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Migraine and its Management

Preeti R. Bhupali , Preeti R. Bhupali , Deepak Bagi

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International Journal of Neurology and Neurosurgery 5(2):p 59-65, July - December 2013. | DOI:

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Abstract

Migraine is a chronic neurological disorder characterized by recurrent episodes of moderate to severe headaches often in association with a number of autonomic nervous system symptoms, most often unilateral.Worldwide, migraines affect nearly 15% or approximately one billion people. Migraine is caused by the activation of a mechanism deep in the brain that leads to release of pain-producing inflammatory substances around the nerves and blood vessels of the head. Typically the headache is unilateral (affecting one half of the head) and pulsating in nature, lasting from 2 to 72 hours. The Etiology of migraine are, Calcitonin gene related peptides (CGRPs), Genetic, Triggers, Physiological aspects, Dietary aspects, Environmental aspects.Migraines typically present with self-limited, recurrent severe headache associated with autonomic symptoms. There are four possible phases to a migraine, although not all the phases are necessarily experienced 1) Prodrome phase (Early warning signs), 2) Aura phase, 3) Pain Phase (Attack phase: The headache begins), 4) Postdrome. Prevention & management through medication, includes NSAID’s, Triptans,Ergotamines, Botox Injections, ACE Inhibitors, Angiotensin-Receptor Blockers, Histamine and Beta Blockers.Studies have showed mixed results on the benefits of acupuncture for preventing migraine. Herbs & Supplements treatment includes, Butterbur (Petasites hybridus), Feverfew, Riboflavin (Vitamin B2) and Magnesium, Fish Oil, Ginger etc. Other treatments include spinal manipulation/ Chiropractic manipulation,relaxation techniques combined with applying a cold compress, Cognitive- ehavioral therapy, laughter therapy, Yoga Nasal sprays and powders, Intra-oral appliances Biofeedback, Transcranial magnetic stimulation, Vagus Nerve Stimulation, Occipital nerve stimulation, Arterial surgery, Muscle Surgery: Trigger site release, Septoplasty and Turbinectomy, Decompression of certain nerves around the head and neck and Patent foramen ovale closure.  

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