. The study also reveals that 97.5% of study participants would recommend these sessions to others.
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