Nursing process for diseases of the autonomic nervous system

Migraine is not just a headache .
Migraine pain can be debilitating, sudden, or accompanied by a variety of problems, such as severe nausea, blurred vision, difficulty speaking, and numbness in the fingers.

The attacks last for several hours. A person can begin to experience migraine attacks from childhood, and their frequency usually increases until the age of 35-40. Migraine pain is three times more common in women, and their attacks last longer.

Numerous studies have linked migraine to significant reductions in quality of life and disability. It is well known that migraine attacks are associated with an increased risk of ischemic stroke.

What methods of treating migraines and preventing attacks can modern medicine offer?

Today we will talk about the five most popular approaches to this problem abroad.

What to do first during an attack

Emergency help for migraines consists of premature relief of the pain syndrome, when it has not yet arisen, but the first symptoms are already present: a feeling of thirst, general malaise, increased irritability.

If such clinical manifestations occur, you can lie down in bed and try to take a nap. In most cases, migraines disappear during sleep. But those cases where neurological symptoms appear precisely when falling asleep are no exception.

If a migraine occurs in a place unsuitable for sleep, for example, on the street, in a store, at a party, you need to leave the stuffy room and go out into the fresh air. If possible, you can drink strong tea with lemon and sugar. It is the glucose contained in sugar that can fight migraine-like headaches.

Help for migraines can be as simple as using a heating pad on your forehead. Helps stop an attack and massage the cervical and head. This manipulation helps normalize blood circulation in these areas and restore normal oxygen exchange in the brain.

If you cannot prevent the headache, you can try taking a warm bath. As an alternative - a contrast shower. Often such water procedures help eliminate headaches and other unpleasant symptoms of migraine.

The room in which a person is located should not have bright or sunlight or loud sounds: it is necessary to close the curtains, windows and turn off sound-producing devices (TV, radio, etc.).

Quick help for migraines is to use a balm that contains menthol. Rub your temples with this product using your index fingers. This method of treating headaches is suitable even for women during pregnancy and while breastfeeding a child.

First aid may include a foot massage. A person needs to relax as much as possible and remove extraneous thoughts from his head. Compresses will be no less effective:

• from cabbage leaf or burdock;
• from lemon slices secured on top with a piece of bandage;
• from a towel soaked in warm water.

They will help eliminate headaches within 15-20 minutes. Of course, each body is individual and reacts differently to one or another remedy, including folk remedies. While compresses help some people get rid of migraine symptoms, for others they may not work.

If each of the above methods of emergency treatment for migraine is ineffective, you should not endure the pain, but urgently call a doctor. Upon arrival, he will provide the person with qualified medical care and prescribe further treatment for the disease.

Of course, when providing emergency care for migraine at home, the doctor will not be able to carry out the necessary diagnostic measures to identify the cause of the pathology. This is only possible when visiting a specialist located in a specialized institution (in a public or private clinic).

As soon as the opportunity arises, you need to go to the hospital to see a local therapist, who, if necessary, will refer the patient to a specialized specialist. The latter will prescribe instrumental (and laboratory) tests, the results of which can determine the source of the migraine, and prescribe appropriate therapy.

Migraine mechanism, the “joy hormone” is to blame.

Scientists have always tried to answer the question of where this headache comes from. And, despite such deep roots, they still have not come to a common point of view.

In heated debates, it was found that migraines mainly affect people aged 18.

.35 years, with women three times more likely than men. This disease is genetic in nature, that is, it is inherited, often through the maternal line.

But at the same time, some researchers believe that cerebral vascular pathology is inherited, others - platelet pathology. But most people tend to blame this suffering on the “hormone of joy” - serotonin, which has a strong vasoconstrictor effect.

As a result of research, it was found that immediately before the onset of an attack, the level of serotonin in the blood increases catastrophically, leading to severe constriction of the blood vessels in the brain. As a result, the nerve cells of the brain do not receive enough oxygen, and they begin to “slow down”: confused speech appears, vision is impaired, and so on.

Medicines in the treatment of migraine

Classic migraine with aura, like other types of disease, is not difficult to treat. Medicines that are used as first aid for migraines, as well as to prevent headaches, will come to the rescue.

Medicines that are intended to eliminate an attack are prescribed to each patient. Preventive treatment of the pathology is prescribed for persons suffering from severe headaches that occur more often than 2-3 times in 30 days.

Painkillers that can combat migraines include:

• analgesic tablets and drugs from the group of non-steroidal anti-inflammatory drugs;
• tablets containing sporinha alkaloids;
• medications - triptans.

