Migraine belongs to vascular headache, which is a recurrent headache caused by vasomotor dysfunction in and out of the brain. Its attack is characterized by unilateral or turning from one side to the other, accompanied by nausea and vomiting. There may be premonitions before the attack, and the intermission may be like a normal person with a family history.
Second, what are the types of migraine?
Migraine can be divided into the following categories:
(1) Common migraine (migraine without aura): It is the most common type of migraine, accounting for more than 80% of migraine patients. The premonitory symptoms are dispensable, and if there are premonitions, they are only short-lived and slightly vague. The process of headache is the same as typical migraine, but it is usually left and right, and it is pulsating in nature. Physical activity can aggravate headaches. Sometimes it starts from both sides. Headache lasts for a long time, usually lasting 1 ~ 3 days, or several days, accompanied by nausea, vomiting, sweating and other symptoms. Often have a family history. In women, headache is sometimes related to menstrual cycle, which is called "menstrual migraine".
(2) Typical migraine: (symptomatic migraine with aura) The clinical manifestation is recurrent migraine, which has the following characteristics: there are the most common and typical visual aura before the onset of headache, and some flickering dark spots, sparks, "W" flashes, "stars in front of eyes" or hemianopia (one side can't see) appear 20-30 minutes before the onset of headache. These symptoms often appear on one side of the visual field, peak before the headache comes, and then disappear. Rare aura may include hemiplegia, facial acupuncture, hemiplegia or inability to speak. Migraine occurs shortly after the aura disappears, usually starting from one side of the frontotemporal region (around the temple) or around the orbit, and a few can start from the occipital region and gradually spread to half of the head or the whole head. Headache is getting worse, from dull pain to pulsatile or pulsatile pain (jumping pain). Fix on one side or both sides. Pressing local blood vessels with your fingers can relieve headaches. Headache is accompanied by autonomic symptoms such as pallor, nausea and vomiting. At this time, the patient is very tired, obviously afraid of light and noise, and likes to lie alone in a dark room. Every headache lasts for several hours to more than ten hours. A few people can persist in 1 ~ 2 days, and often they can fully recover after a sleep. There are many abnormal findings in cerebral rheogram and Doppler ultrasound, which are helpful for diagnosis.
Typical migraine can be divided into several subtypes:
(1) Typical migraine with aura: including ocular migraine, hemiplegic migraine and aphasic migraine. At least the above two typical attacks have occurred, and the diagnosis can only be made after excluding organic diseases.
(2) Migraine with prolonged aura (complex migraine): The symptoms are the same (1). During the headache attack, the aura still exists, lasting more than 1 hour, but less than 1 week. Neuroimaging examination can not find intracranial structural lesions.
(3) Basal migraine (formerly known as basal migraine): There are premonitory symptoms clearly originating from brain stem or bilateral occipital lobes, such as blindness, visual symptoms in both temporal and nasal visual fields, dysarthria, dizziness, tinnitus, hearing loss, diplopia, ataxia, bilateral paresis or insanity. Most of them disappeared within a few minutes to 1 hour, followed by bilateral occipital pulsating headache.
(4) Headache-free migraine aura (migraine equipotential attack): There are various aura symptoms during migraine attack, but sometimes headache does not follow. When the patient is older, the headache can disappear completely, and there are still paroxysmal premonitory symptoms, but few people have premonitory symptoms without headache. The first onset after the age of 40 requires in-depth examination, except for thromboembolic TIA.
Ophthalmoplegia migraine: rare. The onset age is mostly under 30 years old. Have a history of headache attacks fixed on one side. After severe headache (orbital or retroorbital pain), ipsilateral ophthalmoplegia occurs, especially ptosis. Paralysis lasts for a few days or weeks and then recovers. At first, the paralysis completely recovered, but after several attacks, part of the eye muscle paralysis could not be recovered. Neuroimaging examination excluded intracranial organic lesions.
(4) Benign paroxysmal vertigo (migraine attack) in childhood: there is a family history of migraine but the child himself has no headache. It is characterized by repeated and short-term vertigo attacks, paroxysmal imbalance and anxiety, accompanied by nystagmus or vomiting. The nervous system and EEG are normal. Everything is normal during the intermission. Some children will turn into migraines as adults.
