Materiały źródłowe

• #1 Visual Migraines – Optometrists.org

  https://www.optometrists.org/general-practice-optometry/guide-to-eye-conditions/guide-to-blurry-vision-and-headaches/visual-migraines/

  Retinal migraines are rare, affecting 1 in 200 migraine sufferers. […] Retinal migraines should be suspected if repeated temporary blindness or vision loss occur in one eye. This occurs due to sudden changes in tiny blood vessels in the back of the eye, known as the retina which transfers visual signals to the brain. […] Retinal migraines can be an indication of a serious hidden health problem, retinal disease or other eye disease. These are considered a medical emergency. […] Retinal migraines may be caused by a more serious condition, such as retinal disease and should be treated immediately. […] Seek emergency medical care there is any type of sudden vision loss. […] An eye doctor may recommend the latest medicines for treating migraines, including medicines designed to prevent future attacks.

• #1 Ocular Migraine: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24961-ocular-migraine

  If ocular migraines happen infrequently, such as once a month, healthcare providers generally dont recommend treatment. […] If you have frequent ocular migraines, the goal of treatment is to reduce the frequency of attacks. Treatment includes: Avoiding possible triggers: Its helpful to know what situations trigger your ocular migraines. Keeping a journal of when and how your migraines happen can help with this. Lifestyle changes, such as avoiding dietary triggers, managing stressors like high blood pressure and quitting smoking, may help reduce the number of attacks you have. […] Medication: If lifestyle changes dont help, medication that can help prevent ocular migraines (prophylaxis therapy) is the next step. Calcium channel blockers such as nifedipine and verapamil are the go-to medications. Aspirin and antiepileptic drugs may also help.

• #1 Migraine Headache Prophylaxis | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0101/p17.html

  Preventive therapy should be considered in patients having four or more headaches a month or at least eight headache days a month, significantly debilitating attacks despite appropriate acute management, difficulty tolerating or having a contraindication to acute therapy, medication overuse headache, patient preference, or the presence of certain migraine subtypes (i.e., hemiplegic migraine; migraine with brainstem aura; migrainous infarction; or frequent, persistent, or uncomfortable aura symptoms). […] Divalproex (Depakote), topiramate (Topamax), metoprolol, propranolol, and timolol are effective for migraine prevention and should be offered as first-line treatment. […] Behavioral treatments, such as relaxation training, thermal biofeedback combined with relaxation training, electromyographic biofeedback, and cognitive behavior therapy, are effective options for migraine prevention.

• #1 Migraine Prophylaxis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507873/

  Prophylactic therapy may decrease the frequency, severity, and duration of migraine attacks, increase responsiveness to acute migraine therapy and improve quality of life. […] Once the need for prophylaxis is established, the following consensus-based principles of care should be adhered to improve the success of prophylactic treatment: Start medications with the highest evidence-based effectiveness. Avoid agents that may exacerbate comorbid conditions. Begin with the lowest effective dose and increase every two to four weeks to achieve the therapeutic effect and stop if the patient develops adverse effects. Successful treatment is described as a 50% reduction in the episodes of headaches or days, a significant shortening of episode duration, or an increase in response to acute therapy. If headaches are under control for at least 6 to 12 months, therapy should be slowly tapered and discontinued.

• #1 Migraine Headache Prophylaxis | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0101/p17.html

  Migraines impose significant health and financial burdens. Approximately 38% of patients with episodic migraines would benefit from preventive therapy, but less than 13% take prophylactic medications. Preventive medication therapy reduces migraine frequency, severity, and headache-related distress. Preventive therapy may also improve quality of life and prevent the progression to chronic migraines. Some indications for preventive therapy include four or more headaches a month, eight or more headache days a month, debilitating headaches, and medication-overuse headaches. […] First-line medications established as effective based on clinical evidence include divalproex, topiramate, metoprolol, propranolol, and timolol. […] Preventive therapy for episodic migraines may decrease headache frequency, severity, and prevent progression to chronic migraines.

• #1 Ocular Migraines: Causes, Symptoms, Diagnosis, Treatment

  https://www.webmd.com/migraines-headaches/ocular-migraine-basics

  Ocular Migraine Prevention […] The first step to preventing migraines is to avoid your triggers. To do that, you must know what your triggers are. To help determine what your triggers are, try keeping a journal with: […] What you were doing before you got an ocular migraine […] What you ate or drank before your migraine […] How you felt before your migraine […] If you have migraines regularly, ask your doctor about preventive medicines such as calcium channel blockers. Nifedipine or verapamil seem to work the best for people with ocular migraine. […] […] It’s rare, but people who have these types of migraine may have a higher risk of permanent vision loss in one eye. Experts don’t know whether medications that prevent migraines — such as tricyclic antidepressants or anti-seizure medications — can help prevent that vision loss. But if you have ocular migraine, even if it goes away on its own, it’s a good idea to talk to your doctor about your symptoms.

