Migraine revisited (1)

My brother, Abg Wa just now sms me asking for any better treatment for his wife, Kak Nina who's sufferring from recurrent chronic headache, presumably migraine. she also has hypertension. for the past few days, I have touched on migraine treatment from acupressure to meditation, affirmation, visualisation etc (hollistic approached). I think its better now if I can summarize it and start from the basic, ie what is migraine, the precipitating factors, modern treatment, useful herbal, vitamins etc. Other readers spt Farahish Yang Baik hati might also find its useful.:)I'll start with migraine from modern view first..

So what is migraine?

Migraine headaches are usually classified as either common migraine or classic migraine. A classic migraine is preceded by an aura with characteristic visual (penglihatan), sensory (rasa), or motor (pergerakan) symptoms. Aura usually includes visual abnormalities (e.g., flashes, shimmering, and other hallucinations that seem to migrate through the visual field) and neurological abnormalities such as tingling sensations (rasa kebas-kebas)

Migraine attacks often include features that occur in sequence, including the following:

Prodrome. This stage is marked by a change in mood that begins hours or days before the headache. Symptoms of prodrome include depression, sleepiness, talkativeness, restlessness, or other alterations

Aura. Aura is characterized by visual abnormalities, including flashes, shimmering, and other hallucinations.

Headache phase. The headache itself is typically one sided but may affect both sides of the head. It is usually gradual in onset, moderate to severe in pain intensity, throbbing (berdenyut), and worse with physical exertion, and it can last anywhere from 2 hours to 2 days in children and 4 hours to 3 days in adults . The frequency of migraine attacks is unpredictable. The headache stage is often accompanied by loss of appetite, nausea, vomiting, sensitivity to light and sound, blurred vision, tenderness of the scalp or neck, lightheadedness, sweating, and pallor

Migraines are about three times as common in women as in men.The frequency of migraine headaches appears to increase with age, with peak frequency in women during their 30s and 40s and in men during their 30s, and then seems to decrease. Among some women, migraines decrease in severity or disappear entirely during menopause. Clearly, migraine's close correlation with sexual maturity and menopause in women suggests that steroid hormones are involved in the disease

Migraine headaches also tend to run in families, and there is a definite genetic predisposition . More than 50 percent of migraine sufferers have a relative who also suffers from migraine

Migraine Triggers

Several lifestyle factors may trigger a migraine headache

-Lack of sleep
-Consumption of alcohol, especially red wine and beer
-Excessive exercise
-Consumption of foods containing monosodium glutamate or nitrates
-Consumption of other potential food triggers, including chocolates, aged cheese, dairy foods, caffeine, fermented or pickled foods, shellfish, and wheat
-Emotional stress
-Use of certain medications may trigger a migraine - these include the following:
----Birth control pills or conventional hormone replacement therapy with synthetic estrogens and progestins
---Drugs that dilate the blood vessels, such as Viagra ® (sildenafil)
---Antimigraine drugs used excessively, which can cause rebound migraine
-Migraines also may be triggered by the overreaction of blood vessels to a variety of factors:

------Menstruation
------Fatigue
------Changes in altitude, weather, or time zone
------Glaring lights
------Perfumes or other powerful odors
------Head trauma

Conventional Treatment of Migraine

Generally speaking, conventional treatment of migraine follows one of three approaches—all of which may be used in the same patient. The first is prevention of migraines; the second is stopping a migraine as it is beginning; and the third is to lessen the pain of an ongoing migraine attack. In each approach, certain drugs have been shown to be effective

Drugs used to abort fledgling migraines or treat the pain associated with migraines include the following:

-5-HT (serotonin receptor) agonists (triptans) eg sumatriptan

-Ergot alkaloids and ergot derivatives eg cafergot

-Painkillers and painkiller combination drugs

-Nonsteroidal anti-inflammatory drugs eg voltaren, ponstan,synflex etc

-Opiate analgesics. eg morphine

-Antiemetics (penahan muntah)

-Corticosteroids.

-Botox

Prophylactic drugs (ubat pencegah) must be taken daily, and there is usually a lag of two to six weeks before the effect is felt . Drugs approved by the Food and Drug Administration to prevent migraines include propanolol, timolol, sodium valproate, methysergide, verapamil, and amitriptyline. The probability of success with any drug is about 50 percent to 75 percent, so it is not unusual for drugs to be rotated until an effective one is found.

(Ref: Life Extension articles)

-cont

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