Abstract
Migraine is one of the most common types of headache, which can lead to a significant decrease in quality of life. Researchers identify migraine with aura, migraine without aura, and chronic migraine that substantially reduces the ability of patients to work and is frequently concurrent with mental disorders and drug-induced headache. The complications of migraine include status migrainosus, persistent aura without infarction, migrainous infarction (stroke), and a migraine aura-induced seizure. The diagnosis of migraine is based on complaints, past medical history, objective examination data, and the diagnostic criteria as laid down in the International Classification of Headache Disorders, 3 rd edition. Add-on trials are recommended only in the presence of red flags, such as the symptoms warning about the secondary nature of headache. Migraine treatment is aimed at reducing the frequency and intensity of attacks and the amount of analgesics taken. It includes three main approaches: behavioral therapy, seizure relief therapy, and preventive therapy. Behavioral therapy focuses on lifestyle modification. Nonsteroidal anti-inflammatory drugs, simple and combined analgesics, triptans, and antiemetic drugs for severe nausea or vomiting are recommended for seizure relief. Preventive therapy which includes antidepressants, anticonvulsants, beta-blockers, angiotensin II receptor antagonists, botulinum toxin type A-hemagglutinin complex and monoclonal antibodies to calcitonin gene-related peptide or its receptors, is indicated for frequent or severe migraine attacks and for chronic migraine. Pharmacotherapy is recommended to be combined with non-drug methods that involves cognitive behavioral therapy; progressive muscle relaxation; mindfulness; biofeedback; post-isometric relaxation; acupuncture; therapeutic exercises; greater occipital nerve block; non-invasive high-frequency repetitive transcranial magnetic stimulation; external stimulation of first trigeminal branch; and electrical stimulation of the occipital nerves (neurostimulation).
Highlights
Мигрень – одна из самых распространенных форм головной боли, которая может приводить к значимому снижению качества жизни
Researchers identify migraine with aura, migraine without aura, and chronic migraine that substantially reduces the ability of patients to work and is frequently concurrent with mental disorders and drug-induced headache
The diagnosis of migraine is based on complaints, past medical history, objective examination data, and the diagnostic criteria as laid down in the International Classification of Headache Disorders, 3rd edition
Summary
Филатова Е.Г.1, Осипова В.В.2, 3, Табеева Г.Р.1, Парфенов В.А.1, Екушева Е.В.4, Азимова Ю.Э.3, Латышева Н.В.1, Наприенко М.В.1, Скоробогатых К.В.3, Сергеев А.В.1, Головачева В.А.1, Лебедева Е.Р.5, Артёменко А.Р.1, Курушина О.В.6, Корешкина М.И.7, Амелин А.В.8, Ахмадеева Л.Р.9, Рачин А.П.10, Исагулян Э.Д.11, Данилов Ал.Б.1, Гехт А.Б.2 1ФГАОУ ВО «Первый Московский государственный медицинский университет им. Migraine treatment is aimed at reducing the frequency and intensity of attacks and the amount of analgesics taken It includes three main approaches: behavioral therapy, seizure relief therapy, and preventive therapy. С. Возникновение ГБ ≥8 дней в месяц в течение 3 мес, соответствующей любому из следующих критериев: – мигрень без ауры (критерии C и D), – мигрень с аурой (критерии B и С), – по мнению пациента, имелся приступ мигрени, купированный или облегчаемый приемом препарата из группы триптанов или содержащего эрготамин. Профилактическая терапия Профилактическое лечение рекомендуется пациентам, у которых наблюдается три или более интенсивных приступов ГБ в течение месяца и ≥8 дней в месяц с ГБ при адекватном купировании приступов мигрени, а также пациентам с тяжелыми и пролонгированными аурами, даже при небольшой частоте приступов [61,62,63]. Ботулинический токсин типа А – гемагглютинин для профилактического лечения мигрени и заключается комплекс и мАТ к CGRP или его рецепторам [69, 70, 73, 74]. в выполнении специальных упражнений по медитации
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