{"id":1651,"date":"2025-10-10T04:00:00","date_gmt":"2025-10-10T00:00:00","guid":{"rendered":"http:\/\/vitamed.test\/migraine-causes-diagnosis-threatment\/"},"modified":"2026-09-17T11:57:25","modified_gmt":"2026-09-17T07:57:25","slug":"migraine-causes-diagnosis-threatment","status":"publish","type":"post","link":"https:\/\/vitamed.production.am\/en\/migraine-causes-diagnosis-threatment\/","title":{"rendered":"MIGRAINE &#8211; CAUSES, DIAGNOSIS, THREATMENT"},"content":{"rendered":"<p><!-- vitamed:content-featured-image:start --><\/p>\n<figure class=\"article-content-thumbnail-wrap\"><img decoding=\"async\" width=\"1280\" height=\"720\" src=\"https:\/\/vitamed.production.am\/wp-content\/uploads\/2026\/05\/migren.jpg\" class=\"article-content-thumbnail\" alt=\"MIGRAINE - CAUSES, DIAGNOSIS, THREATMENT\" loading=\"lazy\" \/><\/figure>\n<p><!-- vitamed:content-featured-image:end --><\/p>\n<h2 style=\"text-align: justify\">What is Migraine?<\/h2>\n<p style=\"text-align: justify\">Migraine is a primary neurological disorder characterized by recurrent unilateral, pulsating headaches of moderate or high intensity, often accompanied by nausea, photophobia, and phonophobia.<br \/>\nAccording to the European Academy of Neurology (EAN), migraine is a disease with well-defined neurobiological mechanisms, and not merely a &ldquo;response to stress&rdquo; or &ldquo;unhealthy lifestyle.&rdquo; It is associated with hyperexcitability of the central nervous system, sensory filtering disturbances, and involvement of the trigeminovascular system.<\/p>\n<h2 style=\"text-align: justify\">Causes and Pathogenesis<\/h2>\n<p style=\"text-align: justify\">Migraine has a genetic and neurovascular basis.<\/p>\n<p style=\"text-align: justify\"><strong>Key mechanisms include:<\/strong><\/p>\n<ul>\n<li style=\"text-align: justify\">Cortical Spreading Depression (CSD) &mdash; a wave of depolarization in the cerebral cortex, especially in migraine with aura<\/li>\n<li style=\"text-align: justify\">Activation of the trigeminovascular system<\/li>\n<li style=\"text-align: justify\">Release of neuropeptides, especially CGRP (Calcitonin Gene-Related Peptide), leading to vasodilation, neurogenic inflammation, and pain signaling<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Risk factors and triggers:<\/strong><\/p>\n<ul>\n<li style=\"text-align: justify\">Genetic predisposition<\/li>\n<li style=\"text-align: justify\">Female sex (3 times more frequent than in males)<\/li>\n<li style=\"text-align: justify\">Menstrual cycle, hormonal fluctuations<\/li>\n<li style=\"text-align: justify\">Stress, sleep disturbances<\/li>\n<li style=\"text-align: justify\">Use of alcohol, caffeine, monosodium glutamate<\/li>\n<li style=\"text-align: justify\">Fasting, strong odors, sensory overload<\/li>\n<\/ul>\n<h2 style=\"text-align: justify\">Classification and Types<\/h2>\n<p style=\"text-align: justify\">According to the International Classification of Headache Disorders (ICHD-3, 2020), the following forms are distinguished:<\/p>\n<p style=\"text-align: justify\"><strong>1. Migraine without aura (up to 75% of cases)<\/strong><\/p>\n<p style=\"text-align: justify\">&bull;&nbsp;&nbsp; &nbsp;Unilateral, pulsating pain that worsens with physical activity<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Duration: 4&ndash;72 hours<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Associated symptoms: nausea, photophobia, phonophobia<\/p>\n<p style=\"text-align: justify\"><strong>2. Migraine with aura<\/strong><\/p>\n<p style=\"text-align: justify\">&bull;&nbsp;&nbsp; &nbsp;Aura precedes or accompanies the headache<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Symptoms: visual phenomena (flashes, zigzags), paresthesias, aphasia<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Aura duration: 5&ndash;60 minutes<\/p>\n<p style=\"text-align: justify\"><strong>3. Chronic migraine<\/strong><\/p>\n<p style=\"text-align: justify\">&bull;&nbsp;&nbsp; &nbsp;&ge;15 days of headache per month, of which &ge;8 fulfill migraine criteria<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Duration: &ge;3 months<\/p>\n<h2 style=\"text-align: justify\">Diagnosis<\/h2>\n<p style=\"text-align: justify\">Diagnosis is clinical, based on ICHD-3 criteria. MRI of the brain is indicated in atypical presentation or when secondary headache is suspected.