Migraine
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Migraine
Migraine (, ) is a complex neurological disorder characterized by episodes of moderate-to-severe headache, most often unilateral and generally associated with nausea, and light and sound sensitivity. Other characterizing symptoms may include vomiting, cognitive dysfunction, allodynia, and dizziness. Exacerbation or worsening of headache symptoms during physical activity is another distinguishing feature. Up to one-third of people with migraine experience aura, a premonitory period of sensory disturbance widely accepted to be caused by cortical spreading depression at the onset of a migraine attack. Although primarily considered to be a headache disorder, migraine is highly heterogenous in its clinical presentation and is better thought of as a spectrum disease rather than a distinct clinical entity. Disease burden can range from episodic discrete attacks to chronic disease. Migraine is believed to be caused by a mixture of environmental and genetic factors that influe ...
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Headaches
A headache, also known as cephalalgia, is the symptom of pain in the face, head, or neck. It can occur as a migraine, tension-type headache, or cluster headache. There is an increased risk of depression in those with severe headaches. Headaches can occur as a result of many conditions. There are a number of different classification systems for headaches. The most well-recognized is that of the International Headache Society, which classifies it into more than 150 types of primary and secondary headaches. Causes of headaches may include dehydration; fatigue; sleep deprivation; stress; the effects of medications (overuse) and recreational drugs, including withdrawal; viral infections; loud noises; head injury; rapid ingestion of a very cold food or beverage; and dental or sinus issues (such as sinusitis). Treatment of a headache depends on the underlying cause, but commonly involves pain medication (especially in case of migraine or cluster headaches). A headache is one ...
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Headache
A headache, also known as cephalalgia, is the symptom of pain in the face, head, or neck. It can occur as a migraine, tension-type headache, or cluster headache. There is an increased risk of Depression (mood), depression in those with severe headaches. Headaches can occur as a result of many conditions. There are a number of different classification systems for headaches. The most well-recognized is that of the International Headache Society, which classifies it into more than 150 types of Primary headache disorder, primary and secondary headaches. Causes of headaches may include dehydration; fatigue; sleep deprivation; Stress (biology), stress; the effects of medications (overuse) and recreational drugs, including withdrawal; viral infections; loud noises; head injury; rapid ingestion of a very cold food or beverage; and dental or sinus issues (such as sinusitis). Treatment of a headache depends on the underlying cause, but commonly involves analgesic, pain medication (esp ...
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Calcitonin Gene-related Peptide Receptor Antagonists
Calcitonin gene-related peptide (CGRP) receptor antagonists, commonly known as gepants, are a class of drugs that act as antagonists of the calcitonin gene-related peptide receptor (CGRPR). Several monoclonal antibodies that bind to the CGRP receptor or peptide have been approved for prevention of migraine. Nerve activation triggers the release of CGRP and other neuropeptides, leading to inflammation, pain, and swelling. Three small molecule CGRPR antagonists are approved in the U.S. as antimigraine agents. Drugs of this class have also been investigated for use in osteoarthritis. Examples Non-peptide small molecules * Ubrogepant is approved for acute treatment of migraines * Rimegepant (BMS-927711) is approved for acute and preventative treatment of migraines * Atogepant (AGN-241689) is approved for preventative treatment of migraines * Zavegepant (BHV- 3500) is a nasal spray approved for acute treatment of migraines. * Telcagepant (MK-0974), reached phase III clinical tria ...
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Triptan
Triptans are a family of tryptamine-based medication, drugs used as abortive medication in the treatment of migraines and cluster headaches. This drug class was first commercially introduced in the 1990s. While effective at treating individual headaches, they do not provide preventive treatment and are not considered a cure. They are not effective for the treatment of tension headache, tension–type headache, except in persons who also experience migraines. Triptans do not relieve other kinds of pain. The drugs of this class act as agonists for serotonin 5-HT1B receptor, 5-HT1B and 5-HT1D receptor, 5-HT1D receptors at blood vessels and nerve endings in the brain. The first clinically available triptan was sumatriptan, which has been marketed since 1991. Triptans have largely replaced ergotamines, an older class of medications used to relieve migraine and cluster headaches. Medical uses Migraine Triptans are used for the treatment of severe migraine attacks or those that do no ...
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Osmophobia
Osmophobia or olfactophobia refers to a fear, aversion, or psychological hypersensitivity to odors. Osmophobia seems to be a consistent part of the patient’s migraine history, but additional criteria are needed to differentiate it from episodic tension-type headache (ETTH). The phobia generally occurs in chronic migraine sufferers who may have ''odor triggered'' migraines. Such migraines are most frequently triggered by foul odors, but the hypersensitivity may extend to all odors. One study found as many as 25% of migraine sufferers had some degree of osmophobia. The condition may also be present in individuals in substance withdrawal, specifically opioid withdrawal syndrome, where it is usually associated with nausea and/or vomiting. The term ''osmophobia'' comes from the Greek (), meaning "smell, odour", and (), meaning "fear". ''Olfactophobia'' comes from the Latin , meaning "to smell at".
