What causes migraines? - Marianne Schwarz
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With knowledge of the migraine phases, we can start to explain why some therapies work by their actions on this pathway. Dopamine blocking drugs could potentially work in the prodromal phase, where its release is governed by the hypothalamus. Drugs designed to block CGRP and the CGRP receptors can be effective in treating and preventing migraines. Other medications reduce stop pain by blocking CGRP release. Regular onabotulinim toxin injections, used in the cosmetic industry for skin wrinkles, can also effectively prevent migraines by blocking CGRP release from nerve endings. Devices periodically applied to the head and neck, such as single pulse transcranial magnetic stimulation or non-invasive vagal nerve stimulation may treat migraines by blocking the changes in charge (cortical spreading depolarization) spreading over the cerebral cortex, for example. These as well as non-pharmacologic strategies such as avoidance of migraine triggers and exercise can help manage migraine attacks.
Every migraineur is unique and not all treatments are safe or suitable for everyone. Treatment options should always be reviewed with a qualified physician prior to starting them.
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