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Oct01
MIGRAINE- ITS CAUSE AND TREATMENT
Migraine is a serious type of Headache which occurs with so much robust type of headache mostly in one half of head with throbbing or pulsating type prececded by an aura or a smell or perception of some thing going to happen,blackspots in eye field,flickering movements of eye,face and hands or sensation of tingling type or numbness in head or any part of body preceded by nausea or vomiting feeling or vomiting and patient become very sensitive to light or sound needing a dark room and a noise less enviornment for soothing .This type of Headache is believed to be caused by extreme sensitivity of Blood Vessels and nerves to many chemicals and toxins yet to be discovered or many other physical agents like bad or unpleasant smell or flashing ,extreme cold or hot or un familiar enviornment any psychological insult like fear,apprehension,tension,anger,happiness or grief leading to contraction or dilatation of these blood vessels There is no cure or medications for migraine headache but the drugs can help reduce the frequency and severity of migraines.Migraine usually affects more female than male ,usually middleaged ladies are involved and subsides in intensity after menopause but seen too commonly in male too and involves children too.Migrain attack is severe one and usually last for 12-24 hrs but may last for 2-3 days and usually remission and recurrence are common ,mostly recurs in week or monthly wise but in some days it may occur at days interval.Usually it subsides normally without leaving any spot or complication like paressis or paralysis of any part or any defects in sensory or motor nerves of Body or any epileptic or any other type of slow or rapid movements or uncontrol of bowel and bladder or any type of para or sympathetic alterations.
There are many drugs specifically designed to treat migraine which are given below,some are drugs which abort or stops attack of Migraine once it has started like NSAIDs,Triptans,Ergot derivative,butabital,barbiturates,anxiolytic and sedative with opiates ,others are used to prevent its recurrance like B-Blockers,calcium channel blocker,Angiotensin receptor blockers,major tranquilisers and antivomiting medicines,anti epleptics,anti depressants,serotonin uptake or receptor inhibitors,anti histaminic like Cyprohepatidine,Botulinum and norepinephrine receptor or uptake inhibitors but still after their use recurrence is delayed but not completely inhibited.
Aborting drugs:-------These types of drugs are taken during migraine attacks and are designed to stop symptoms that have already begun. These are taken as soon as symptoms of a migraine occur. It may help if you take rest or sleep in a dark room after taking them.
Nonsteroidal anti-inflammatory drugs (NSAIDs):? Ibuprofen,Paracetamol or Aspirin or Diclofenac sodium or Acllofenac,Rafecoxib, Etorcoxic ,Naproxen,Indomethacin etc., may help relieve mild migraines.Combination of acetaminophen, aspirin and caffeine also may ease moderate migraines .Side effects: can lead to ulcers, gastrointestinal bleeding and rebound headaches.
Triptans: Both oral and injectable preparation even nasal spray is also available,Sumatriptan has been widely used rizatripan is showing promising result.
Used for severe migraine attacks.DRUGS ARE AS FOLLOWS:-Sumatriptan, rizatriptan ,Naratriptan, zolmitriptan, Almotriptan, frovatriptan and eletriptan .Side effects: nausea, dizziness and muscle weakness.They are not used in heart attack and stroke.
ERGOT DERIVATIVES:Used for pain lasting for more than 48 hours.DRUGS ARE'--- Ergotamine,Dihydroergotamine, Antivomiting or nauseating Medications if nausea or Vomiting present : Metoclopramide,prochlorperazine.
Butalbital:It is a sedative which is used in combination with other drugs for migraine attacks. Combination of butalbital with aspirin or acetaminophen Combination with caffine and codeine but rebound headache ,withdrwal symptoms.
OPIATES: Medicines containing narcotics, particularly codeine, are sometimes used to treat migraine pain when people can't take triptans or ergot.
Side effects: Habit-forming and patients are usually addicted.
Preventive medications:
These drugs are taken daily on a regular basis, to reduce the severity or frequency of migraines. Are used when two or more debilitating attacks a month occur and if pain-relieving medications aren't helping or symptoms include a prolonged aura or numbness and weakness.
Cardiovascular drugs:
Beta blockers: Commonly used to treat high blood pressure and coronary artery disease ? can reduce the frequency and severity of migraines.
Calcium channel blockers: Verapamil also may be helpful in preventing migraines and relieving symptoms from aura.
Antihypertensive medications: Lisinopril and candesartan are useful in reducing the length and severity of migraines..Side effects: Dizziness, drowsiness or lightheadedness.
Central Nervous System drugs:
Tricyclic antidepressants: Amitriptyline, nortriptyline and protriptyline .
Selective serotonin reuptake inhibitors (SSRIs) and serotonin and nor epinephrine reuptake inhibitors (SNRIs): Venlafaxine may be helpful in preventing migraine.
Anti-seizure drugs: Divalproex and Topiramate, and Gabapentin .Side effects: Nausea and vomiting, diarrhea, cramps, hair loss, and dizziness.
Major Tranqualisers : Trifluperazine,(Sibelium,no miraine)prochlorperazine(Stemetil).
Cyproheptadine: This antihistamine specifically affects serotonin activity. Doctors sometimes give it to children as a preventive measure.
Botulinum toxin type A: Botulinum toxin type A injections in mutiple sittings over head is sometimes used for treatment of chronic migraines,but relapses are common after 6-12 months of therapy.
Dr.D.R.Nakipuria
,09434143550


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