How does it feel to be hungover?

migraine : Like a hangover without alcohol

Everyone has a headache at times. How is a migraine different from an ordinary headache?
A migraine often feels like a hangover - except that the migraine sufferer hasn't drunk any alcohol. A throbbing, pulsating headache, vomiting, sensitivity to light and noise are typical symptoms. In two thirds of patients, the pain occurs on one side. This is where the disease name comes from - the ancient Greek word means "half skull". Many people never have a migraine headache, others only get it once or twice in a lifetime. People who suffer from severe migraines have to live with at least eight attacks a month.

How do the migraine attacks come about? What happens in the brain?
I always tell my migraine sufferers that they can actually be a little proud of their brains. Because their nerve networks are strongly excited, the stimulus processing runs on high voltage, they are usually more concentrated, more receptive and can perform more tasks at the same time. If the brain were a car, they would drive a Porsche. However, the brake pedal blocks. The body's own inhibition of pain by the brainstem seems to be less pronounced in migraineurs than in healthy people. This makes those affected less stress-resistant. So migraines have genetic causes and are neither the product of a wrong upbringing nor a mental illness, as some fear.
It used to be assumed that certain external stimuli, so-called triggers, gave the nerves running at full speed the rest and overstimulated them ...
Yes, that was previously assumed, but this trigger factor concept is no longer up-to-date. However, we observe that migraine headache often occurs with the menstrual period.

So much for the body's own causes. But what triggers an attack?
First of all, it is important to distinguish between cause and cause. As already mentioned, the latter is the genetic predisposition to highly excited nerves and less resistance to stress. The cause that brings the barrel to overflow can be, for example, psychological or physical stress, unfamiliar living conditions or hormone fluctuations. However, far too often migraines are unnecessarily pathologized, i.e. perceived as a disease phenomenon. For example, if a youngster suffers from frequent attacks, some are quick to suspect psychological problems. But that is often complete nonsense. Such diagnoses only unnecessarily unsettle the affected children and adolescents and put them under additional pressure.
Migraine is a widespread disease that plagues millions of people. What helps against the headache?
Mild to moderate migraine attacks can be treated well by yourself - for example with over-the-counter pain relievers such as acetylsalicylic acid, ibuprofen, paracetamol, diclofenac or naratriptan. Combination preparations of the active ingredients acetylsalicylic acid, paracetamol and caffeine are particularly effective against migraine pain.

But what to do if the medicine cabinet does not fight migraine pain?
For moderate to severe migraines, so-called triptans are the drug of choice. Triptans are to migraine sufferers what insulin is to diabetes sufferers. The active ingredient regulates the serotonin metabolism and thus stabilizes the brain vessels. The rather rare side effects of triptans, such as a slight feeling of exhaustion, slight nausea or abnormal sensations such as tingling or hot flashes, are by the way far more harmless than those of other painkillers. And mostly inseparable from the "normal" symptoms of a migraine attack.

The full interview can be found in the magazine for medicine and health in Berlin: "Tagesspiegel Gesund - Berlin's doctors for the brain and nerves".

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