Resolution

 

  Migraine Associations

 

        Information about migraine

 

Introduction to Migraine

 

The standard medical definition :

The medical definition of migraine states that migraine is a primary headache disorder manifesting as recurring attacks usually lasting for 4–72 hours. This sometimes means that clients are told by GPs that it cannot possibly be migraine if it lasts for more than 72 hours! Migraine involves pain of moderate to severe intensity, often with nausea, sometimes vomiting, and/or sensitivity to light, sound, and other strange sensations. 

 

The Migraine Resolution Programme (MRP) description of migraine

As the creator of The Migraine Resolution Programme, and having worked within the medical therapy area of migraine for many years I have developed this, my own description of migraine:

Migraine begins with a wave of neurological activity that travels along the nervous system. It can affect many different areas of the body.  Usually (but not always) it affects the blood vessels covering the brain, causing alternate dilation and contraction - the pounding headache. Some sufferers feel the pain as a constant severe pain, rather than pounding. Other courses taken by this rogue wave of neurological activity include the stomach, where it can cause severe pain, and also different areas of the body such as the shoulder. The migraine attack may run along a familiar course continually, or it can change courses. Instead of affecting the right eye, it may move to the left, for instance, or it can begin to affect anywhere else. Instead of affecting the head, it can begin to affect the stomach. As well as a pounding headache, caused by the contraction and dilation of meningal blood vessels, usually there is nausea, vomiting, and extreme light sensitivity. Some people cannot bear to open their eyes when they have a migraine, and some even go temporarily blind. For a full list of all of the symptoms and conditions that seem to have been linked to migraine or IBS, click here.

Aura

In addition to the wave of neurological activity that instigates the actual migraine pain, there are preliminary neurological activities that cause aura.  An aura is a combination of one or more of visual, balance, smell, and taste disturbances that warn the person of the impending migraine. Some people only ever experience the aura, and their migraine does not develop further. The Migraine Resolution Programme can also be effective in reducing  symptoms of the aura.  Other signs of an impending migraine include pins & needles or numbness down one arm and hand. Many other more unusual happenings such as tinitis can occur. 

Daily migraine

There are some people who get migraine almost every day, and the duration can be almost continual, with varying degrees of migraine present at any one time. 

 

Pain

One symptom of migraine cannot be over-stated. The pain of migraine has been described as being the worst possible. Many people believe that they must be the only people to be experiencing such extreme pain. They can’t imagine that anything as bad as this could exist and not be making headline news. Many describe it as being much worse than having a baby, worse than the worst toothache etc. Some people have a severe headache that is not as bad as the worst possible migraine pain, and are able to function despite it.  There are even some people who have migraine, and do not experience any pain. They simply have neurological disturbances, nausea or vomiting, or any combination of these.

After a migraine subsides, there is a feeling of bruising in the area that was affected by the pain. Most migraine sufferers feel strange the following day. Some people feel so ill during this phase that that they have to stay at home while they recover.

 

Medical terms for migraine

Migraine without aura occurs in about 75% of cases (formerly called common migraine)

Migraine with aura occurs in about 20% of cases (formerly called classic migraine)

Childhood periodic syndromes like cyclical vomiting and abdominal migraine.

Retinal migraine


The Aura

Some people have an aura stage. Many do not. The aura signs begin before the main migraine attack.  This early warning is felt hours, or sometimes just a few moments, before an attack.   Visual disturbance may start in one eye and may spread, perhaps affecting just one side of the visual field but in both eyes. Geometric visual patterns and even hallucinations may occur.  Paraesthesiae sometimes is experienced.  This is a feeling of pins and needles or tingling.  Numbness can starts in the hand and move up the arm before involving the face, lips and tongue. Legs are sometimes affected. Sensitivity to light often begins at this stage.  Some people even experience temorary blindness.

An aura can be a combination of one or more of visual, balance, smell, and taste disturbances.  Some people only ever experience the aura, and their migraine does not develop further. The Migraine Resolution Programme can also be effective in reducing symptoms of the aura for these people. Many other more unusual signs, such as tinnitis, (ringing in the ears) can occur. 

