"Medical Chat" has a kind of painful headache, so arrogant and no trace

I am an unforgettable pain, called migraine.Whenever the attack, people are upside -down and can’t wait to beat our heads; but we will suddenly disappear, as if you have never had pain.

Moreover, we have a variety of personality and never play cards according to common sense:

Each patient is different in pain; (on the left/right/top/back/behind the entire head) Each patient’s pain time is different; (4-72 hours may be possible)((Specific odor/emotion/light/sound/hormone level may be possible) So far humans have not explored the cause of the disease; (the migraine pathogenesis mechanism has so far, it is a hypothesis.) There is no healing method.

However, we have several common characteristics of migraine: Although it is terrible, there is no organic lesions in the brain; it is often accompanied by nausea and vomiting when headaches;There is no difference from the health crowd when it hurts.Usually it will gradually improve/no longer with age.(Such as women after menopause)

Our migraine is divided into: seizure of migraine and chronic migraine. If we do not control it in time, we may convert from seizure of migraine to chronic headache.It may cause sleep disorders and anxiety depression.

So, let’s take a good understanding of our migraine today ~ Try to avoid the cause of the attack, and learn to relieve you for your own pain.

Introduction of guests in this issue

Li Xiang

Doctorate in neurology, the attending physician of the Department of Neurology, Huashan Hospital affiliated to Fudan University.Good at diagnosis and treatment of neurotomic diseases, such as autoimmune encephalitis and other central nervous system diseases.

The cause of migraine is unknown, and there are many incentives

There are many factors that induce our migraine to make a blessing:

Tension/labor/sudden change/changes in air pressure

Strong light stimulation/scorching sun/too full/too hungry

Demplating drugs/drinking

Consumers high -cheese foods (chocolate, cheese), etc.,

But human beings do not know the cause of migraine.

Clinically, about 50%of patients have family history,

Female patients mostly occur during menstruation.

Such as "menstrual correlation with migraine".

Matsusetory correlation migraine

About 15%of female migraine patients occur only before and after menstruation, known as "menstrual migraine".Most female patients have decreased after pregnancy, and most of them stopped attacks during pregnancy.After menopause, most women will improve or not.It shows that the onset may be related to hormone changes.

Clinical manifestations of migraine headache

The pain caused by our migraine is repeated,

General duration: 4 ~ 72 hours.

Typical symptoms are: unilateral and fighting,

Pain is generally unbearable,

(This can be different from tension headache)

Daily activities will exacerbate the power of migraine,

Human vomiting/crowded, etc. often make humans vomiting.

Typical threatened migraine can be divided into four phases,

(There may be cross or change between these stages)

Some symptoms such as sensitivity and neck pain

Can continue to exist throughout the process.

Early stage of attack:

A few hours or days before migraine occurring, some patients show certain symptoms of precursor.Boarding, fatigue, inadequate concentration, and neck stiffness are the most common symptoms.

Sinuminal period:

Migraphy usually occurs within 15-30 minutes after the start of the threatened symptoms, or occurs at the same time as a threatened.

During the threatened period, visual symptoms are the most common: such as light, flashing, spark or complex visual illusion, and visual field defects, dark spots, partial blindness, or brief blindness.Frequent symptoms of eyes.In addition, symptoms of defects or stimulation symptoms such as numbness, mildness, hemiplegia, and language disorders can occur.Most of the aura lasted for 5 ~ 60 minutes, and different signs could appear one after another.

Headache period:

Most of the typical headaches are located on one side, and gradually worsen to the medium weight. It often appears at the time when the aura starts or appears at the same time as a threatened.

The pain is mostly on the upper orbital, orbacco, or the mesh area of one side, and gradually worsen and expand to the half -side head, and even the entire head and neck.

Headache is mostly fighting, dancing or drilling, and gradually worsening, developing into persistent drama pain, often accompanied by nausea, vomiting, photophobia, and fear.A seizure can last for 4 to 72 hours, and headaches can usually be significantly relieved after sleeping.

