What is the difference between migraine with aura and without aura: causes, symptoms, treatment, implications
Migraine with aura and its treatment – one of the most discussed topics in neurology, since about 60% of the population suffer from headaches of varying intensity. Migraine is among the most frequent causes reduction of labor activity of people.
More often this disease affects women. For the first time it makes itself felt usually in 18 – 35 years. Much less frequently the disease occurs in childhood and old age. Women and men of the older generation subject to its attacks almost equally.
One of the main reasons is genetic predisposition. If migraine headache and the mother and father, the risk of the disease of their children reaches 90%. Moreover, it is transmitted mainly through the maternal line, the probability is more than 70%. The mechanism of hereditary transmission of the disease until the end of the scientists is not yet known.
Before the attack from the endings of the trigeminal nerve is the origin of substances-mediators that cause the inflammatory process, the level of serotonin is reduced, and the activity of the hormones norepinephrine and dopamine is increased.
In Addition to internal, there are external trigger factors, that is, provoking attacks of migraine are:
- dazzling light or frequent blinking;
- too loud or corrosive uniform noise
- sharp aromas;
- significant weather extremes;
- cheese, milk, canned meat, herring, broad beans, citrus, chocolate, bananas, dried fruits, nuts, sunflower seeds, coffee, tea, Coca-Cola, champagne, wine, beer containing tyramine;
- strong stress;
- travel in public transport
- sexual acts
- long rest, the release of excessive negative or positive emotional States;
- medications: nitrates, oral contraceptives, "Reserpine", etc.
For many the trigger of migraine are not separate factors and their combination. For example, a bottle of wine with a slice of cheese between the monthly – fun is completely safe, and the same during menstruation, can cause severe migraine attack.
Classification and symptoms
According to the international classification, migraine is a pathological condition characterized by recurrent attacks of severe, pulsating headache localized in one (mostly in the orbital or fronto-temporal) region. Often they are overlaid with nausea, vomiting, intolerance to bright lights and too loud sounds. After the attack comes the General weakness, drowsiness and even euphoria.
Neuroscientists have identified two main forms of the disease: migraine without aura, observed in 70% of all patients suffering from severe headaches, migraine with aura, a fixed 30% of patients. What is this exotic phenomenon – the aura? The so-called neurological condition before pain attacks, which gives rise to various visual, auditory anomalies, speech disorders, muscle restrictions.
The type of aura depends on the form of the disease. It can be:
- typical (previously known as classic migraine ophthalmic);
- with a prolonged aura;
- with a sharp onset of the aura;
- without a subsequent headache.
depending on which arteries are involved in the pathological process, the migraine can be complicated:
- oftalmologicheskiy (with pupil dilation, eyelid drooping, vision)
- gemiparetic (difficult movements in one hand or arm and leg);
- basilar (with dizziness and confused speech, double vision, hearing impairment or ringing in the ears).
Isolated panic migraine. It is characterized by the accession to headaches feelings of fear, breathlessness, chills, tachycardia, frequent urination. Such attacks usually occur over a long, difficult, and patients need special medical approach.
Effects migraine – complications of two kinds. If you want a series of heavy attacks or occurs alone, but very long and acute onset, often with vomiting, it is status migrainous, occurring in 1-2% of cases.
If the migraine affects the blood vessels of the brain, the patient catches up with migrainous stroke.
For migraine with aura require the following symptoms:
- any symptoms of the aura do not last more than 1 hour;
- after the attack, many of them entirely disappear;
- between the aura and the beginning of the pain attack comes the "pause" that lasts no longer than 1 hour.
The alert signal such symptoms: a change in the nature or intensity of attacks in patients "with experience", the appearance of the disease at age 50 years and older, the appearance of new symptoms.
In such cases, careful examination to exclude the presence of an aneurysm under the mask of a migraine.
According to experienced practitioners, the main principle of the identification of the disease – a thoroughhistory. In instrumental and laboratory methods of research need not, as in this disease they aren't helpful. They are used if atypical migraine occurs.
Organic neurological symptoms often are not detected. Although the symptomatology of migraine without aura and with aura has a number of similarities, yet doctors have often to differentiate it from tension headaches. In this disease the pain is usually bilateral, less intense and throbbing, and squeezing.
In addition, all of the symptoms typical for migraine, headaches tension sometimes appears only one, for example, photophobia, or mild nausea. And the nature of the attacks in this case is quite different: they provoke stress, prolonged static postures, in which numb the muscles of the neck, head, etc.
In making a final diagnosis, the physician must be guided by the criteria of the International classification of headache.
The Symptoms and treatment of migraine are closely related to each other. Treatment has two main objectives: the elimination of seizures and prevention prevention them in future.
Painkillers should be used before the onset of the pain attack, but not when she's already played, otherwise taking them ineffective. With migraines at night these drugs are best taken in the afternoon, in the second half. To prevent attack are also used nonsteroidal anti-inflammatory agents.
With heavy attacks, especially migraine with status, requires hospitalization of the patient. In the hospital is assigned a drip intravenous administration of one of the drugs of the ergot.
The Attack can be eliminated by a comprehensive appointment of sedatives, nootropic, diuretic agents, drugs of antidepressant.
In the periods between the attacks to treat the disease should medications that you can take a long time. It antagonists of serotonin, their high doses of pain first cropped the attack, and then a few months courses of maintenance therapy.
These drugs include beta-blockers, calcium blockers, antidepressants. High preventive efficacy has a number of drugs-anticonvulsants. It is important to keep in mind: preventive medication is appropriate, on a monthly basis if the patient is more than two attacks.
In the treatment of migraine of any forms it is also advisable to apply the tools of psychotherapy, autogenic training, electromyostimulation, acupuncture, massage. Important diet that excludes foods containing tyramine. Prophylactic courses of treatment are long – 3 to 6 months.
- international classification of headaches. Vladimir Osipov. Magazine "Treatment of nervous diseases", No. 4, 2003.
- Migraine: clinical features, diagnosis and treatment approaches. Vladimir Osipov. Journal "Pharmateca", No. 20, 2008.
- Headache. "Neurology for General practitioners" edited by A. M. Wayne, "Eidos Media", 2002.
- Headache. O. A. Kolosova. "Pain syndromes in neurological practice" edited by A. M. Wayne, "Medpress", 2001.
- Sleep and headache. J. I. Levin. The magazine "Medicine for all", №4, 1998.