(5) The status quo of migraine A migraine attack lasts for more than 72 hours (during which there may be a remission period shorter than 4 hours), which is called the status quo of migraine.
Third, the clinical manifestations of migraine
Clinically, migraine attacks can be divided into three stages: intracranial vasoconstriction, extracranial vasodilation and remission. Each period has corresponding clinical symptoms:
(l) Intracranial vasoconstriction: also known as pre-headache or premonitory period, it often occurs within a few minutes or hours before headache, mainly manifested as symptoms of insufficient blood supply to the brain. For example, in terms of vision, there are often stars, hemianopia and visual field defects; Individual patients may have temporary numbness, weakness and slurred speech, but rarely permanent injuries. The above symptoms often indicate that a headache is coming.
(2) Extracranial vasodilation: With the gradual relief of ischemic symptoms, headaches caused by vasodilation appear immediately, usually lasting for several hours to several days. Headache can be persistent jumping pain, dull pain and swelling pain in the frontotemporal region or both sides, and most of them are serious enough to affect work and study, accompanied by autonomic nervous symptoms such as general weakness, pale or redness, irritability, nausea, vomiting, loss of appetite and palpitation. After falling asleep, the headache can be alleviated or disappeared. During this period, EEG is sometimes abnormal, transcranial Doppler ultrasound shows that blood flow velocity is accelerated, and cerebral rheogram is hypotonic or rapidly decreased.
(3) Remission period: People enter this period when vasodilation and headache attacks last for a certain period of time and tend to be normal. During this period, the above symptoms disappeared and the patient had no obvious discomfort. Only a few people have dizziness, fatigue and dreaminess. If you check the instruments during the remission period, most of them can't find anything abnormal. This period may range from weeks to months.
In fact, the above three periods can not be completely separated, and there is no obvious interval. The duration of each period varies from person to person. Some patients may not have an aura.
Fourth, the treatment of migraine
1, drug therapy:
Dr. Guo, an expert outpatient neurologist, has been engaged in the research and treatment of nervous system diseases for more than 20 years and has rich clinical experience. He believes that the cause of migraine is not simple, but is caused by the imbalance of five internal organs and yin and yang. So in treatment, Dr. Guo broke the old method of nourishing blood and calming the nerves. According to the symptoms, etiology, pathogenesis and the function of drugs, he adopted the method of combining traditional Chinese and western medicine, carefully selected a variety of precious drugs through strict compatibility, and formulated a series of agreed prescriptions for treating various migraines-migraine capsules and migraine headaches, which have the effects of nourishing the brain, calming the nerves, expelling wind and relieving pain. According to different causes and types, dialectical medication has the characteristics of quick response and short course of treatment. The advantages of this prescription are: stable curative effect, no toxic and side effects, and no recurrence after consolidated treatment.
The series of migraine prescriptions are specially used to treat various intractable migraine and its accompanying symptoms such as dizziness, irritability, anxiety, palpitation, shortness of breath, fear, tinnitus, stuffy head, insomnia and dreaminess, backache, stiff neck and so on. This prescription can regulate nerve function, improve blood supply and oxygen supply to the brain, eliminate mental stress and relieve head muscle spasm, and has special effects on various symptoms such as migraine, dizziness, palpitation, irritability, anxiety and insomnia.
Prescribe migraine capsules and migraine pills once a month for one course of treatment, and general cases can be cured after 1-2 courses of treatment.
Click to view the prescription of migraine capsule and Piantongling series agreement.
2, acupoint injection of nerve cell activator:
Acupoint injection is a treatment method of combining traditional Chinese and western medicine, that is, a drug is injected into relevant acupoints or some parts with positive reaction are found by palpation of meridians, and acupuncture and liquid medicine are used to stimulate acupoints, so as to achieve the purpose of treating diseases.
(1), acupoint selection: according to the meridian palpation: according to the disease, etiology and the meridian trend of the disease, the most obvious acupoints are selected as the main acupoints for treatment, mainly showing nodules, tenderness and morphological changes. Experienced doctors can easily find these acupoints. Secondly, the meridian tester is used to find acupoints: some parts of human body surface are closely related to zang-fu meridians, and the physiological and pathological changes of some zang-fu meridians are observed and speculated by the meridian tester through the changes of skin resistance in some parts, and combined with clinical manifestations, it can be used as the basis for selecting acupoints or as a reference for clinical diagnosis and treatment.