Late session:

After the attack, the patient will be tired, decreases attention, may be emotionally low, anxiety and other performances, and patients are happy and refreshing.Some patients still have symptoms of scalp tenderness, and some feel muscle weakness, pain, decreased appetite or hunger.The interval period is normal.

Migraine Diagnosis Standard

When a headache, the biggest role in going to the hospital is:

Determine which headache is.

Then you can get appropriate diagnosis and treatment

And improve lifestyle.

Treatment is divided into acute phase and preventive treatment

Different headache therapy drugs are not exactly the same.


Non -warning migraine

A.Headache that meets the B-D standard at least 5 times

B.Headache seizures last 4-72 hours (unsuccessful treatment or treatment is unsuccessful)

C.At least 2 of the following 4 items:

1. Unilateral

2. Fighting

3. Middle-severe headache

4. Daily physical activity can aggravate headaches or can not be competent for daily activities due to headaches

D.During the attack, at least one of the following two items:

1. Nausea and/or vomiting

2. Cute and fear

E.Can not be better explained with other diagnosis in ICHD-3.

Some migraine symptoms are difficult to distinguish between "migraine" symptoms, so similar attacks are needed to diagnose more than 5 times. If the number of seizures is less than 5 times, it can be diagnosed as a possible premature migraine.


There is a threatened migraine

A.Headache that meets the B-D standard at least 2 times

B.At least one threatened symptoms that can be fully recovered:



3.Voice and/or language




C.At least 2 of the following 4 items:

1. At least one threatening lasts for more than 5 minutes, and continuously occurs with/or 2 or more symptoms;

2. Each independent aura symptoms last for 5-60 minutes

3. At least one threatening is unilateral

4. Headache with a threatened or in a threatened 60 minutes

D.Can not be better explained with other diagnosis in ICHD-3.


Chronic migraine

The headache lasts for 3 months per month lasts for 3 months, and the headache that meets the characteristics of migraine is at least 8 times a month

A.Headaches that meet B and C (headache that meets tension headaches or headache characteristics) per month for at least 15 days, at least 3 months

B.It meets 1.1 without aura migraine diagnosis B-D or 1.2 headaches with aura migraine B and C at least 5 times

C.Headache is in line with any of the following, and the monthly attack is greater than 8 days, which lasted more than 3 months:

1. Non -threatened partial headache C and D

2. There are B and C with aura biased headache

3. The patient’s migraine is carried out and can be relieved by taking Quputan or wheat horns

D.Can not be better explained with other diagnosis in ICHD-3.


Vestibular migraine

A.Headache that meets C-D standard at least 5 times

B.There is a history of 1.1 unparalleled biased headache or 1.2 threatened headache

C.Middle or severe vestibular symptoms, last 5 minutes to 72 hours

D.At least 50%of the seizures are accompanied by at least 1 migraine symptoms:

1. Headache meets at least 2 of the following 4 items:

a) Unilateral

b) Footability

c) Middle or severe

d) Daily physical activity aggravate headache

2. Cute and fear

3. Visual aura symptoms

E.Can not be better explained with other diagnosis in ICHD-3.

How to relieve migraine?

There are two misunderstandings to treat migraine:

1. Too anxious

Many people are worried about the disease of the disease after encountering me,

Or there are secondary reasons to seek medical treatment everywhere,

The quality lesions are not very anxious.

Do too much unnecessary check, try all kinds of recipes,

I hope I will completely cut off my magic claws at all at all costs,

However, we always follow the shadow.

2. Too random

Others, deal with me too casually

Each attack is relieved by painkillers,

Eventually leading to excessive drugs.

Or cannot improve the lifestyle,

For example, Drinking will summon my appearance,

Still unable to quit alcohol.

The correct method is that if you diagnose migraine,

To understand your exclusive password for yourself,

(A certain odor, sound, light, food, drug, etc.)

To improve lifestyle to avoid meeting us narrowly.

During the session, resting and restraint,

Patients with obvious vomiting can use relief drugs

On the one hand, spitting can also relieve headaches.

