Una migraña es mucho más que un fuerte dolor de cabeza. Puede causar tal malestar que obliga a quien la padece a estar en cama durante días y alterar su ritmo de vida, su trabajo y relaciones personales. El estrés, el alcohol y otros desencadenantes pueden causar síntomas como fatiga, náuseas, cambios en la visión o irritabilidad, además del dolor.
¿Qué son las migrañas y cómo se manifiestan?
Una migraña es un dolor de cabeza intenso, punzante y pulsátil en un lado de la cabeza. Muchas personas presentan además síntomas como malestar, náuseas y aumento de la sensibilidad a la luz o al sonido. Las migrañas pueden ser muy invalidantes, interfiriendo en la rutina diaria y afectando a la capacidad para cumplir con las obligaciones personales y sociales. La patología afecta a aproximadamente 1 de cada 5 mujeres y aproximadamente 1 de cada 15 hombres. Por lo general, comienzan a principios de la edad adulta.
La frecuencia de una migraña varía de persona a persona. Es posible que el afectado tenga una migraña por año o una por semana. En promedio, la mayoría de las personas experimentan de dos a cuatro por mes. Son más comunes por la mañana. La mayoría de las migrañas son impredecibles, pero a veces se puede anticipar cuándo ocurrirá, como antes de la menstruación, tras una jornada estresante o si se ha bebido alcohol.
Existen distintos tipos de migraña, que inicialmente se pueden clasificar en dos:
- Migraña con aura: existen señales de advertencia específicas justo antes de que comience la migraña, como visión borrosa o ver luces parpadeantes.
- Migraña sin aura: el tipo más común, en estos casos la migraña ocurre sin signos de advertencia específicos.
Causas y factores desencadenantes de las migrañas
Se desconoce la causa exacta de las migrañas. Cuando se tiene dolor de cabeza, los nervios específicos de los vasos sanguíneos envían señales de dolor al cerebro. Esto libera sustancias inflamatorias en los nervios y vasos sanguíneos de la cabeza, pero no está claro por qué se producen estos cambios.
Genética y predisposición
Aunque las investigaciones no han determinado aún el origen de las migrañas, los estudios muestran que la genética influye. Hasta el 80% de las personas con migrañas tienen un familiar de primer grado que también padece la enfermedad, lo que sugiere que los genes pueden desempeñar un papel muy importante a la hora de padecer esta dolencia.
Estrés y cambios hormonales
Algunas personas encuentran que este tipo de cefalea está asociada a ciertos desencadenantes como el estrés y los cambios hormonales, de hecho en muchas mujeres los ataques de migraña coinciden con la menstruación y en otros afectados coinciden con períodos de estrés.
Alimentación y otros desencadenantes
La alimentación juega un papel importante en el desarrollo de migrañas debido a que el cuerpo humano puede tener sensibilidad a sustancias químicas o conservantes específicos de los alimentos. Esta sensibilidad hace que sea más probable que ocurra una migraña, especialmente si se combina con otros desencadenantes. Algunos de estos alimentos son:
- Queso añejo
- Bebidas con alcohol
- Chocolate
- Aditivos alimentarios como nitratos y glutamato monosódico
- Alimentos procesados o curados
- Alimentos fermentados o encurtidos
Además existen otros posibles desencadenantes de las migrañas:
- Ciertos medicamentos
- Cambios en el sueño (dormir poco o demasiado)
- Las condiciones climáticas (a algunas personas los días nublados les provocan migraña)
- La actividad física o un esfuerzo excesivo
- Sustancias como la cafeína o el tabaco
- Saltarse una comida
- Exposición a luces brillantes, ruidos u olores fuertes
Síntomas y diagnóstico de las migrañas
Si la migraña se presenta con aura, previo al dolor de cabeza se podrán experimentar debilidad muscular, cambios en la visión, zumbidos en los oídos o tinnitus, sensibilidad al tacto, entumecimiento y hormigueo o dificultad para hablar o concentrarse.
