Migraine Treatment
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Migraine Treatment
Migraine treatment may be either prophylactic (preventive) or abortive (rescue). Prevention is better than cure, so the ideal treatment goal is to prevent migraine attacks. Because migraine is an exceedingly complex condition, there are various preventive treatments which have their effect by disrupting different links in the chain of events that occur during a migraine attack. As rescue treatments also target and disrupt different processes occurring during migraine, these are summarized, with their relative merits and demerits. Preventive treatment Preventive treatments can be sub-divided into non-drug treatments, and treatment with medication. Non-drug treatment, when possible, is preferable because of the high incidence of unpleasant or debilitating side-effects that occur with migraine preventive drugs. Non–medication-based Because of the complexity of migraine, no preventive treatment modality is effective for all migraine sufferers. However in FDA trials the Nociceptive ...
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Migraine
Migraine (, ) is a common neurological disorder characterized by recurrent headaches. Typically, the associated headache affects one side of the head, is pulsating in nature, may be moderate to severe in intensity, and could last from a few hours to three days. Non-headache symptoms may include nausea, vomiting, and photophobia, sensitivity to light, hyperacusis, sound, or Osmophobia, smell. The pain is generally made worse by physical activity during an attack,as PDF
although regular physical exercise may prevent future attacks. Up to one-third of people affected have Aura (symptom), aura: typically, it is a short period of visual disturbance that signals that the headache will soon occur. Occasionally, aura can occur with little or no headache follow ...
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Temporalis Muscle
In anatomy, the temporalis muscle, also known as the temporal muscle, is one of the muscles of mastication (chewing). It is a broad, fan-shaped convergent muscle on each side of the head that fills the temporal fossa, superior to the zygomatic arch so it covers much of the temporal bone.Illustrated Anatomy of the Head and Neck, Fehrenbach and Herring, Elsevier, 2012, page 98''Temporal'' refers to the head's temples. Structure In humans, the temporalis muscle arises from the temporal fossa and the deep part of temporal fascia. This is a very broad area of attachment. It passes medial to the zygomatic arch. It forms a tendon which inserts onto the coronoid process of the mandible, with its insertion extending into the retromolar fossa posterior to the most distal mandibular molar.Human Anatomy, Jacobs, Elsevier, 2008, page 194 In other mammals, the muscle usually spans the dorsal part of the skull all the way up to the medial line. There, it may be attached to a sagittal cre ...
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Skeleton
A skeleton is the structural frame that supports the body of an animal. There are several types of skeletons, including the exoskeleton, which is the stable outer shell of an organism, the endoskeleton, which forms the support structure inside the body, and the hydroskeleton, a flexible internal skeleton supported by fluid pressure. Vertebrates are animals with a vertebral column, and their skeletons are typically composed of bone and cartilage. Invertebrates are animals that lack a vertebral column. The skeletons of invertebrates vary, including hard exoskeleton shells, plated endoskeletons, or Sponge spicule, spicules. Cartilage is a rigid connective tissue that is found in the skeletal systems of vertebrates and invertebrates. Etymology The term ''skeleton'' comes . ''Sceleton'' is an archaic form of the word. Classification Skeletons can be defined by several attributes. Solid skeletons consist of hard substances, such as bone, cartilage, or cuticle. These can be further ...
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Supratrochlear Nerve
The supratrochlear nerve is a branch of the frontal nerve, itself a branch of the ophthalmic nerve (CN V1) from the trigeminal nerve (CN V). It provides sensory innervation to the skin of the forehead and the upper eyelid. Structure The supratrochlear nerve is a branch of the frontal nerve, itself a branch of the ophthalmic nerve (CN V1) from the trigeminal nerve (CN V). It is smaller than the supraorbital nerve from the frontal nerve. It branches midway between the base and apex of the orbit. It passes above the Trochlea of superior oblique, trochlea of the superior oblique muscle. It then travels anteriorly above the levator palpebrae superioris muscle. It exits the orbit through the frontal notch in the superomedial margin of the orbit. It then ascends onto the forehead beneath the corrugator supercilii muscle and frontalis muscle. It then divides into sensory branches. The supratrochlear nerve travels with the supratrochlear artery, a branch of the ophthalmic artery. Func ...
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Supraorbital Nerve
The supraorbital nerve is one of two branches of the frontal nerve, itself a branch of the ophthalmic nerve. The other branch of the frontal nerve is the supratrochlear nerve. Structure The supraorbital nerve branches from the frontal nerve midway between the base and apex of the orbit. It travels anteriorly above the levator palpebrae superioris and exits the orbit through the supraorbital foramen (or notch) in the superior margin orbit. It exits the orbit lateral to the supratrochlear nerve. It then ascends onto the forehead beneath the corrugator supercilii and frontalis muscles and divides into a medial branch and lateral branch. Function The supraorbital nerve provides sensory innervation to the skin of the lateral forehead and upper eyelid, as well as the conjunctiva of the upper eyelid and mucosa of the frontal sinus The frontal sinuses are one of the four pairs of paranasal sinuses that are situated behind the brow ridges. Sinuses are mucosa-lined airspaces within the ...