<\/p>\n<p style=\"text-align: justify\"><strong>Diagnostic criteria (ICHD-3):<\/strong><\/p>\n<p style=\"text-align: justify\">&bull;&nbsp;&nbsp; &nbsp;At least 5 attacks meeting the following criteria:<\/p>\n<ul>\n<li style=\"text-align: justify\">Duration: 4&ndash;72 hours<\/li>\n<li style=\"text-align: justify\">At least 2 of the following: unilateral location, pulsating quality, moderate\/high intensity, aggravation with physical activity<\/li>\n<li style=\"text-align: justify\">At least 1 of: nausea\/vomiting or photophobia and phonophobia<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Modern Treatment (According to EAN and NICE Guidelines)<\/strong><\/p>\n<p style=\"text-align: justify\">1. Acute treatment (attack relief)<br \/>\n2. Preventive migraine therapy<\/p>\n<p style=\"text-align: justify\"><strong>Indications for preventive therapy:<\/strong><\/p>\n<ul>\n<li style=\"text-align: justify\">&ge;4 attacks per month<\/li>\n<li style=\"text-align: justify\">Reduced quality of life<\/li>\n<li style=\"text-align: justify\">Adverse effects or low efficacy of acute treatment<\/li>\n<li style=\"text-align: justify\">Chronic migraine<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Botulinum toxin type A (Botox&reg;):<\/strong><\/p>\n<ul>\n<li style=\"text-align: justify\">Indicated for chronic migraine (&ge;15 days\/month)<\/li>\n<li style=\"text-align: justify\">Efficacy confirmed by PREEMPT trials<\/li>\n<li style=\"text-align: justify\">Administered every 12 weeks<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Non-Pharmacological Approaches<\/strong><\/p>\n<ul>\n<li style=\"text-align: justify\">Cognitive behavioral therapy, biofeedback<\/li>\n<li style=\"text-align: justify\">Trigger reduction: regular sleep, stable diet, stress reduction<\/li>\n<li style=\"text-align: justify\">Moderate physical activity (proven to reduce attack frequency)<\/li>\n<li style=\"text-align: justify\">Acupuncture &ndash; limited efficacy, may be used as adjunctive therapy<\/li>\n<\/ul>\n<h2 style=\"text-align: justify\">When to See a Doctor<\/h2>\n<ul>\n<li style=\"text-align: justify\">If headaches occur &ge;4 times per month<\/li>\n<li style=\"text-align: justify\">If standard analgesics are ineffective<\/li>\n<li style=\"text-align: justify\">In the presence of severe nausea, vomiting, photophobia, or phonophobia<\/li>\n<li style=\"text-align: justify\">If quality of life or work ability is impaired<\/li>\n<li style=\"text-align: justify\">In case of sudden onset of &ldquo;the worst headache of your life&rdquo; (exclude subarachnoid hemorrhage)<\/li>\n<\/ul>\n<p style=\"text-align: justify\">Migraine is a neurobiological disease requiring a comprehensive approach and personalized therapy. Modern medicine offers effective strategies &mdash; from triptans and preventive medications to targeted monoclonal antibody therapy. Accurate diagnosis and early treatment can significantly reduce the frequency and severity of attacks, improving the patient&rsquo;s quality of life.<\/p>\n<h2 style=\"text-align: justify\">Neurological Services &amp; and botox injections in &laquo;VitaMed&raquo; MC (Yerevan, Charentsavan, Stepanavan)<\/h2>\n<table border=\"1\" cellpadding=\"1\" cellspacing=\"1\" style=\"width:500px\">\n<tbody>\n<tr>\n<td>Migraine treatment with botox injections<\/td>\n<td>120.000 AMD<\/td>\n<\/tr>\n<tr>\n<td>Initial consultation with a neurologist, including repeated consultation within 10 days<\/td>\n<td>12.000 AMD<\/td>\n<\/tr>\n<tr>\n<td>Initial online consultation with a neurologist, including repeated consultation within 10 days<\/td>\n<td>10.000 AMD<\/td>\n<\/tr>\n<tr>\n<td>Repeated consultation with a neurologist (3rd visit)<\/td>\n<td>6.000 AMD<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n","protected":false},"excerpt":{"rendered":"<p>Migraine is a neurobiological disease requiring a comprehensive approach and personalized therapy. Modern medicine offers effective strategies \u2014 from triptans and preventive medications to targeted monoclonal antibody therapy.<\/p>\n","protected":false},"author":1,"featured_media":1646,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[173,171],"tags":[],"class_list":["post-1651","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog-en","category-blog"],"acf":[],"_links":{"self":[{"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/posts\/1651","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/comments?post=1651"}],"version-history":[{"count":3,"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/posts\/1651\/revisions"}],"predecessor-version":[{"id":6532,"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/posts\/1651\/revisions\/6532"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/media\/1646"}],"wp:attachment":[{"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/media?parent=1651"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/categories?post=1651"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/tags?post=1651"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}