[Click! Health] Migraine, If Underestimated, Lasts Long... "Must Treat Before It Becomes Chronic"

Advice has been issued not to ignore migraines that interfere with daily life. This is because migraines become more difficult to treat once they become chronic.

Migraine. [Image source=Pixabay]

Professor Imiji from the Department of Neurology at Seoul National University Hospital advised, "Migraines are generally known as pain on one side of the head, but this is a mistaken definition." Migraines are likely if a significantly severe headache that disrupts daily life or work lasts for more than half a day and improves on its own within three days at the latest. While pulsating pain resembling a heartbeat is characteristic, migraines can also manifest as stabbing, tightening, or throbbing headaches.

The diagnosis of migraines is made through medical history taking. If migraine headaches that significantly disrupt daily life occur and return completely to normal within 4 to 72 hours on five or more occasions, migraines are likely. Brain imaging tests may be necessary during the medical history process to differentiate from other causes of headaches.

Migraines usually progress through four stages in order: prodrome, aura, headache, and postdrome. It is important to carefully observe the prodromal symptoms and aura before the headache begins, as they often aid in diagnosis. Prodromal symptoms include fatigue, lethargy, decreased concentration, neck stiffness, changes in appetite, and heightened emotions. Migraine aura refers to symptoms that occur simultaneously with or just before the onset of migraine. These include visual auras such as blurred or shimmering vision, or sensory auras such as numbness and tingling in the lips and fingertips.

Effective migraine treatment involves combining acute treatment and preventive treatment. Acute treatment aims to stop or alleviate the headache and accompanying symptoms after the headache begins. Once a migraine starts, it is important to promptly take acute migraine medications for pain relief and rest to prevent worsening.

Currently, there are various treatment options related to migraines, allowing for personalized approaches for each patient. Mild migraines can be treated with general painkillers, but moderate to severe migraines require prescription of specialized medications such as 'Triptan' drugs that constrict dilated cerebral blood vessels. Recently, 'Ditan' drugs, which do not have vasoconstrictive effects, have been introduced in Korea. Neurostimulation therapy using medical devices, known as electronic medicine rather than oral medication, is also available. However, caution is needed because using acute pain medications more than 10 times a month can lead to complications such as chronic migraine and medication-overuse headache.

If headaches occur too frequently or are too severe to be managed with acute medications, preventive treatment to reduce the frequency and intensity should be combined. Preventive treatments include antidepressants, antiepileptic drugs, beta-blockers, and calcium channel blockers. These medications require consistent use over several months to observe therapeutic effects, so short-term benefits may not be noticeable. Professor Imiji advises that it is best to continue long-term treatment in consultation with the attending physician to increase the success rate of preventive therapy.

In addition to medication, maintaining regular lifestyle habits such as consistent sleep, waking, eating, and exercise schedules is necessary to prevent migraines. Situations that cause brain hyperactivity, such as caffeine intake or strong visual stimuli, should be avoided. Identifying and avoiding migraine triggers can prevent a significant portion of migraines, according to Professor Imiji.

If migraine symptoms occur frequently, it is also important to consult a specialist at an appropriate time. Professor Imiji stated, "If headaches caused by migraines occur frequently and disrupt daily life, it is a 'headache disorder,' that is, a disease," and advised, "As headaches become more frequent and chronic, treatment becomes more difficult, so it is essential to actively seek accurate diagnosis and treatment through consultation with a neurology specialist."