The algorithm for taking pills for a neurological disease is as follows:

1. As soon as the first symptoms of migraine appear or at the initial manifestation of headache, an analgesic or non-steroidal drug is required (this can be Acetylsalicylic acid, Ibuprofen, etc.).
2. For better absorption of the drug and prevention of vomiting, experts recommend taking one of the following drugs in combination, such as Metoclopramide, Domperidone, Cerucal.

To enhance the analgesic effect of the analgesic drug, it is allowed to combine it with caffeine. This could be caffeine contained in coffee, tea, or Coca-Cola. There are also special preparations containing such a substance, for example, Askofen-P.

If it is impossible to take the drug in tablet form (for example, due to incessant vomiting), you can use an anesthetic drug in the form of rectal suppositories (Voltaren, etc.).

If analgesics are ineffective, triptans are prescribed (Sumamigren, Zomig, Naramig, etc.). As a rule, such drugs are started to be used if 3 attacks in a row could not be stopped using conventional analgesics.

Some migraine medications come in spray form, which makes them easy to use even if you are vomiting. For example, this includes Imigran in the form of a nasal spray.

Sporinha preparations are no less effective, but the exact principle of their effect on the body has not yet been determined. These may be Dihydrergot, Ergotamine, Dihydroergotamine, etc. Despite the fact that the drugs have a natural composition, they can cause side symptoms, including nausea and vomiting syndrome, muscle pain, tachycardia, etc.

Preventive agents include beta-blockers (Anaprilin, etc.), antidepressants (Amitriptyline, Prozac, etc.), anticonvulsants (sodium valproate, etc.). Such products are used for a long time (about 6 months).

Nutritional supplements for migraines

Nutritional supplements are widely used for the treatment of migraine and are safe and well tolerated:

• Coenzyme Q10.
Recent research suggests that CoQ10, along with preventive medications, may reduce the frequency, duration and intensity of migraine attacks.

• Riboflavin (vitamin B2).

Based on the latest scientific evidence, riboflavin protects the nervous system and may have a devastating effect on the structure and function of the brain due to migraines.

• Magnesium.

The mineral magnesium plays an important role in many metabolic processes and blood pressure regulation. Some scientists claim that magnesium supplements reduce the intensity and frequency of migraine attacks.

• Melatonin.

The mysterious hormone melatonin regulates sleep and wakefulness in mammals and also counteracts oxidative stress in plant organisms. European researchers consider melatonin one of the most promising preventive agents for migraine, effective and safe.

• Butterbur.

Extracts of the hybrid butterbur plant (Petasites hybridus) are used to prevent migraine attacks. Popular in Europe, less common in North America and Asian countries.

Non-drug therapy

Physiotherapeutic procedures are effective help for migraines. In combination with drug treatment, electrophoresis with medicinal substances (Diphenhydramine, calcium chloride, Seduxen, etc.) is often prescribed. Local anesthetics include Lidocaine or Novocaine, sedatives - sodium bromide, antispasmodics - Papaverine, etc.

You can do massage of the collar area, ultraviolet irradiation in an erythemal dosage, mud applications, ultra-high-frequency therapy, darsonvalization. Baths with the addition of carbon dioxide, radon, iodine, and hydrogen sulfide will also be useful.

To prevent migraine-like headaches, physiotherapeutic procedures are carried out in courses - 2-3 times a year.

To prevent disruption of the cerebral vascular system, which is a direct indication for the development of migraine, it is important to take care of proper nutrition. There are several diets that, if followed, reduce the risk of headaches:

• hypoallergenic: avoiding consumption of food containing vasoactive substances (tyramine, phenylethamine) and histamines (those found in sausages, sausages, smoked fish, marinades and pickles, chocolate products, citrus fruits, alcohol);
• vitamin: inclusion in the diet of as many foods as possible containing vitamin B, which has an immunomodulatory, vascular-stabilizing and antioxidant effect on the body (this is buckwheat and oatmeal, leafy green vegetables, peas, dairy products;
• a diet that normalizes the process of food absorption: consumption of fish, meat by-products, greens;
• a diet that includes the inclusion of foods that have a low percentage of fats;
• ketogenic, which involves the inclusion of foods high in fat and low in carbohydrates and proteins in the diet.

An important condition for increasing the effectiveness of any diet is its appointment by a qualified nutritionist. Self-medication rarely leads to recovery and, moreover, can cause additional harm to health.

Treatment of migraine (especially cervical) can be carried out with the help of physical education. Daily performance of certain exercises included in the exercise therapy complex will help reduce the number of attacks that occur or even prevent their occurrence in the future.

Yoga is no less effective in treating headaches. This technique allows you to eliminate pain, as well as the immediate cause of this condition - accumulated stress and nervous tension.

