The diagnosis and treatment of migraine.

4 th international epilepsy symposium in Pula – how to start seizure treatment Migraine is one of the ten most disabling disorders worldwide, and despite recent developments in the management of migraine, it remains underdiagnosed and undertreated. Migraine diagnosis. Migraine is a chronic condition with recurrent attacks. Most (but not all) migraine attacks are associated with headaches. Migraine headaches usually are described as an intense, throbbing or pounding pain that involves one temple. (Sometimes the pain is located in the forehead, around the eye, or at the back of the head). Th e pain usually is unilateral (on one side of the head), although about a third of the time the pain is bilateral (on both sides of the head). Th e unilateral headaches typically change sides from one attack to the next. (In fact, unilateral headaches that always occur on the same side should alert the doctor to consider a secondary headache, for example, one caused by a brain tumor). A migraine headache usually is aggravated by daily activities such as walking upstairs. Nausea, vomiting, diarrhea, facial pal-lor, cold hands, cold feet, and sensitivity to light and sound commonly accompany migraine headaches. As a result of this sensitivity to light and sound, migraine suff erers usually prefer to lie in a quiet, dark room during an attack. A typical attack lasts between 4 and 72 hours. An estimated 20% of migraine headaches are associated with an aura. Usually, the aura precedes the headache, although occasionally it may occur simultaneously with the headache. Migraine treatment. Treatment of migraine includes therapies that may or may not involve medications. Th erapy that does not involve medications can provide symptomatic and preventative therapy. Using ice, biofeedback, and relaxation techniques may be helpful in stopping an attack once it has started. Sleep may be the best medicine if it is possible. Preventing migraine takes motivation for the patient to make some life changes. Patients are educated as to triggering factors that can be avoided. Th ese triggers include:smoking, and avoiding certain foods especially those high in tyramine such as sharp cheeses or those containing sulphites (wines) or nitrates (nuts, pressed meats). Generally, leading a healthy lifestyle with good nutrition, an adequate intake of fl uids, suffi cient sleep and exercise may be useful. Medication for migraine. Individuals with occasional mild migraine headaches that do not interfere with daily activities usually medicate themselves with over-the-counter …