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Migraine

Migraine is a type of severe headache, often one-sided, which may also be accompanied by nausea, vomiting or increased sensitivity to light. Migraine headaches are one of the most common types of headache. It is most common in people aged between 25 and 55.

據估計,超過95%的人患有間歇性壓力性頭痛。可是,到目前為止仍然未能確定箇中原因。雖然精神緊張或肌肉過度收緊通常都跟頭痛有關,但這些並不一定是頭痛的病源。一般來說,頭痛現象較容易發生在女性以及有家庭成員患頭痛病症的人身上。其他導致壓力性頭痛的因素包括:

  • 情緒或心理問題,如抑鬱症、焦慮或壓力
  • 肌肉收縮不協調或不良坐姿
  • 過量服食止痛藥

間歇性頭痛通常是暫時性的,這類頭痛會維持半小時至一個星期不等;成因往往十分明顯,例如工作壓力大,情緒低落,或經期臨近。

如果頭痛持續不斷或出現次數頻密,那便屬於慢性頭痛。大約有3%的人患有這類頭痛。當中有些人幾乎每天都會感到頭痛,而且這種情況可能會持續多年。有很多患者會擔心這是由某些潛伏體內的嚴重疾病(如腦腫瘤)所導致的,但事實上這些可能性極低。

有某類人士同時較易患上壓力性頭痛和偏頭痛,要注意這兩類頭痛的治療方法可能有所不同。

患有嚴重或頻密頭痛的人通常會服食止痛藥,而服用的分量往往不斷增多。其實過量服食止痛藥只會減低其功效,不但不能止痛,更反而會令頭痛加劇(這種情況一般稱為「錯誤使用藥物」或「頭痛復發」)。一旦有這種情況出現,病人便應立即停止服食止痛藥。初期病人會出現戒斷症狀,如頭痛、噁心、嘔吐、失眠和精神緊張等。這些症狀可能會持續3至10天。

The brain contains a natural chemical called serotonin. When a migraine happens, something triggers a drop in serotonin levels. This causes an area of the brain to send messages to a nerve in the face and to blood vessels in the head. The blood vessels widen, and it's this that causes pain. The serotonin drop also affects the way other parts of the brain work, which can result in other symptoms that some people experience as an "aura".
 
In women who suffer from migraines, hormone changes may also be involved. In some women, migraines occur a few days before, during, and immediately after a period. About 70% of women who have migraines can relate their migraine headaches to their menstrual period.
 
About 80% of people who get migraine headaches have a family history of migraines, which suggests that there may be a genetic basis to migraines.
 
Some people find that their migraines are triggered by something. Triggers might include:
  • certain foods – such as chocolate, cheese, red wine, citrus
  • fruits, coffee, tea, tomatoes, potatoes
  • too much or too little sleep
  • changes in hormone balance in women – such as periods, the pill, menopause
  • stress or even relaxation
  • irregular meals
  • caffeine withdrawal
  • physical activity
  • smoking
  • flashing lights
  • noise
  • weather – high pressure conditions, changes in pressure, hot dry winds, seasonal changes, exposure to sun and glare
  • exercise – too much or too little
  • sexual arousal
  • smells – paint, fumes from car heaters or perfume
Often, several triggers work together to provoke a migraine. Unfortunately, avoiding triggers may not prevent migraines, as most migraines are not caused by a single, identifiable trigger.

很少人會因為頭痛而去看醫生。但萬一遇到以下情況,還是應該立即求診:

  • 突然感到頭部劇痛但沒有明顯原因
  • 有嚴重或頻密的頭痛
  • 所感受的痛楚集中在頸部、牙齒、耳朵、鼻竇或眼睛
  • 頭痛令人睡醒

很多時,頭痛會不藥而癒。偶有少許頭痛,只要服食一般藥房有售的止痛藥(如撲息熱痛(Paracetamol)、阿士匹靈(Aspirin)和異丁苯乙酸(Ibuprofen)等)便能紓緩痛楚。病人應尋求藥劑師的意見,並按指示服用適當分量。由於含有咖啡因和可待因的止痛藥(例如上述止痛藥的特效配方)容易使人上癮,以致過量服用,故患者應避免經常服用這類藥物。

慢性頭痛患者應盡量避免服用止痛藥。對付慢性頭痛較好的方法是服用一些預防性藥物。有證據顯示每晚睡前服用少量amitriptyline(一種抗抑鬱藥),能有效預防某類慢性頭痛,但服用的分量要比治療抑鬱症的分量少。

壓力性頭痛通常會與精神緊張和憂慮等情緒問題相提並論。我們應找出壓力的來源,然後嘗試改變自己的生活方式。舉例來說,假如工作過勞使我們身心疲憊,繼而引致頭痛,那麼我們便應適當地調節一下工作量。

有研究顯示,部分患者能透過鬆弛神經減輕慢性頭痛,但任何鬆弛神經的方法都一定要持之以恆,才能達至持久的效果。另外,一些輔助療法,如針灸、 Alexander technique、反射學、瑜珈和按摩等,亦有助減壓和鬆弛神經;用薄荷油和乙醇進行香薰療法,同樣可紓緩頭痛。

保持坐姿正確十分重要,在辦公室工作或經常使用電腦的人尤其要謹記這一點。此外,均衡飲食和多做運動對個人健康亦有幫助。

Over-the-counter medicines
Mild migraine attacks settle in a few hours. It's best to rest in a quiet, darkened room, and take simple painkillers, such as paracetamol, aspirin or ibuprofen. Preparations containing the anti-sickness drug buclizine may help with any nausea and sickness.
 
Prescription medicines
There are many prescription drugs available if these simple remedies don't help. Drugs called metoclopramide and domperidone can stop nausea and vomiting. A combination of aspirin and metoclopramide is also now available, to help with pain and nausea. And the findings of a drug in trial called tolfenamic acid suggest that it is effective.
 
The triptan group of drugs work by correcting the serotonin imbalance. These are available as tablets, injections, nasal sprays or dissolvable wafers. But they should not be used after a heart attack or stroke, or in people who suffer from high blood pressure. Some people get side-effects from these drugs, such as dizziness, a feeling of pressure in the neck or chest area, nausea and vomiting.
If avoiding triggers doesn't seem to help, and you get at least two severe migraines a month, you might want to consider taking daily preventive treatment. These include:
  • a-blockers, such as propranolol
  • tricyclic antidepressants, such as amitriptyline
  • pizotifen
The anti-epileptic drug sodium valproate may also be effective, but is not a common treatments due to the side-effects. Another option is the drug methysergide, but this can have dangerous side-effects and should only be administered under hospital supervision. For menstrual migraine, hormone treatment with oestrogen may help.
 
Whatever the approach, it will take some time, and support from a doctor, for each individual to find a treatment that best helps manage their migraine.

This information was published by Bupa Group's Health Content Team and has been reviewed by appropriate medical or clinical professionals. To the best of their knowledge the information is current and based on reputable sources of medical evidence, however Bupa (Asia) Limited makes no representation or warranty as to the completeness or accuracy of the Content.

The information on this page, and any information on third party websites referred to on this page, is provided as a guide only. It should not be relied upon as a substitute for professional medical advice, nor is it intended to be used for medical diagnosis or treatment. Bupa (Asia) Limited is not liable for any loss or damage you suffer arising out of the use of, or reliance on, the information.

Third party websites are not owned or controlled by Bupa and any individual may be able to access and post messages on them. Bupa is not responsible for the content or availability of these third party websites. Last updated August 2017.

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