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Neurodevelopmental Disorders and Treatment

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Treatment and Prevention of Migraine

Author(s): Komalpreet Kaur



Migraine may be a frequent disease with some extent prevalence of 20% in women and eight in men. Therefore, guidelines for the treatment of migraine attacks and therefore the prevention by
drug treatment or behavioural therapy have great practical importance. the aim of this guideline is to optimize the treatment of acute migraine attacks and therefore the prevention of migraine. The rule is evidence-based, takes into account the clinical experience of the rule authors and is a further development of the subsequent guidelines and
recommendations. In migraine, there are attacks of moderate to severe, frequently one-sided pulsating-throbbing headache which increase in intensity on physical activity.

One-third of the patients suffer holocranial headache. The individual attacks are amid lack of appetite (almost always), nausea (80%), vomiting (40–50%), photophobia (60%), sensitivity to noise (50%) and hypersensitivity to certain odours (10%). Signs of activation of the parasympathetic system are observed in up to 82% of the patients, most frequently mild watering eyes. When the top pains are one-sided, they may change sides during an attack or from one attack to a different. The intensity of the attacks may vary markedly from attack
to attack. The duration of the attacks, consistent with the definition of the International Headache Society (IHS), is between 4 hours and 72 hours. In children, the attacks are shorter and should manifest without headache, with only severe nausea, vomiting and dizziness.

Triptans are specific migraine medications. However, the response to triptans isn't suitable for diagnosing migraine, since triptans could also be ineffective in migraine and effective, in secondary headache, for instance, subarachnoid haemorrhage. In long-lasting migraine attacks, migraine headache may recur after the top of successful pharmacological effect of a migraine medication (recurrent headache/headache recurrence). Recurrent headache is defined as a worsening of headache intensity from no headache or mild headache to moderate or severe headache during a period from 2 hours-24 hours after the primary effective medication application. Triptans with a extended half-life, like frovatriptan and naratriptan, have a bent to lower recurrence rates than those with a shorter half-life. However, their initial efficacy is lower. If the primary administration of a triptan is ineffective, a second dose is typically also ineffective, unless the first dose was vomited. In these cases, a non-opioid analgesic should be used as a substitute.

Tramadol together with paracetamol160 was found effective in acute migraine attacks. Nonetheless, opioids and tranquilizers shouldn't be wont to treat migraine attacks. Opioids have limited efficacy, often cause vomiting, central-nervous side effects, have a big potential for dependency and overuse and lead more quickly to medication-overuse headache.

Numerous procedures are offered and advertised also and especially for non-pharmaceutical preventive migraine therapy, that no controlled studies are performed. Quite 80% of all migraine patients have experience with complementary or alternative therapy procedures. Mainly, the patients are motivated to use such procedures by the will to go away nothing untried and to take action themselves against their disease, and therefore the desire for therapy with few or no side effects.