 

The Migraine Attack

Neurologists have studied this condition for many years.  It is known that a wave of neurological activity begins a cascade, releasing hormones in a certain order, triggering a sequence of events.  At first there is a wave of distension across the meningal blood vessels.  A hormone is then released to contract these dilated blood vessels.  The blood vessels contract, but they contract too much, and a second wave of hormones is released to dilate the blood vessels again.  There follows a long series of these alternate hormone releases, with the result that the blood vessels are dilating and contracting wildly, and the patient feels the terrible pain of the distension as a throbbing, pounding headache, far beyond the pain of a normal tension headache.  The patient then begins to feel sick (nauseous).  Possibly the pain itself is the trigger for nausea or the crescendo of similar hormones triggering one to another. The patient feels sick, and then actually vomits.   A separate hormone is responsible for the action of vomiting, and some people feel very nauseous, but are never actually sick. Migraine attacks usually involve, simultaneously, the most excruciating pain in the head, nausea and vomiting, and sensitivity to bright light.

 

How common is migraine?

From medical information available on the internet, I found the following facts : -

More women suffer migraine than men.  Prevalence has been reported to be 5–25% in women and 2–10% in men, according to various studies. 

Migraine has been reported to be 50% more likely in people with a family history of migraine. 

 

Migraine in Children:

Migraine often starts in childhood. Childhood periodic syndromes including cyclical vomiting and abdominal migraine are thought by many to be a precursor of migraine in later life.

 

Is Migraine Hereditary? 

Many people with migraine assume that because their family suffers from migraine, they will inevitably have to live with it too.   It looks as though they may be correct in thinking that it can be inherited.  I have found that 'reactionary conditions' such as asthma, psoriasis, allergies, and irritable bowel syndrome, and migraine, do tend to run in families.  I put it down to the way people are made.  If you are constructed in a certain way, your stress will channel itself along a certain route, just like the other members of your family.  The Migraine Resolution Programme works even for familial migraine, because it re-educates your system NOT to react in that way.

Menstrual Migraine

Many women suffer migraine at just that 'time of the month'.   On the menopause, most of these women find their migraine is abating, but some unfortunate women find this is the time when migraine first begins.   The Migraine Resolution Programme works equally well for women who have menstruation, or the menopause, as their trigger. 

 

Chocolate, Red Wine,  & Cheese

I expect most of you who have had migraine for a while will be very familiar with triggers.  Here is a list, with the top three in the title of this section. 

Tiredness

Hormones

Stress or even relaxation after periods of stress. Stress can include bright lights, loud noise, long distance travel and extremes of weather, or even a change in air pressure.  Flying can be a problem for these people.

Anxiety or depression

Trauma to the head or neck

Alcohol

Citrus fruits

Missed meals

Sleep deprivation or excessive sleep

Oral contraceptives

Exams

Blood Pressure medication - vasodilators may precipitate or exacerbate the condition.

Bereavement. Shock. Trauma. Worry. Cold. Heat. Pollen - and many, many more.

Migraine and Strokes

Migraine has a suspected link with strokes, and there have been clinical studies to try and discover if people are more at risk of having a stroke if they suffer from migraine.  Some studies have found a link, others have concluded there is no link.

However, please click on this link to make sure that you identify a stroke at the earliest possible time, wherever, and whoever is involved.  Click here.

 

Avoidance -

Works for a while, until the migraine finds new triggers!

That is why it sometimes migraine is referred to as  “The demon”.

Many people do not know what begins their migraine.

Luckily, the Migraine Resolution Programme works equally well, whatever the trigger. 

 


Drugs used for migraine

 
 

 

Aspirin, Non-steroidal anti-inflammatory drugs (NSAIDS)

Aspirin - the most commonly used worldwide.  Three aspirin taken at the onset is the standard recommended dose for migraine.

Aspirin is classed as an 'NSAID' -(non-steroidal anti-inflammatory drug).  Other Nsaids are Neurofen, and diclofenac (also known as Voltarol) and many more.  They offer pain relief.  These are slightly different in their action and some can be more effective in pain relief for some people.  There are risks to health from any NSAIDs.  Internal bleeding can occur where a small perforation in any part of the alimentary tract can remain open and allow continuous bleeding.  This is due to interference with the clotting agent in blood. This type of incident is often referred to as a 'G.I. bleed' (Gastro-intestinal bleed). 

The statistics are that 1 in 12,000 nsaid takers result in death.

 

Class I & II drugs for pain relief

Codeine - mild narcotic- a nuisance side-effect is that it often causes constipation

Morphine, fentanyl - narcotics - also cause constipation

These are esed only in extreme cases, often when patients are admitted to hospital.

OTC - Over-The-Counter medication

These are drugs that are sold over the counter at a pharmacy.  The Pharmacist has to oversee the sale.

Migraleve - contains an anti-emetic (anti-nausea and sickness)  plus analgesic. 

