Acephalgic Migraine
Acephalgic migraines are as old as humanity. It is not until the advent of the developed s... more and also
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Acephalgic migraines are as old as humanity. It is not until the advent of the developed societies of the second half of the twentieth century, when the investigation into its causes and how to treat them have taken a major boom. With the discovery of new specific drugs for the treatment of the crisis sick headache, and the use of prophylactic agents, has improved the quality life of patient's migraine. Yet even today has not been achieved absolute control of this disease.
The Concept, classification and clinical manifestations are as follows
Acephalgic migraine is a disorder characterized by family crisis headaches that a) occur with varying degrees of frequency, intensity and duration; b) tend to be unilateral, though they are often bilateral; c) often are associated with gastrointestinal symptoms d) may be preceded or associated with various neurological disorders and e) can be regarded as a peculiar response of the central nervous system (CNS) To a variety of stimuli.
Clinically, Acephalgic migraine has a number of different steps. In a first phase the prodromal or the patient will be faced with vague neurological symptoms systemic symptoms and alteration of feeding behavior. The length varies from one to two days to several hours which in terms will appear in 25% of migraine.
The next phase would be the onset of headache, normally a pulse location hemicranias of dominance in front-temporal region or retro-eye. Although you can locate in jaw, molar eminence, the anterior portion and upper neck, and even the upper hemi thorax. It is often accompanied by phenomena associated sono, photo and olorofobia. Autonomic phenomena are frequent partners as Gastrophryne nauseated and vomiting, profuse sweating, renal disorder, diarrhea, skin coloration changes, facial swelling, coldness Acre, and feeling stuffy nose. And even changes in pupil diameter of the same side of a headache. Sometimes the sick Patients experienced an impressive response. Other neuropsychiatry symptoms associated going to be the mood of depression, irritability, difficulty in concentration, drowsiness, impaired memory and difficulty thinking abstractly. Sometimes the aura will last at this stage be called prolonged aura. In other neurological disorders appear during the headache, what is known as migraine accompanied. One typical aspect of migraine headaches will be his aggravated with exercise and with cranial movements. In some patients often fall asleep at the finish.
A third stage is the stage of the resolution, in which the headache is referring to disappear in hours. Sometimes the patient is asleep for several hours.
The fourth and final phase is the phase of "hangover" in which the patient experiences difficulty concentrating, fatigue, drowsiness, and so on. In more rare cases can produce euphoria. Is the duration of several hours a day until 3-5?
Classification
The International Headache Society instituted a system of classification, although increasingly controversial, is currently the only used. This system identifies 12 categories of major headaches, which in turn are divided into two broad groups: primary headaches and secondary headaches
In primary headaches there is no underlying cause, and the headache itself is the problem. In the secondary headache is the symptom of a systemic or neurological primary.
Among the primary headaches there are 4 different types according to their clinical treatment and prognosis. Among these are primary headaches: migraine, tension headache, the headache in clusters, and a miscellaneous group of headaches that do not meet the criteria of the above.
Occurrence
Acephalgic migraine can occur in a random or related to the menstrual cycle, or other temporary factors such as lack of sleep or excess (migraines weekend). There may be a close relationship with certain times of year, especially in relation to sudden changes in weather (spring, fall, etc.)... They may also appear in connection with the intensity of environmental stimuli such as light, sounds or certain odors. The most frequently going to be two to three times a month.
Quality and intensity of pain
In Acephalgic migraine pain is often a pulsating, although in many cases begins in an "oppressive", "deaf" and progressive deterioration. The pain of migraine makes the patient look for quiet places, remaining subject to the minimum possible physical activity, unlike the headache in "clusters" that produces a great nervousness in which the suffering.
Symptoms
In Acephalgic migraine symptoms may appear as an extension of Neurological aura or only during the headache. If symptoms are prolonged beyond a headache for several days and will be discarded infarction Acephalgic migraine. This produces a table ischemic brain injury visible by neuroimaging techniques after a migraine with aura with or prolonged, with persistent neurological deficit. It's going to occur in women with migraine with aura, over 40, smokers, and who take oral contraceptives.
The tension headache is the type of headache most prevalent, which gives it great significance and social causes high labor costs.
Although the pathogenic mechanisms are not sufficiently clarified, invoking the participation of central and peripheral tissues involving meiosis and central elements responsible for sensitive modulation.
In therapeutic approach is based largely empirical, postulates the use of conventional analgesics and NSAIDs, as well as physical therapy and behavioral non-pharmacological. Recently proposed treatment with neutralizing presenting preliminary results are very encouraging.
Amitriptyline hydrochloride would be the drug of choice for prophylaxis of forms of CTC, as for cases resistant to conventional drugs at Forms of CTE.
Probably as we move closer to a more definite pathos knowledge of such an entity, create new therapeutic options that, from a less empirical basis, will allow us to improve the prediction and functional status of patients afflicted by one of the forms of tension headache .
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