El dolor de cabeza en sí, típico de la migraña, se vuelve gradualmente más intenso. Lo habitual es que afecte a un solo lado de la cabeza pero puede darse en ambos. El dolor es palpitante, como un latido, y puede acompañarse de náuseas y vómitos y de sensibilidad a la luz, al sonido y al olor.
Herramientas de diagnóstico y evaluación
Si sufres migrañas es conveniente que acudas a tu médico de atención primaria quien puede iniciar el tratamiento o derivarte a un neurólogo. Posiblemente realicen un examen físico y un examen neurológico, un análisis de sangre y pruebas de imagen (como una tomografía computarizada o una resonancia magnética ) para asegurarse de que no haya otras causas para el dolor de cabeza. Un electroencefalograma (EEG) puede ayudar a descartar otras afecciones.
Tratamientos médicos para las migrañas
No existe una cura para la migraña, pero el especialista puede ayudar a controlar los síntomas a través de medicamentos:
- Medicamentos para detener la cefalea: lo ideal es tomarlos ante el primer signo de migraña. Detienen o reducen los síntomas de la migraña como dolor, náuseas o sensibilidad.
- Medicamentos para prevenir las migrañas: se suelen recetar medicamentos preventivos si se experimentan síntomas graves que interfieren en la rutina diaria o se tienen migrañas frecuentes. Estos medicamentos reducen la frecuencia y la gravedad de las migrañas.
- Los medicamentos de venta libre son eficaces si se tienen síntomas de migraña leves o moderados. Entre ellos podemos encontrar analgésicos como el ibuprofeno, la aspirina, el paracetamol, el naproxeno y la cafeína. Pero ¡ojo! hay que tener cuidado, su uso excesivo puede provocar dolores de cabeza medicamentosos o un problema de dependencia.
Terapias alternativas y complementarias
Existen terapias alternativas que pueden ayudar a controlar las migrañas:
- Complementos a base de vitaminas, minerales o hierbas como riboflavina (vitamina B2), magnesio, matricaria, petasita o coenzima Q10 .
- Técnicas de relajación como el yoga
- Acupuntura
- Biorretroalimentación
- Inyecciones de toxina botulínica tipo A (Botox).
Consejos para aliviar las migrañas
Lo ideal es identificar qué desencadena las migrañas. Para ello es útil un diario de migrañas para poder realizar un seguimiento de cuándo ocurrió una migraña, cómo te sentiste y cuánto duró. También puedes agregar detalles sobre los alimentos que comiste o las actividades que se realizaron, para obtener más información sobre los posibles desencadenantes.
Una vez que identificado un desencadenante puedes tomar medidas para evitarlo, aunque no siempre es posible. Por ejemplo, si detectas que el estrés es un desencadenante, puedes realizar técnicas de relajación o si presentas síntomas cuando te saltas una comida, configura una alarma para recordarte que debes comer en un horario regular.
Hay ciertas cosas que pueden ayudar a sentirse mejor cuando ocurre un ataque de migraña:
- Descansar en una habitación oscura, tranquila y fresca.
- Aplicar una compresa o toallita fría o tibia en la frente o detrás del cuello.
- Masajear el cuero cabelludo.
- Aplicar presión en las sienes con un movimiento circular.
- Mantenerse en un estado de calma (meditación).
Prevención y manejo del dolor de cabeza por migrañas
Si sospechas que un desencadenante específico está causando migrañas, como el estrés o cierto tipo de comida, evitar este desencadenante puede ayudar a reducir e riesgo.
También puede ayudar el mantener un estilo de vida saludable que incluya ejercicio, sueño y comidas regulares, además de garantizar una buena hidratación y limitar la ingesta de cafeína y alcohol.
Si las migrañas son graves o se han intentado evitar posibles desencadenantes y aún se experimentan síntomas, lo mejor es acudir al médico para que te recete un tratamiento. Ten en cuenta que pueden pasar varias semanas antes de que los síntomas de la migraña comiencen a mejorar.
878 comentarios
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