Migraine

Introduction Migraine is a kind of pulsating headache that is repeated and is a "big family" among many headache types. Before the onset, there are often signs of flashing, blurred vision, numbness of the limbs, and the pain of one side of the head jumps from about a few minutes to an hour or so, and gradually increases until there is nausea and vomiting. Better to relieve headaches in a quiet, dark environment or after sleep. It can be accompanied by neurological and mental dysfunction before or during a headache. At the same time, it is a disease that can gradually deteriorate, and the frequency of onset is usually higher and higher. According to research, patients with migraine are more likely to have local brain damage than normal people, which may lead to stroke. The more times you have a migraine, the larger your brain will be damaged.

Cause

Chinese and foreign experts have said that the cause of migraine is still unclear, but may be related to the following factors:

(1) Genetic factors, because about 60% of patients can ask for family history, some patients have epilepsy in the family, so experts believe that the disease is related to heredity, but there is no consistent genetic form.

(2) Endocrine factors, vascular migraine is more common in adolescent women, frequent episodes during menstruation, seizures during pregnancy, recurrence after childbirth, and gradually reduce or disappear after menopause.

(3) Dietary factors, people who regularly eat cheese, chocolate, irritating food, or smoke or drink are susceptible to vascular migraine.

(4) Other factors, emotional stress, trauma, anxiety, anxiety, hunger, insomnia, poor external environment and climate change can also induce migraine.

an examination

Related inspection

Brain CT examination EEG cerebral angiography

1. EEG examination: It is generally believed that the abnormal incidence of EEG in patients with migraine is higher than that in the normal control group, whether in the attack or intermittent period. However, the EEG changes in migraine patients are not specific. Because it can have a normal waveform. Common slow waves, spike discharges, focal spikes, waves, and various waveforms that respond abnormally to hyperventilation and flash stimulation. The abnormal rate of electroencephalogram in children with migraine is high, ranging from 9% to 70%. There may be spikes, paroxysmal slow waves, fast wave activity and diffuse slow waves.

2. Cerebral blood flow examination: The main changes in the cerebral blood flow map of the patient during the attack period and intermittent period are asymmetric amplitude on both sides, one side is high or one side is low.

3. Cerebral angiography: In principle, patients with migraine do not need cerebral angiography. Only in patients with severe headache episodes, patients with high degree of suspected subarachnoid hemorrhage undergo cerebral angiography, except for intracranial aneurysms. , arteriovenous malformations and other diseases. Undoubtedly, the majority of cerebral angiograms in migraine patients are normal.

4. Cerebrospinal fluid examination: routine examination of cerebrospinal fluid in patients with migraine is usually normal, and lymphocytes in cerebrospinal fluid can be increased in general.

5. Immunological examination: The formation of immunoglobulin IgG, IgA, C3 and E rosettes in migraine patients is generally considered to be higher than normal.

6. Platelet function test: platelet aggregation in patients with migraine can be increased.

Differential diagnosis

It should be differentiated from the following symptoms:

1. Intracranial headache Intracranial headache refers to cerebrospinal fluid or lumbar puncture after trauma, so that the cerebrospinal fluid continues to exude too much from the puncture site to the outside of the meninges, resulting in decreased pressure in the spinal canal. Pulling down the headache caused by the downwards. Headaches are common after lumbar puncture.

2. Functional headache Functional headache is also known as psychogenic headache. It mainly includes neurasthenia, rickets, concussion sequelae, depression, and menopausal syndrome. Headaches often recurrent, mainly pain, irregular parts, ambiguous nature, no regularity, often have a cap-like contraction at the top of the head, or pull pain from the forehead to the neck, and there are many bugs on the top of the head. The feeling of going. In addition, often accompanied by dizziness, fatigue, multiple dreams, insomnia, memory loss, lack of concentration and other symptoms, long course, when the time is good.

3. Recurrent headaches Cerebral veins and venous sinus thrombosis are commonly called benign intracranial hypertension or pseudo-brain tumors. The clinical manifestations are mainly repeated headaches, eye swelling, and more often in the morning, often misdiagnosed as neurological headache or neurasthenia. It is often overlooked in normal brain CT and MRI. Cerebral venous and venous sinus thrombosis is commonly called benign intracranial hypertension or pseudo-brain tumor. The clinical manifestations are mainly repeated headache and eye swelling. Most of them are heavier in the morning and often misdiagnosed as neurological headache or neurasthenia. It is often overlooked in normal brain CT and MRI.

4. Local headache Local headache This is a vascular neuropathic headache and is a functional disease.

5. Chronic headache Chronic daily headache (CHD) refers to frequent headaches that occur more than 15 days a month, and headaches last for more than 4 hours a day. Primary and secondary, primary CHD refers to headaches for more than 15 days per month without organic or systemic disease, a survey showing 4-5% of the total population in the United States, Europe and Asia Primary CHD, chronic tension headache (ie, neurological headache) is the first in CHD, and the main clinic visit is chronic vascular migraine.

6. Pulsating headache is a "big family" among many headache types. Before the onset, there are often signs of flashing, blurred vision, numbness of the limbs, and the pain of one side of the head jumps from about a few minutes to an hour or so, and gradually increases until there is nausea and vomiting. Better to relieve headaches in a quiet, dark environment or after sleep. It can be accompanied by neurological and mental dysfunction before or during a headache. At the same time, it is a disease that can gradually deteriorate, and the frequency of onset is usually higher and higher. According to research, patients with migraine are more likely to have local brain damage than normal people, which may lead to stroke. The more times you have a migraine, the larger your brain will be damaged.

diagnosis

1. Family history and patient history can be used as a reference for diagnosis.

2. Diagnose according to the signs of the patient's headache.

3. Use the relevant instrument inspection methods to assist in the diagnosis.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.