The migraine

Migraine is a disease characterized by the regular and repetitive occurrence of severe headaches.

  • The disease begins in childhood or adolescence; it peaks between the ages of 30 and 40 and then subsides.
  • The percentage of children with migraine is estimated to be between 5 and 10%, their attacks being generally shorter than in adults.
    In addition, sleep relieves the child in times of crisis migraine.
  • After puberty, migraine is more common in girls than in boys.
  • In women, migraine can be punctuated by hormonal life: it can occur only during menstruation and it usually disappears during pregnancy and after menopause

Migraine is well defined and its diagnosis requires the presence of the following signs:

  • Painful attacks lasting 4 to 72 hours between which the symptoms disappear completely;
  • The pain is throbbing, which means it feels like it is "beating" regularly to the beat of the heart, and it is predominant on one side of the skull;
  • Light, noise and movement increase the pain, possibly accompanied by nausea and vomiting.

THE TRIGGERING FACTORS :

  • Fatigue, lack of sleep; 
  • Stress;
  •  Consumption of certain alcohols or foods (chocolate, alcohol, excessively rich diet, etc.).
  •  Migraine sufferers thus declare on average at least four triggering factors.

MIGRAINE TREATMENTS 

Treatment of migraine includes treatment of the attack , which aims to relieve pain quickly, and disease-modifying treatment , which aims to decrease the frequency and the intensity of the seizures.

In a mild to moderate attack, aspirin, paracetamol, or ibuprofen may be sufficient.

In the event of a severe crisis immediately or not relieved by these treatments, there are specific treatments: triptans (Sumatriptan: Migrex®) and rye ergot derivatives.

The treatment of a migraine attack should be as early as possible. It is a function of the intensity of the seizure and the effectiveness of the drugs in previous seizures. In the event of a mild to moderate crisis, the treatment may be non-specific (NSAIDs, aspirin or paracetamol). In the event of a severe crisis immediately or not relieved by NSAIDs, there are specific treatments: triptans, powerful vasodilators, and rye ergot derivatives.

TREATMENTS NOT SPECIFIC TO THE MIGRAINE CRISIS

Non-specific treatments are based on taking analgesics : paracetamol, aspirin alone or combined with an antinausea, NSAIDs. The NSAIDs recommended for migraine are diclofenac, ibuprofen, ketoprofen and naproxen .

Some AINS-based medicines have a specific indication for migraine attacks. They are listed below. Analgesics containing an opiate (codeine, tramadol) or a morphine derivative are not recommended due to a risk of abuse.

TREATMENTS SPECIFIC TO THE MIGRAINE CRISIS

When the migraine attacks are intense or they are not relieved by the usual analgesics such as AINS, the doctor can prescribe a specific treatment: either a drug of the triptans family, or a derivative of rye ergot. .
Triptans (eg Sumatriptan Migrex®) are powerful vasoconstrictors which act mainly on the cranial vessels. They are active on headache and associated symptoms (nausea, vomiting, intolerance to light and noise). They should be taken early, when the headache first appears. A second dose of triptan is only justified if there is a recurrence (recurrence of the migraine attack within 24 hours) after the relief of the initial attack. 

rye ergot derivatives (ergotamine, dihydroergotamine) are generally offered when other treatments (NSAIDs, triptans Sumatriptan: Migrex®) do not help relieve seizures.

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