Don't treat migraine as a disease

This is the 4941th article of Da Yi Xiao Hu

May 2024 is the first Migraine Care Month proposed by the China Headache Prevention and Control Alliance and the Headache and Sensory Disorders Committee of China Research Hospitals. May 27 is designated as China's first "Migraine Care Day". Focusing on the theme of "Don't treat migraine as a disease", let's talk about some common sense about the diagnosis and treatment of migraine today.

1. Migraine is more than just pain

Migraine is a highly disabling disease. When moderate or severe migraine attacks occur, daily activities will be affected and may be accompanied by nausea and vomiting. People may become irritable when hearing loud noises or particularly bright lights. In severe cases, people may not even be able to get out of bed. It ranks second among disabling diseases according to the World Health Organization. Therefore, the timely use of appropriate analgesics in the acute phase to terminate migraine attacks is the first principle of treatment. If long-term non-standard treatment is not provided, it may lead to neuropsychological symptoms such as anxiety, depression, and insomnia, and increase the risk of cardiovascular and cerebrovascular accidents such as myocardial infarction and cerebral infarction. If it progresses to chronic migraine, the patient will have to endure frequent headache attacks.

2. How to quickly screen whether it is a migraine?

Headache is a common symptom in life, so what kind of headache is considered to be a migraine? First of all, the nature of migraine headache is generally pulsating, which is what ordinary people often call "a throbbing pain" or "a jumping pain", and it often occurs near one side of the temple, which is medically called the temporal side. Secondly, the duration of a migraine is generally 4-72 hours. If the pain improves after a few seconds or minutes, it is mostly not considered a migraine. At the same time, most patients are accompanied by nausea or vomiting, fear of light or noise, which is called photophobia or phonophobia in medical terms. Third, severe migraine can affect daily life. For example, patients with severe migraine cannot get up, and their social life and work are affected and cannot be completed. Therefore, not all headaches are attributed to migraines. Only when they meet the above characteristics can the possibility of migraine be considered. It is better to go to the headache specialty clinic of the neurology department to see what type of migraine it is and how to treat it.

3. What is the best way to treat migraine?

Different types of migraine treatments vary, but there is a basic principle: to stop the headache. Mild headaches can be treated with non-drug treatments such as acupuncture, massage, relaxation training, etc. Establish a good lifestyle in daily life, regular work and rest, balanced nutrition, a reasonable diet, adequate sleep, regular and moderate physical exercise, and try to avoid or remove the causes of migraine.

When to use drugs to treat migraine is the most difficult thing for ordinary people to judge. When the headache is severe or reaches the most painful, the use of analgesics usually does not work immediately. The best time is to use analgesics to control acute attacks when the headache is mild to moderate. Commonly used analgesics include acetaminophen, ibuprofen, naproxen, etc., triptan drugs such as sumatriptan, rizatriptan, etc., and new drugs include remegipam, atrogepam, etc.

The treatment of migraine is a long-term chronic process. As long as you master the correct principles, you will have less pain from headaches in your life. I hope every migraine patient can take care of themselves and find a treatment strategy that suits them. Don't treat migraine as a disease!

Department of Neurology, The Second Hospital of Jilin University

Written by: Zhu Bochi, attending physician

Reviewer: Man Yuhong