Migramax - asprin/metaclopramide/lysine.  Metaclopramide helps with gut motility which usually stops during a migraine attack.  Often migraine sufferers vomit their medication intact even hours after they were taken because the easophagus, and the stomach cease all movements at the neginning of a migraine.  Metaclopramide encourages this movement once again, and allows any medication to be properly absorbed.  The lysine added to the medication makes the aspirin 200 x more soluable, so it passes through the wall of the stomach very quickly, and this gives the migraine a 'hard hit'.  The equivalent of three aspirin is included in the dose.

 

 

Triptans

Triptans are also referred to as HT5,  (serotonin) agonists.

Many migraine sufferers do not ask their GP for medication.  They simply take paracetamol and suffer!  Others seek medical help, and they will be given triptans if their simptoms are especially severe, and the GP feels triptans are appropriate.  GPs are reluctant to prescribe triptans because they are expensive, and must not be over-used because of potentially severe side-effects.  Occasionally patients feel side-effects as if they were having a stroke. GPs feel that it is unwise to encourage their use, unless the benefits outweigh the risks.

The most frequently used triptans are Imigran, Maxalt ‘melt’, and Zomig

Triptan Examples - Generic name followed by brand names

sumatriptan succinate - Imigran, Imitrex

almotriptan malate  - Axert

naratriptan hydrochloride - Naramig, Amerge

rizatriptan - Maxalt

zolmatriptan - Zomig

frovatriptan succinate  - Frova

eletriptan hydrobromide - Relpax

Maxalt melt is designed to dissolve in your mouth. Sumatriptan (Imigran) is also available as an injection. Both sumatriptan and zolmitriptan are available as a nasal spray.

 

How Triptans Work

Triptans narrow (constrict) blood vessels in the brain and relieve swelling.

Triptans work best when they are taken as soon as the headache pounds in. However, they can still reduce headache pain and other symptoms when taken after the attack has begun. Clients may need to take more than one dose of a triptan if the migraine returns.

 

 

Side Effects of Triptans

Flushing.

Tingling.

Drowsiness.

Dizziness.

Weakness.

A feeling of warmth or coldness.

Burning at the injection site (with the injected form of sumatriptan).

Bitter taste at the back of the throat (with sumatriptan and zolmitriptan nasal sprays).

Less common side effects can occur and may include an allergic reaction (a red, itching rash will appear or you may have trouble breathing). Some people may experience temporary chest pressure or tightness, although this is usually not dangerous.

Triptans should not be taken with other drugs such as monoamine oxidase inhibitors (MAOIs) or other migraine drugs such as ergotamines. If the client has risk factors for heart disease (such as high blood pressure, high cholesterol, diabetes, or a smoker), triptans may not be advisable.

These drugs should not be taken if there are heart problems, uncontrolled high blood pressure, problems with liver function, or a history of transient ischemic attacks (TIA) or stroke.

Overuse of triptans can cause rebound headaches.  These are almost like a continuance of the interupted migraine, with all of the severity of the original migraine.  Often migraine sufferers say they are getting two migraines with a day off in-between.

 

Beta-blockers

Normally used to lower blood pressure

Can’t be used for people with low blood pressure

Can’t be combined with some other hypertension drugs

 

Anti-Epilepsy Drugs,  Tricyclics and other prophylactic drugs

A variety of other drugs are used in order to help reduce the incidence or severity of migraine. 

These are taken every day, rather than just when a migraine threatens.

 

Other ways to help migraine sufferers

Dental appliances have been found to help some people. 

Other complimentay therapies that can also help migraine sufferers.  Often it is a case of trial and error.  There are people who have found their migraine has disappeared after acupuncture, homeopathy, reikie, and many other therapies. 

Copper bracelets, and magnetic bracelets also have been tried by some migraineurs.

Simply drinking more water has helped one person I met, and switching from tube lighting to standard lighting has helped another.

 

Summary

Many of the ways that people have found to alleviate their migraine has reduced one or more factors from their body or their life.  Dental appliances reduce night-time teeth-clenching. Medication reduces blood-pressure. Avoiding certain foods.  It all seems to point to one thing. 

Migraine is a response that is triggered by something that may or may not be harmful.  It may be triggered only when a particular combination of factors are present.  It may switch from one to another trigger, or accummulate triggers to end up responding to anything and everything. 

Some people find that they are able to avoid migraine by avoiding triggers, and they need no further assistance.  Other people try anything and everything and have found temporary relief before their migraine finds another way to continue.

The Migraine Resolution Programme is the first therapy to offer a combination therapy to deal firstly with the tensions that instigate migraine, and secondly, eliminate the migraine response.

 


 

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