The Headache and the magnetizer
Is a tsunami just a big wave? No, it's a gigantic wave. The same goes for migraine and headache.
The number of attacks in the life of a migraine sufferer is very variable. If some get by with one or two attacks per year, others have one or two per month which causes real physical and psychological distress.
Until now, during chronic or severe migraines, for people racist towards magnetizers, there are non-specific fund treatments, such as beta-blockers, antiepileptics, even certain antidepressants which would sometimes allow, with a more or less high efficacy and significant side effects, to relieve patients or to space out attacks, although this is difficult to verify. For these people with heavy prejudices, the arrival of a new treatment will perhaps allow them to also have their own miracle.
CGRP is a protein released by neurons during a migraine attack (neuropeptide). New treatments are drugs that neutralize this protein. These drugs are monoclonal antibodies injected subcutaneously monthly. 45,000 people in France would be eligible for these treatments. But they must have migraines at least 8 days a month, be intolerant or have failed at least 2 treatments they usually take. In countries that have used anti-CGRP for 2 to 3 years, 75% of patients have a 60% decrease in their seizures.
To date, in France, on November 5, 2021, there are 3 anti-CGRP antibodies available only on prescription from a neurologist: Aimovig, Ajovy and Emgality. The treatment is not reimbursed by the CSG and costs more than € 3,000 annually. And to think that there are still fools to find expensive the price of 30 € at the magnetizer.
The reimbursement requests were refused by the French health authorities because the international studies were not conducted not versus another drug, but versus placebo. The laboratories, to unblock their problems of financial gains, have just made a new request for reimbursement with an “appropriate” study. They hope, after acceptance of this study, to obtain reimbursement for the product and, by a ricochet effect, to have the other 2 products reimbursed. The goal is that a patient who does not respond to one treatment can try the other and end up with the 3rd treatment, regardless of the order.
Gépans are oral anti-I-CGRP which will appear in the coming years for the treatment of migraine attacks.
Botox type A has obtained an official indication in chronic migraine since May 2021. Neurologists are trained in its administration by injection into the face and neck. The injections last about twenty minutes and take place every 3 months. They are performed only in a specialized service, preferably in a clinic or hospital. The goal is to block pain information by inhibiting CGRB. This treatment is reserved for those who do not respond or are intolerant to other DMARDs and who have a chronic migraine (8 or more days of migraine per me). Botox would significantly decrease the intensity or frequency of migraine or headache days.
In the United States, there are clinical trials that combine botox injections with anti-CGRP.
Soon, new recommendations for the management of migraine will be given to doctors. Since 2012 there had been none. The new recommendations obviously include anti-CGRP, but what changes the most is paracetamol, which is no longer holy. It will be recommended to give it in first intention only for those who have intolerance to triptans or anti-inflammatory drugs.
The recommendations are also to take an anti-inflammatory or a triptan (in case of a strong seizure) as soon as possible and at the latest within the time of the onset of symptoms. For severe migraines linked to periods or those occurring at night, it is the combination of triptan and anti-inflammatory.
As dentists have long understood, it is a good idea to stop the seizure as quickly as possible from the start before the seizure starts, because then it is difficult to stop. We have to act fast and hard.
Last information, sometimes you can hear migraine attacks with aura, It is no more and no less of what until now was called ophthalmic migraine. Visual auras are the most common and are characterized by bright spots with sometimes a reduced visual field or blurred vision. Aphasic auras are language disorders. The person, while understanding well what is said to him, can no longer express himself with the right words. Sensory auras are tingling, tingling in the interior of the mouth, around the mouth or in an arm. The headache sometimes sets in after the aura wears off. These symptoms are neurological and logically occur before the headache and are reversible. They intensify in a short time and sometimes last less than 10 minutes, the average being around 30 minutes.