HEADACHE AND MIGRAINE,SINUS,AURA,TRIGGERS
It is a chronic neurological disorder that was characterized by recurrent moderate to severe headaches that often association with number of autonomic nervous system symptoms.
Typically this headache was affected to one half of the head & pulsating in nature. This lasts from 2 to 72 hours,associated symptoms like nausea,vomiting and photophobia, phonophobia and pain is generally aggravated by physical activity.
There are many activities that can create the ache and also medical literatures have complied a lengthy compendium of the causes .
Causes :
Triggers:
Dietary aspects:
Physiological aspects:
There are many activities that can create the ache and also medical literatures have complied a lengthy compendium of the causes .
Causes :
- Overuse of common prescription or over the counter pain medication.
- They run in families in about two thirds of cases and rarely occur due to single defect.
- A number of Psychological conditions are associated including depression,anxiety and bipolar disorder as are many biological event.
- Migraines may be induced by Triggers with some reporting it as an influence in a minority of cases and others the majority.
- Many things have been labelled as triggers, however the strength and significance of these things are uncertain.
- A trigger may be encountered upto 24 hours prior to the onset of symptoms.
- Reviews of dietary triggers have found that evidence mostly relies on the self reports and is not rigorous enough to prove or disprove any particular triggers.
- Regarding specific agents there does not appear to be evidence for an effect of tyramine on migraine and while monosodium glutamate is frquently reported as a dietary trigger evidence does not consistently support this.
- Common triggers quoted are stress, hunger and fatigue.
- Migraines are more likely to occur around menstruation.
- Other hormonal influences occur such as menarche,oral contraceptive use,pregnancy,perimenopause,menopause play a role.
Management :
Analgesics:
Aspirin can relive the moderate pain,paracetamol, Ibuprofen also useful to avoid pain.
Ergotamines:
These are older medications still prescribed for migraines.
Prevention :
Medications :
Preventive migraine medications are considered effective if they reduce the effect or severity of migraine attack.
Timolol is also effective for migraine prevention, and in reducing the migraine attack frequency,
Botox has been also found to be useful in chronic migraines.
Alternative methods :
There is some tentative benefits for magnesium, of the all alternative medicines butterbur is the best evidence for its use.
Devices and Surgery :
Medical Devices such as biofeedback and neurostimulators, have some advantages in migraine prevention.Neurostimulation uses neurostimulators similar to peace makers for the treatment of interactive chronic migraines with encouraging uses for severe cases.
History :
An early description consistent with migraines is contained in the ebers papyrus,the partial relief occurs in after vomiting .
Trepanation, the deleberate drilling of holes into a skull was practised in early days. while sometimes people survived , and many of people died because of infection.
While many treatments for migraines has been attempted.During the 20th century with better study design effective preventative methods were found and confirmed.
Epedemiology :
During adolescene migarines become more common among women ,and this persists for the rest of the aura, however in men two types occur in similar frequency.
While symptoms resolve in about two thirds of the elderly in between 3 to 10 % they persist.
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