(2) Selection of drugs: Acupoint injection of "nerve cell activator" for migraine patients is a compound preparation invented by Dr. Guo after more than 20 years of clinical practice and experimental research. Referring to foreign treatment experience, he finally found that some drugs can activate brain nerve cells, wake up sleeping nerve cells, relax some nerves, and play a role in regulating nerves, regulating the process of brain excitement and inhibition. It can also regulate the vasomotor function of blood vessels and improve the blood supply to the brain. Clinical and experimental results show that this therapy can obviously improve brain function, memory and thinking function, and significantly reduce the number and degree of headache attacks. After acupoint injection, many patients have a clear mind and a clear vision, which can have an immediate effect. Moreover, acupoint injection can also warm meridians and dredge collaterals, dispel cold and dampness, regulate qi, blood and nerve functions of viscera, and improve autonomic nerve dysfunction and endocrine disorders, that is, through comprehensive regulation of meridians, nerves, cortex and viscera, the purpose of treating diseases can be achieved. This is the best treatment of integrated traditional Chinese and western medicine. Dr. Guo's related papers were published in important domestic journals, read and exchanged at national academic exchanges for many times, and were highly praised by relevant experts and scholars.
Acupoint injection of "nerve cell activator" is generally treated once a week, and 5 times is a course of treatment. During my work in Yimeng hospital and municipal hospital, I treated 460 migraine patients with this method. The effective rate is 100%, and the cure rate is over 90%.
2, acupoint catgut embedding method:
Acupoint catgut embedding therapy originated from acupoint catgut embedding in the early 1960s. It uses catgut embedding device to implant protein magnetized silk soaked with special drugs into corresponding acupoints, and the drugs and silk can continuously and effectively stimulate acupoints (natural dissolution and absorption of silk in the body 15 days to 3 months) to achieve the purpose of treating diseases. Acupoint catgut embedding therapy makes up for the shortcomings of short acupuncture time, multiple acupuncture times, short curative effect and difficult consolidation after illness.
Catgut embedding at some acupoints of patients can effectively treat migraine. Acupoint catgut embedding is to dialectically select points to treat diseases according to individual differences, different symptoms and different causes of patients, and then catgut embedding plays the roles of warming meridians, dispelling cold, eliminating dampness, regulating qi and blood of viscera and regulating nerve function, which can improve autonomic nerve dysfunction and endocrine disorder, that is, through comprehensive regulation of meridians, nerves, cortex and viscera, to achieve the purpose of treating diseases. This therapy can adjust nerves, adjust the process of brain excitation and inhibition, adjust the function of vasodilation, improve the blood supply to the brain and activate nerve cells. Clinical and experimental results show that this therapy can obviously improve brain function, memory and thinking function, and has obvious curative effect on nervous headache. Acupoint catgut embedding/kloc-once every 0/5 days, which avoids the trouble and pain of patients' "acupuncture" once a day, and is also easy for busy modern people to accept.
The biggest advantage of acupoint catgut embedding therapy is that it has no side effects, is safe and painless, is easily accepted by patients, and has a very low recurrence rate.
3, acupoint cutting therapy:
For more than 20 years, we have conducted in-depth discussion and development of Chinese medicine. According to the meridian theory of traditional Chinese medicine, acupoint cutting therapy evolved from acupuncture therapy. Its function lies in dredging meridians, promoting the coordination of qi, blood, yin and yang, and calming the nerves. Acupoint cutting treatment of diseases is based on individual differences, different symptoms and different causes of patients, and then acupoint cutting treatment can play a role in warming meridians, dredging collaterals, eliminating cold and dampness, regulating viscera and qi and blood, and regulating nerve function. Cooperate with oral series of specific drugs and acupoint cutting therapy to coordinate with each other and enhance the curative effect.
Oral drugs are organically combined with acupoint injection or acupoint catgut embedding therapy, and the curative effects are complementary, thus achieving the goal of completely curing migraine. Generally, 30 days is a course of treatment, and mild cases can be cured after 2-3 courses of treatment, and generally there is no toxic or side effect. During the treatment, avoid drinking alcohol and eating irritating foods such as cold and spicy food. Keep a good mood and live a regular life. Most patients can be cured as long as they actively cooperate with the treatment.