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Know your migraine. Indeed, there are different types of migraine. They mainly differ by their mechanism. The advantage of knowing that you have is to optimize your treatment. Explanations of Dr Michel Dib, a neurologist and migraine specialist *.

What are the different types of migraines?

Dr Michel Dib: Migraine occurs in the usual way: pulsating pain, often nausea, intolerance to light, noise. However, migraine attacks have different causes.

The first type of migraines are triggered by food, through serotonin, a messenger in the brain. The 2nd type of migraines are triggered by stress and changes of pace, as the arrival of the weekend, holiday or are migraines that occur during the night, and that are caused by adrenaline (stress hormone ).

The 3rd type of migraine is related to the rules (menstrual migraine) and under the influence of hormonal factors.

Finally, the 4th type of migraine is accompanied by diffuse muscle pain, especially at the shoulder, head. These pains are very different from the pulsating pain of migraine attack, even if they accompany. They are like a disease called fibromyalgia. Such headaches are muscle quickly degenerate and occur at a very frequent, more than 15 days per month, sometimes, in addition, chronic daily headaches. It is very important to identify migraine muscle because the treatment requires taking care of two elements: the pulsatile classical migraine whose origin is inflammation in the arteries and the muscular element that comes from a heightened sensitivity muscles, as in fibromyalgia.

This type of migraine is largely unknown to both physicians and patients.

The treatments are different depending on the type of migraine?

Dr Michel Dib: Recognize the type of migraine that are suffering is essential because the management is not the same in the “4 color” of the migraine.

In the case of hormonal migraines, the choice of the contraceptive pill is essential. Should be given the pills without rules, ie containing progesterone. Whether low or high dose, conventional pills contain both estrogen and progesterone. But the trigger migraines are hormone estrogen, one must resort to a pill called 3rd generation containing only progestin. The measure most often sufficient to treat this type of menstrual migraine.

In migraine adrenergic (due to stress), rather it uses a drug that blocks adrenaline, known as beta blockers, also prescribed drug class against hypertension.

Serotonin in migraine, using serotonin drugs.

The treatment of the crisis are also different depending on the type of migraine?

Dr Michel Dib: In migraine, there are three levels of care. The first level is based on prevention, which is to avoid triggers the crisis and which is the type of migraine. The second level is the treatment of the crisis, which is the same regardless of the type of migraine (serotonin, adrenergic, hormonal or muscle). It is based on taking analgesics (paracetamol), anti-inflammatory or triptans (drugs against migraine attacks).

Finally, the 3rd level is the bottom of said treatment, which depends on the type of migraine. As indicated above, it is the pill continuously progrestative in migraine hormone, beta-blockers in the case of migraines adrenergic, anti-serotonin against migraines involving serotonin and pain associated with muscle relaxants such as benzodiazepines or tricyclic antidepressants when it comes to migraines muscle. In the latter category of migraine, it also uses physical therapy, massage helps treat muscle hypersensitivity.