Migraine: learn about symptoms, causes and treatments – 09/29/2024 – Balance

Migraine is often confused and even used as a synonym for headache. But, although headache is one of the symptoms of the disease, they are not the same thing.

“Headache is a sensation that human beings can perceive and describe”, says Flávio Rezende, supervisor of the neurology residency at Unifesp (Federal University of São Paulo).

According to the doctor, headaches can appear in a variety of illnesses, from flu to obstructive sleep apnea.

Migraine is one of these diseases. It is distinguished by the recurrent nature of pain attacks, the association with nausea and vomiting and sensitivity to light, smells and sounds. The sensation of throbbing and location of the pain on one side of the head also provide clues to the diagnosis.

Migraine symptoms

The headache can manifest itself from a moderate to severe degree and predominates on one side of the head. Sensitivity to light and sound, which can worsen pain, are common. Physical exertion also tends to aggravate the pain. Nausea and vomiting are symptoms that can accompany crises.

“In most patients, pain attacks appear abruptly and take between four and 72 hours to disappear completely”, says Rezende.

The most typical manifestation of migraine, besides pain, is the aura. These are sensory changes, in vision, touch or speech, which usually last about an hour, and precede pain attacks.

“During a visual aura, for example, the person with a migraine loses part of their field of vision and only sees part of the objects. At the same time, they perceive brightness and geometric patterns. Some patients describe it as lightning, a waterfall or broken glass”, he says the neurologist.

Changes in speech may also occur. Reports of dysphasia, a temporary confusion in speech that causes confusion with words and expression, are not uncommon.

According to Rezende, headache and aura are the symptoms that usually make migraineurs seek specialized doctors, but there are other symptoms associated with the disease, such as mood changes, insomnia, drowsiness, difficulty concentrating, fatigue, desire to eat sweets, dizziness. He says that some of these demonstrations appear a few days before or after the crisis.

After a crisis, it is common to feel hungover and tired.

“The characteristics of pain can vary from one person to another, and from one pain attack to another”, says the neurologist.

Causes of migraine

According to Rezende, migraines are a genetic disease and those with a migraine-suffering father or mother have around an 80% chance of developing the condition.

But crises have specific triggers for each person — some report that excess caffeine or certain foods, such as spicy foods, cause pain, others say that specific lights, such as from shows or parties, have an impact. Strong odors, episodes of stress, excessive physical exertion and sleep deprivation can also trigger a crisis.

Furthermore, hormonal issues seem to be closely linked to the disorder. According to Rezende, a third of women have migraines, while a sixth of men say they have the disease. Women with the disease say that the proximity of their menstrual period tends to worsen crises and pain.

Migraine treatment and cure

According to Rezende, migraine is a disease with no cure. But there are strategies to reduce the number and intensity of crises.

One of them is a change in lifestyle, with regular physical exercise, meditation and relaxation techniques, and good sleep hygiene. Avoiding prolonged fasting, alcohol consumption and foods associated with crises can also help, says Rezende.

When a person has a number of attacks that make the disease a chronic problem – according to Rezende, at least 15 days with a headache, with migraine characteristics, monthly for three consecutive months – preventive treatments can be carried out.

This can be done with the use of antihypertensive medications, medications for epilepsy, application of botulinum toxin to the muscles of the head and neck or the injection of antibodies to combat migraines – a treatment that can cost up to R$1,000 per month.

During a migraine attack, treatment involves analgesics, such as dipyrone, anti-inflammatory drugs, such as ibuprofen, and triptans, which are more effective than conventional and directional analgesics for migraines.

“Overusing medications for migraine attacks can cause the frequency of headaches to increase, a condition called medication overuse headache,” says Rezende.

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