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Forehead
In human anatomy, the forehead is an area of the head bounded by three features, two of the skull and one of the scalp. The top of the forehead is marked by the hairline, the edge of the area where hair on the scalp grows. The bottom of the forehead is marked by the supraorbital ridge, the bone feature of the skull above the eyes. The two sides of the forehead are marked by the temporal ridge, a bone feature that links the supraorbital ridge to the coronal suture line and beyond. However, the eyebrows do not form part of the forehead. In ''Terminologia Anatomica'', ''sinciput'' is given as the Latin equivalent to "forehead". (Etymology of ''sinciput'': from ''semi-'' "half" + ''caput'' "head".) Structure The bone of the forehead is the squamous part of the frontal bone. The overlying muscles are the occipitofrontalis, procerus, and corrugator supercilii muscles, all of which are controlled by the temporal branch of the facial nerve. The sensory nerves of the forehead connect ...
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Trigeminal Nerve
In neuroanatomy, the trigeminal nerve ( lit. ''triplet'' nerve), also known as the fifth cranial nerve, cranial nerve V, or simply CN V, is a cranial nerve responsible for sensation in the face and motor functions such as biting and chewing; it is the most complex of the cranial nerves. Its name ("trigeminal", ) derives from each of the two nerves (one on each side of the pons) having three major branches: the ophthalmic nerve (V), the maxillary nerve (V), and the mandibular nerve (V). The ophthalmic and maxillary nerves are purely sensory, whereas the mandibular nerve supplies motor as well as sensory (or "cutaneous") functions. Adding to the complexity of this nerve is that autonomic nerve fibers as well as special sensory fibers (taste) are contained within it. The motor division of the trigeminal nerve derives from the basal plate of the embryonic pons, and the sensory division originates in the cranial neural crest. Sensory information from the face and body is proc ...
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Neurological Examination
A neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine whether the nervous system is impaired. This typically includes a physical examination and a review of the patient's medical history, but not deeper investigation such as neuroimaging. It can be used both as a screening tool and as an investigative tool, the former of which when examining the patient when there is no expected neurological deficit and the latter of which when examining a patient where you do expect to find abnormalities. If a problem is found either in an investigative or screening process, then further tests can be carried out to focus on a particular aspect of the nervous system (such as lumbar punctures and blood tests). In general, a neurological examination is focused on finding out whether there are lesions in the central and peripheral nervous systems or there is another diffuse process that is troubling the patient. Once the patient has been ...
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Botox
Botulinum toxin, or botulinum neurotoxin (BoNT), is a neurotoxic protein produced by the bacterium ''Clostridium botulinum'' and related species. It prevents the release of the neurotransmitter acetylcholine from axon endings at the neuromuscular junction, thus causing flaccid paralysis. The toxin causes the disease botulism. The toxin is also used commercially for medical and cosmetic purposes. The seven main types of botulinum toxin are named types A to G (A, B, C1, C2, D, E, F and G). New types are occasionally found. Types A and B are capable of causing disease in humans, and are also used commercially and medically. Types C–G are less common; types E and F can cause disease in humans, while the other types cause disease in other animals. Botulinum toxins are among the most potent toxins known. Intoxication can occur naturally as a result of either wound or intestinal infection or by ingesting formed toxin in food. The estimated human lethal dose of type A toxin is ...
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Procerus Muscle
The procerus muscle (or pyramidalis nasi) is a small pyramidal slip of muscle deep to the superior orbital nerve, artery and vein. ''Procerus'' is Latin, meaning tall or extended. Structure The procerus muscle arises by tendinous fibers from the fascia covering the lower part of the nasal bone and upper part of the lateral nasal cartilage. It is inserted into the skin over the lower part of the forehead between the two eyebrows on either side of the midline, its fibers merging with those of the frontalis muscle. Nerve supply The procerus muscle is supplied by the temporal branch of the facial nerve (VII). It may also be supplied by other branches of the facial nerve, which can be varied. Function The procerus muscle helps to pull that part of the skin between the eyebrows downwards, which assists in flaring the nostrils. It can also contribute to an expression of anger. Procerus is supplied by temporal and lower zygomatic branches from the facial nerve. A supply from its b ...
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Depressor Supercilii
The depressor supercilii is an eye muscle of the human body. The nature of this muscle is in some dispute. Few printed anatomies include it (Netter, et al.) and many authorities consider it to be part of the orbicularis oculi muscle. On the other hand, many dermatologists, ophthalmologists, and plastic surgeons hold that the depressor supercilii is a distinct muscle and has a definite, individual effect on the movement of the eyebrow and skin of the glabella. Origin and insertion The depressor supercilii originates on the medial orbital rim, near the lacrimal bone, and inserts on the medial aspect of the bony orbit, inferior to the corrugator supercilii. In some specimens it exhibits two heads and in others, only one. See also * Corrugator supercilii muscle References External links Illustrationin Facial Action Coding System * - "Botox Botulinum toxin, or botulinum neurotoxin (BoNT), is a neurotoxic protein produced by the bacterium '' Clostridium botulinum'' and rela ...
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Corrugator Supercilii
The corrugator supercilii muscle is a small, narrow, pyramidal muscle close to the eye. It arises from the medial end of the superciliary arch, and inserts into the deep surface of the skin of the eyebrow. It draws the eyebrow downward and medially, producing the vertical wrinkles of the forehead. Structure The corrugator supercilii muscle is located at the medial end of the eyebrow, beneath the frontalis muscle and just above the orbicularis oculi muscle. It arises from the medial end of the superciliary arch. Its fibers pass upward and laterally, between the palpebral and orbital portions of the orbicularis oculi muscle. It inserts into the deep surface of the skin of the eyebrow, above the middle of the orbital arch. Relations The supratrochlear nerve passes by the corrugator supercilii muscle between it and the frontalis muscle. Function The corrugator supercilii muscle draws the eyebrow downward and medially, producing the vertical wrinkles of the forehead. It is th ...
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