You can attend meditation sessions. Complete relaxation of the body (both mental and physical) gives excellent results in the fight against many pathological conditions, including headaches.

Clinical guidelines for adults and children

Features of treating children include responsible study of the instructions for use of the product. Often, drugs used by adults have not been tested on children, so the condition of a child who takes the medicine can lead to serious consequences for his health.

Aspirin, which relieves pain, is contraindicated in children under 14 years of age , since its composition may contribute to the development of Reye's syndrome in the child. Paracetamol and ibuprofen are recognized as safe drugs for children.

As a rule, specialists prescribe medications for children containing ergotamine and caffeine. It is not recommended to resort to exclusively drug therapy for the disease. A developing child's body is susceptible to the effects of drugs, so in combination with medication, doctors advise turning to acupuncture, physiotherapy and following a preventive regimen.

Particular attention should be paid to proper nutrition, sleep and moderate physical activity. Decreased glucose levels in the body lead to exacerbation of migraine attacks, as do factors that increase stress levels.

Factors that provoke hemicrania are identical in children and adults . The cessation of bad habits that accompanies treatment greatly facilitates the process of getting rid of this disease. External influences should be eliminated if the discomfort worsens by going to a quiet, dark and well-ventilated room.

Painkillers help eliminate pain; frequent use of them can lead to addiction. For qualified and effective treatment, it is recommended to consult a specialist who will select an individual method for the patient to get rid of the disease.

You can download the “Clinical protocol for the diagnosis and treatment of migraine in children of the Ministry of Health of the Republic of Kazakhstan” from 2014 here. You can download the recommendations of the European Headache Federation for the management of patients with the most common forms of headaches in general practice from 2010 here. Download the clinical recommendations on diagnosis and treatment and headache prevention in the practice of a family doctor from MD. D.V. Kandyba, professor of the State Budgetary Educational Institution of Higher Professional Education of North-Western State Medical University named after. I.I. Mechnikov of the Ministry of Health of Russia from 2020 here Modern approaches to the diagnosis and treatment of migraine from MD. V.V. Osipov Department of Neurology and Clinical Neurophysiology of the Moscow Medical Academy named after. I.M. Sechenov from 2010 can be downloaded from the link Download clinical recommendations for emergency medical care for acute headaches from 2014 from the Russian Society of Emergency Medical Care from the link

Folk remedies

First aid for migraines is folk remedies, from which infusions and decoctions are prepared, consumed orally, as well as compresses. The following components can be used:

• clover: 1 tbsp. pour 200 ml of hot water and leave to infuse for 1 hour, then strain and take 100 ml orally 2 times a day;
• lilac leaves or white cabbage (also leaves): a compress is made from these on the sore area, which is kept for several hours, secured on top with a piece of gauze;
• potatoes (juice): drink 75 ml of freshly squeezed juice if you have a headache;
• oregano: 1 tbsp. raw materials pour 300 ml of hot water, leave for an hour (or boil for 15 minutes), strain, take 150 ml orally twice a day;
• green tea: it is recommended to drink green tea throughout the day, replacing black varieties;
• viburnum and currant juice: drinking 200 ml of any juice once a day is enough to prevent headaches;
• Siberian elderberry: 1 tbsp. raw materials, pour 200 ml of hot water, leave for an hour, take a glass orally 3 times a day;
• lemon balm: 3 tbsp. raw materials pour 250 ml of water, boil for 10 minutes, cool, strain, take 2 tbsp orally. 4 times a day.

The list of folk remedies used in the fight against migraine could take a long time. Even though they are harmless, you should consult a specialist before use. Migraine is an insidious disease, the wrong treatment of which can cause additional harm to health.

How to avoid an attack?

To prevent migraine attacks you need to know the following.

Nursing interventions

All nursing interventions and treatments are carried out after receiving the necessary information from the doctor.

Main care tasks:

• provide the patient with physical and mental peace,
• carry out drug therapy to relieve a migraine attack (analgesics, non-steroidal anti-inflammatory drugs, ergot drugs, a group of triptans),
• eliminate visual and auditory stimuli (room darkening, rest),
• provide assistance during attacks of nausea or vomiting (remove dentures, turn your head to the side),
• do a light massage of the neck or back of the head (with a menthol pencil),
• apply mustard plasters to the feet or calf muscles, warm baths for the hands and feet (hot ones are possible),
• bandage the head tightly,
• apply hot or cold compresses,
• guarantee food according to the person's needs (stronger tea or coffee).

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During remission, physiotherapy, acupuncture, relaxation techniques, stress relief, and hypnosis are prescribed.