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Propranolol
Propranolol is a medication of the beta blocker class. It is used to treat hypertension, high blood pressure, some types of cardiac dysrhythmia, irregular heart rate, thyrotoxicosis, capillary hemangiomas, akathisia, performance anxiety, and essential tremors, as well to prevent migraine headaches, and to prevent further heart problems in those with angina or previous myocardial infarction, heart attacks. It can be taken oral administration, orally or by intravenous injection. The formulation that is taken orally comes in short-acting and long-acting versions. Propranolol appears in the blood after 30 minutes and has a maximum effect between 60 and 90 minutes when taken orally. Common side effects include nausea, abdominal pain, and constipation. It may worsen the symptoms of asthma. Propranolol may cause teratogen, harmful effects for the baby if taken during pregnancy; however, its use during breastfeeding is generally considered to be safe. It is a non-selective beta block ...
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Cluster Headache
Cluster headache is a neurological disorder characterized by recurrent severe headaches on one side of the head, typically around the eye, eye(s). There is often accompanying eye watering, nasal congestion, or swelling around the eye on the affected side. These symptoms typically last 15 minutes to 3 hours. Attacks often occur in clusters which typically last for weeks or months and occasionally more than a year. The disease is considered among the most painful conditions known to medical science. The cause is unknown, but is most likely related to dysfunction of the posterior hypothalamus. Risk factors include a history of exposure to tobacco smoke and a Family history (medicine), family history of the condition. Exposures which may trigger attacks include ethanol, alcohol, nitroglycerin (medication), nitroglycerin, and histamine. They are a primary headache disorder of the trigeminal autonomic cephalalgias (TAC) type. Diagnosis is based on symptoms. Recommended management ...
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Hyperacusis
Hyperacusis is an increased Hearing, sensitivity to sound and a low tolerance for environmental noise. Definitions of hyperacusis can vary significantly; it often revolves around damage to or dysfunction of the Stapes, ''stapes'' bone, stapedius muscle or tensor tympani. It is often categorized into four subtypes: loudness, pain (also called noxacusis), annoyance, and fear. It can be a highly debilitating Auditory processing disorder, hearing disorder. There are a variety of causes and risk factors, with the most common being exposure to loud noise. It is often coincident with tinnitus. Proposed mechanisms in the literature involve dysfunction in the brain, inner ear, or middle ear. Little is known about the prevalence of hyperacusis, in part due to the degree of variation in the term's definition. Reported prevalence estimates vary widely, and further research is needed to obtain strong epidemiological data. Signs and symptoms Hyperacusis symptoms can include an increased per ...
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Amitriptyline
Amitriptyline, sold under the brand name Elavil among others, is a tricyclic antidepressant primarily used to treat major depressive disorder, and a variety of pain syndromes such as neuropathic pain, fibromyalgia, migraine and tension headaches. Due to the frequency and prominence of side effects, amitriptyline is generally considered a second-line therapy for these indications. The most common side effects are dry mouth, drowsiness, dizziness, constipation, and weight gain. Glaucoma, liver toxicity and abnormal heart rhythms are rare but serious side effects. Blood levels of amitriptyline vary significantly from one person to another, and amitriptyline interacts with many other medications potentially aggravating its side effects. Amitriptyline was discovered in the late 1950s by scientists at Merck and approved by the US Food and Drug Administration (FDA) in 1961. It is on the World Health Organization's List of Essential Medicines. It is available as a generic medicati ...
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Tension Headache
Tension headache, stress headache, or tension-type headache (TTH), is the most common type of primary headache. The pain usually radiates from the lower back of the head, the neck, the eyes, or other muscle groups in the body typically affecting both sides of the head. Tension-type headaches account for nearly 90% of all headaches. Pain medications, such as paracetamol and ibuprofen, are effective for the treatment of tension headache. Tricyclic antidepressants appear to be useful for prevention. Evidence is poor for SSRIs, propranolol and muscle relaxants. The 2016 Global Burden of Disease study revealed that TTHs affect about 1.89 billion people and are more common in women than men (30.8% to 21.4% respectively). TTH was most prevalent between ages 35 and 39. Despite its benign character, tension-type headache, especially in its chronic form, can impart significant disability on patients as well as burden on society at large. In 2016, the global burden of TTH was reported to ...
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Vomiting
Vomiting (also known as emesis, puking and throwing up) is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose. Vomiting can be the result of ailments like food poisoning, gastroenteritis, pregnancy, motion sickness, or hangover; or it can be an after effect of diseases such as brain tumors, elevated intracranial pressure, or overexposure to ionizing radiation. The feeling that one is about to vomit is called nausea; it often precedes, but does not always lead to vomiting. Impairment due to alcohol or anesthesia can cause inhalation of vomit. In severe cases, where dehydration develops, intravenous fluid may be required. Antiemetics are sometimes necessary to suppress nausea and vomiting. Self-induced vomiting can be a component of an eating disorder such as bulimia nervosa, and is itself now classified as an eating disorder on its own, purging disorder. Complications Aspiration Vomiting is dangerous if gastric content e ...
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