Turn off the light. Quiet. How often did the headache lead us to plead these pleas. However, these two simple requests could indicate that it is not a simple headache, but rather a migraine, a disease that affects 1 in 10 Argentinians and can, in some cases, cause disability. What is it, how is it treated, and what can be the methods of relieving this pathology.
“There are nearly 300 types of headache in the international diagnostic classification, but the most common are tension headaches, migraines and trigeminal neuralgia,” he told TN.com.ar, the refractory headache neurologist at the Italian hospital, Fiorella Martín Bertuzzi (MN 136.272 ).
Migraines and headaches
Having an occasional headache seems to be a normal situation. Every time this happens, people attribute its occurrence to various reasons: stress, poor posture, tension or contractures, or something to eat, among many other excuses. But beyond that these can be the causes, the step between headache and migraine depends on a genetic predisposition.
The World Health Organization (WHO) cataloged migraines as a chronic disease and positioned it as the sixth cause of disability worldwide. In a study carried out in 195 countries between 1990 and 2016, he even assured that this was the second reason for incapacity for work or normal activities.
The decision to consider it a chronic disease lies in the moments when it occurs and the length of time it has in a person’s life. “Migraine is a genetic disease that we pass on. More than 80% of the patients have a relative who they blame “, emphasized Martín Bertuzzi and emphasized,” as with asthma there are triggers, better, worse or crisis phases “.
A study by the Headache Group of the Argentine Neurology Society published this June found a global prevalence of migraines of 9.5%. That is, one in 10 Argentines suffers from this pathology, which is more common in women (14%) than in men (5%). “It is a very feminine disease and there is no good reason for it, there are some theories that link it to the normal hormonal cycle (menstrual cycle),” explains the specialist.
With this in mind, he pointed out that “there are nearly 300 types of headache in the international diagnostic classification, but the most common are tension headaches, migraines and trigeminal neuralgia”.
According to the specialist, the tension headache can be described as “slight pain throughout the head” that does not interfere with daily activity. “It’s the usual marathon headache, like feeling full. But if you leave the place, clean up, or take a mild pain reliever, it goes away, ”he said.
Migraines, on the other hand, are pain “more than half the head that throbbing and becomes violent if not cut with a pain reliever, it hinders movement and restricts physical activity. In addition to headaches, the most common symptoms are: sensitivity to light (photophobia) and sensitivity to noise (phonophobia), nausea and vomiting ”.
Finally, trigeminal neuralgia is “seconds of electrical or cutting pain caused by touching, oozing, or moving the face. It is always in the same area and on the same side of the face, “explained the neurologist, emphasizing that while migraines occur around the age of 30, this pathology occurs closer to 50 than 1% of cases,” which is why he considers it Classified as “rare disease”.
First person pain
The story of generalist doctor Lucia Balbastro is both extreme and astonishing. She has had severe migraines every day for 13 years. As he told TN.com.ar, the onset of this disease was linked to a car accident.
“My symptoms and health problems were due to a drunk man. Pre-existing problems that I didn’t know I had are awakened by the accident. It took me time and therapy to understand that it doesn’t heal. I learned to live with my pain, but I also understood that others don’t know what it is to live with pain. It’s not your fault, luckily it didn’t affect you, ”the woman explained.
She suffers from two rare diseases: Chiari type 1, a derivative of a neurological structure in the cerebellum towards the spinal canal, and syringomyelia, which is associated with her other disease and is the development of a fluid-filled cyst. (Syrinx) in the spinal cord.
As Lucia herself admits, her situation is very special, but no less telling when it comes to explaining what migraine sufferers feel, even though the symptoms are not the same for everyone.
In your case, the headache is sharp, severe, frequent, or stabbing, and it also spreads down your neck or face. He also suffers from mild lightheadedness, malaise, or dizziness in the body; Are sensitive to light, see flashes of light or visual disturbances, experience nausea or vomiting, and even have a stuffy nose or irritability.
“I’ve made all the necessary changes: exercise, diet, therapy, stress relief, and finding the cause of the migraines, among other things, but none of them were. With every treatment I felt frustrated because I kept saying it wasn’t working for me. It started all over, but I didn’t give up, ”she says proudly.
In Lucía’s words, she never missed a step on her way to improving her quality of life and never missed a doctor’s appointment. “I’ve done all the treatments you can imagine and more. I have exhausted all instances, ”assures the 43-year-old woman and warns that she decided to have a surgical procedure so that she no longer has as much constant pain.
“My option was the occipital neuromodulator and at the moment it works for me. It’s been almost 20 days since the first operation and only a few days since the second, but that’s not for everyone, not everyone reaches this state, ”he said.
“Lucía’s case is extremely extreme. Post-traumatic headaches are like a terrible migraine. Of the 400 patients that we treat in the headache center of the Italian hospital, only 4 had to undergo surgery for neuromodulation, ”explains Martín Bertuzzi.
For a better quality of life
Beyond the situation that Lucia is going through, headaches and migraines in all their classes, as national and international studies already show, belong to humanity. But still there are treatments so that the pain does not accompany us “until death do us part”, so it is necessary to go to a specialist.
“There is nothing wrong with taking painkillers, but you need to know that if you are taking more than four times a month for headaches, there are other better treatments that are pain modulatory, preventive, and lower your use of these drugs. There are people who take a lot of medication for pain and not to mention those who lose days, so this situation becomes a problem, it is best to see a neurologist, ”explains the expert.
In addition to specialists in refractory headaches such as Martín Bertuzzi, who treat the “most extreme” cases, the so-called general neurologists can resolve 90% of migraines. “It is not a sin to take ergotamine (migral), but it needs to be made clear that it is contraindicated for people with a history of cardiovascular disease and there are other treatments that may be better,” he said.
He also stressed that there are some migraine prevention measures that do not involve medication, such as “eat better, don’t fast, sleep well, meditate, reduce stress”, among others. Therefore, before resuming activity due to the pandemic or to avoid these symptoms, the neurologist has listed four tips to avoid headaches:
- Go as much as you can.
- Hydrate yourself
- Take active breaks: simple stretching and posture exercises useful for both teleworking and the office. You can find them on social media.
- Have compassion: “It is a sentence that may sound weak, but the common denominator these patients have in common is their claim. In the office, we hear stories from people who have lived with this pain for 20 years, who have got used to taking pain medication every day, and who see it as normal. You have to consult, there are new treatments, there are old ones, there is always a lot to do to improve. “
“Migraines can also be understood as a warning of overload. By changing that perspective that it is no longer torture but a biological warning that something is wrong, it slows you down and lets you, for example, review your sleeping, exercise and eating habits and allow you to plan as you do the situation can improve, ”he explained.
With this idea, the Migraine and Headache Association of Argentina (AMyCA) created a space designed by patients and specialist neurologists to get closer to those suffering from this silent chronic disease that has become naturalized. There is not only containment of those affected, but also information on professionals and medication for treatment. As they say: “It is necessary to make the population aware that migraines are not ‘a simple headache'”.