How should analgesic drugs be used?

Pain -relieving medicine can help patients with migraine headache

Reduce the degree of pain and shorten the time of pain

Turn the unbearable every minute.

It is recommended to have an early use of migraine headache,

When the headache is severe, it may not work well,

In addition, some patients vomit obviously when severe,

Not conducive to drug absorption.

However, there are severe liver and kidney insufficiency

And severe gastric ulcers and gastric bleeding patients carefully.

Misunderstanding 1: Dare to take painkillers or take too late

Such patients are mainly worried about the side effects of painkillers.

Most non -sterite anti -inflammatory drugs are OTC drugs,

You can buy it in the pharmacy, and the side effects are small.

Misunderstanding 2: Excessive dependence of painkillers, eat it in one pain

The use of 10-15 times a month

It may cause excessive use of sexual headache,

This is also the most clinical migraine

The cause of chronic.

Many patients drink coffee cola when they like headaches,

Because coffee cola contains caffeine ingredients

Can help relieve pain.

But long -term use can cause caffeine to abstract headache

Or excessive use of sexual headaches similar to drugs.

Frequently Asked Questions Q & A;


Which headaches need to be vigilant?


For the first time, the symptoms of headache; at first, the headache was severe (such as lightning strikes); accompanied by symptoms such as limb numbness or difficulty in words; accompanied by epilepsy (such as sudden syncope and accompanied by limb convulsions);Patients with headaches over 50 years old; headaches different from before; headaches are gradually increasing.


Is migraine "confinement disease"?


no.The seizure of migraine is correlated with the level of hormones of women. Most female patients are usually headache due to changes in hormone levels during pregnancy.The frequency increased significantly and the degree of pain was intensified. This situation was due to the change of "hormone", not the "confinement" was not done well.


The difference between migraine and partial headache?


Many patients often diagnose themselves "migraine" because his headache is biased on one side; or because his headache is not fixed or the whole head pain is considered to be "migraine".but it is not the truth.

Migraine headache is a common name of primary headache; headache on one side can only be partial headache, a symptom expression, all kinds of headache can have partial sideways, and migraine headaches can also occur differently.Lotal pain.


Is it the cause of migraine?


Many primary headaches can cause "cervical headache" caused by cervical spondylosis.

For example, migraine can cause neck discomfort before headache, and it has always existed during the entire headache, and even continues to the late stage of the disease.

However, the headache caused by the strength of the spine is secondary headache, mostly biased, and the occurrence of headaches can be triggered when the cervical spine to a certain part can be triggered, and the neck activity is limited.


The effect of alcohol on patients with headache?


For patients with migraine, alcohol is a clear induction factor. Most patients with migraine have headaches for a few hours after drinking, and various alcohol can cause this phenomenon.

For patients with cluster headaches, alcohol seduce headache is more obvious, and it can even appear immediately after drinking.Therefore, it is recommended that patients with headache do not drink alcohol. Good diet and schedule habits can help reduce headaches.


What is caffeine abstinence headache?


The daily caffeine is greater than 200mg (a cup of Italian concentrated coffee 45ml of caffeine content is about 80 to 100mg). Patients with more than 2 weeks may have headaches within 24 hours after the sudden stop of drinking caffeine. This headache is called it.It is "caffeine withdrawal headache."

For patients with migraine, due to the pain relief effect of caffeine, they especially like to drink coffee. Some patients take more than two cups a day. Once they are discontinued or reduced, they will have headache.Essence


Matsyusal headaches can be understood as a more sensitive crowd. The pain threshold has fallen in certain circumstances, so there will be an unbearable pain.However, at present, the medical community does not fully understand the cause of migraine, so it is difficult to "completely cure".

Patients with migraine can not find organic lesions in the brain of migraine. The most needed thing is to find a specific factors that are suitable for themselves and find that they can induce migraine for themselves to avoid headaches.

Patients with frequent headaches and severe levels can find a lifestyle that suits them under the guidance of a physician.

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