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  Migraine headaches

Migraine headache is a type of vascular headache caused by both vasodilatation (enlargement of meningeal and other blood vessels) and release of chemicals from the nerve fibers that surrounds the blood vessels. Other factors such as depletion of the serotonin neurotransmitter also play a part. The disease is usually familial in pattern and is more common in young women. In fact, migraine afflicts 28 million Americans, with females suffering more frequently (17%) than males (6%).

Migraine headaches
Migraine headaches


In the history, migraine is described as a recurring, severe type of throbbing of pulsating headache, usually unilateral in location with neurologic concomitants specifically a “visual aura” or “visual spots” seen prior to the attack of headache. This is also known as “migraine with aura” or the “typical migraine”. Most often the patient sees flashes of light or zigzag light in both eyes, usually a transitory visual field defect also called scotomas. The headache maybe accompanied by nausea, vomiting, photophobia, intolerance to noise and other neurologic symptoms such diplopia, transient local anesthesia or paralysis. In migraine without aura (atypical migraine), the headache is less severe and more generalized. The headaches typically last for several hours and may severely incapacitate. Often, complete relief is not obtained until after sleep. Some of the triggering factors are: emotional stress, fatigue, menstruation, skipping meals, certain foods (chocolate, nitrate-rich foods), alcohol and oral contraceptive pills (OCPs).

Migraine attacks commonly activate the sympathetic nervous system in the body. This is a part of the autonomic nervous system which mostly controls the body’s internal organs and primitive responses or also known as the “fight or flight” response. Increased sympathetic activity also delays gastric emptying time, therefore, prevents oral medications from entering the intestine for proper absorption and distribution to have it therapeutic effect. This is the main reason for the ineffectiveness of most medications taken to treat migraine headaches. Sympathetic responses also promote vasoconstriction and this leads to pallor of the skin and cold hands in severe anxiety disorders. Increased sympathetic activity also contributes to light and sound sensitivity as well as blurred vision.

During and after attacks of migraine, the physical examination is essentially normal. The role of diagnostic tests is chiefly to rule out if a more serious disorders of the neurologic system is suspected but there are no specific findings. The disorder may often begin in childhood and continues for many years. Depending on the triggering factors, the frequency of headaches may occur daily or at intervals of months or years.

There are two approaches in treating migraine headaches, non-medication therapies and medication therapies. Non-medication therapies which does not involve medications but can provide symptomatic and preventive treatment. Using ice, biofeedback, and relaxation techniques may be helpful at stopping an attack once it has started. An alternative form of treatment such as acupuncture has also been suggested. Proper education to patients with regard to lifestyle modification, such as smoking cessation, avoidance of tyramine-rich foods (e.g. cheeses), sulphites (wines) or nitrates (e.g. nuts, processed meats), is also recommended. Basically, the goal here is to lead a healthy lifestyle with a balanced and good nutrition, adequate water intake, sufficient sleep and regular exercise.

Over-the-counter (OTC) or non-prescription pain relievers or analgesics have been shown to be safe and effective for short-term relief of mild migraine headaches that do not interfere with the daily activities of the patients. There are two major classes of OTC analgesics: acetaminophen (Tylenol) and non-steroidal anti-inflammatory drugs (NSAIDs). The NSAIDs relieve pain by reducing the inflammation that causes the pain. They are called non-steroidal because they are different from the corticosteroids such as prednisone and prednisolone. The corticosteroids have potentially serious side effects when taken for a prolonged period of time. Examples of non-Aspirin NSAIDs are ibuprofen (Advil) and naproxen (Aleve). Some NSAIDs need prescription and are not over-the-counter. Other medication available over-the-counter is a combination of Aspirin, acetaminophen and caffeine. Response to an effective analgesic or analgesic combination is a case to case basis. Therefore, the process of trial and error usually happens among individuals with migraine because a patient may respond differently to different analgesics. In general, the person should use the most effective analgesic that has worked for him in the past. Special precautions that should be observed with OTC analgesics are: children and teenagers should not use aspirin because of the risk of developing Reye’s syndrome; dysequilibrium problem, active ulcers of the stomach and duodenum, advanced liver disease, concomitant use of other blood thinners like warfarin (Coumadin).

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Fioricet tablets

Fioricet

Fioricet, a combination of Butalbital, Acetaminophen, and Caffeine, is a pain reliever and relaxant used to treat tension headaches. Butalbital belongs to the group of medicines called barbiturates that act in the Central Nervous System (CNS) to produce t more...

Ultram tablet

Ultram

Ultram, also called Tramadol, is an analgesic used to relieve pain, including use after surgery. The effects of Ultram are similar to those of narcotic analgesics, and though it is not considered narcotic, it may become habit forming. Be sure to tell more...

Tramadol

Tramadol

Tramadol, also called Ultram, is an analgesic used to relieve pain, including use after surgery. The effects of Tramadol are similar to those of narcotic analgesics, and though it is not considered narcotic, it may become habit forming. Be sure to tel more...

Oxycontin tablets

Oxycontin

Oxycontin, also called Oxycodone is a Narcotic Analgesic used to treat pain. Oxycontin works in the central nervous system (CNS) to relieve pain. Be sure to tell your doctor of any allergies you have whether it is to medication or food, preservatives, more...

Vicoprofen tablet

Vicoprofen

Vicoprofen, also called Hydrocodone and Ibuprofen is a combination is used to relieve pain. Hydrocodone is a narcotic analgesic that works in the central nervous system to relieve pain. Ibuprofen is a Nonsteroidal Anti-inflammatory Drug (NSAID), and is u more...

Lodine tablets

Lodine

Lodine (also known as Etodolac) is one of many Nonsteroidal anti-inflammatory drugs (also called NSAIDs). It is used as an analgesic, to help prevent gout, as an anti-inflammatory to help with the symptoms of arthritis, and as a remedy for certain types o more...

Ultracet

Ultracet

Ultracet is one of a group of combination medicines that contain the narcotic analgesics Tramadol and Acetaminophen, and are used to relieve pain. Ultracet may provide better pain relief than either medicine used alone would be able to, and may possibly a more...

Ibuprofen tablets

Ibuprofen

Ibuprofen is a Nonsteroidal Anti-inflammatory Drug (NSAID), and is used to relieve some symptoms caused by arthritis. It is also used treat other conditions, such as: gout attacks; bursitis; tendonitis; sprains, strains, or other injuries; or menstrual c more...

Oxycodone tablets

Oxycodone

Oxycodone, sometimes called Oxycontin is a Narcotic Analgesic used to treat pain. Oxycontin works in the central nervous system (CNS) to relieve pain. Be sure to tell your doctor of any allergies you have whether it is to medication or food, preservati more...

Atenolol tablets

Atenolol

Atenolol, or Tenormin, is one of a group of medicines is known as beta-adrenergic blocking agents, beta-blocking agents, or beta-blockers. Atenolol is used in the treatment of high blood pressure, used to relieve angina, and in heart attack patients to he more...


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