• #1 Migraine Headache Prophylaxis | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0101/p17.html

  Erenumab (Aimovig) was approved by the U.S. Food and Drug Administration in May 2018 for migraine prevention. […] Petasites, an extract of the butterbur plant, is effective for the prophylactic treatment of migraines in dosages of 50 to 75 mg twice a day. […] A U.S. Headache Consortium meta-analysis concluded that relaxation training, thermal biofeedback combined with relaxation training, electromyographic biofeedback, and cognitive behavior therapy may be considered as treatment options for the prevention of migraine.

• #1 Migraine – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/migraine/

  Prophylactic treatment (e.g., beta blockers) may be indicated if migraines are especially frequent or long-lasting, or if abortive therapy fails or is contraindicated. […] General prophylaxis includes first-line options such as anticonvulsants (e.g., topiramate, divalproex) and beta blockers (e.g., propranolol, metoprolol, timolol). […] For chronic migraine, botulinum toxin (e.g., OnabotulinumtoxinA) and monoclonal antibodies (e.g., erenumab, galcanezumab, fremanezumab) are recommended. […] Prophylactic therapy for migraine includes lifestyle modifications such as exercise in moderation, maintaining a healthy diet, identifying and avoiding potential triggers, and following a regular sleeping schedule. […] There is some evidence that nonpharmacological interventions like acupuncture, noninvasive neuromodulation, behavioral therapy, relaxation techniques, and biofeedback have benefits for patients with migraine.

• #1 The comparative effectiveness of migraine preventive drugs: a systematic review and network meta-analysis | The Journal of Headache and Pain | Full Text

  https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-023-01594-1

  CGRP(r)mAbs have the best safety and efficacy profile of all drugs for migraine prophylaxis, followed closely by gepants. […] We show that CGRP(r)mAbs have the highest efficacy and the lowest incidence of adverse events compared to placebo, closely followed by gepants. […] Our results suggest that CGRP(r)mAbs and gepants are the most effective and better tolerated drugs for migraine prophylaxis. However, different international guidelines and national reimbursement policies only support these drugs for patients who have not responded to other prophylactic drugs. […] CGRP(r)mAbs are the most effective and tolerated treatment for migraine prophylaxis, followed closely by gepants. Commonly used older classes of drugs appear to not only be less effective than CGRP(r)mAbs and gepants, but they are also associated with substantially higher risk of adverse events.

• #1 Migraine with Aura: Symptoms, Visual Disturbances, and Management

  https://headacheaustralia.org.au/migraine-aura/

  Migraine with retinal aura causes fully reversible visual disturbances in one eye, such as shimmering or flickering of vision, blind spots, or blindness. In migraine with retinal aura, the visual symptoms typically only occur in one eye. […] Preventive treatments are used when migraine attacks begin to significantly disrupt your day-to-day life. Typically, this will be when you have four or more migraine days per month. […] Some research has also suggested that low-dose daily aspirin can help prevent migraine with aura. […] Several clinicians at the Migraine World Summit have suggested aspirin may be a useful preventive for those who experience migraine with aura. […] An observational case series of 49 patients with migraine were given aspirin 80 mg daily. Aura frequency was reduced in 39 of the 42 cases (92%) and full cessation of auras in 20 (48%). […] Daily low-dose aspirin is readily available and well-tolerated. With further evidence it could play a significant role in migraine management and may be worth discussing as an option with your healthcare professional.

• #1 Medications for Migraine Prophylaxis | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0101/p72.html

  Evidence supports the use of naproxen sodium (Anaprox) and naproxen (Naprosyn) for migraine prevention. […] The angiotensin-converting enzyme inhibitor lisinopril (Zestril) has demonstrated some effectiveness in the prevention of migraine. […] The angiotensin receptor blocker candesartan (Atacand) was evaluated in a prospective, randomized, double-blind, crossover study with 60 patients. […] Evidence does not support the use of diltiazem (Cardizem) in migraine prevention, and the evidence for several other calcium channel blockers, such as nifedipine (Procardia), is poor and suggests only modest effect. […] A Cochrane review identified only one effective medication for migraine prophylaxis in children: propranolol. […] Preventive therapy for chronic migraine in women who are pregnant should be approached cautiously and initiated only with the consent of the patient after informed evaluation of the risks.

• #1 What Is an Ocular Migraine?

  https://www.verywellhealth.com/ocular-migraine-overview-and-more-5205087

  A retinal migraine affects only one eye and can occur before or during a headache. The symptoms, which can be more serious than those for a migraine with aura, may include temporary blindness or decreased vision. […] If you have retinal migraines, avoid using triptans or ergots, as they can increase the risk of complications. Also, people with retinal migraine should stop hormonal birth control and stop smoking.

• #1 Ocular Migraine: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24961-ocular-migraine

  It may not always be possible to prevent ocular migraines. But avoiding potential triggers of them can help. Try to record what you were doing before you got an ocular migraine, such as activities, what you ate or drank, how you felt, etc. It may take time to figure out what triggers your migraines.

• #1 Retinal migraine: Causes, symptoms, and treatment

  https://www.medicalnewstoday.com/articles/314917

  Prevention of retinal migraine is similar to prevention of regular migraine. It can include a combination of medication and lifestyle changes. […] Some preventive measures a person can take include: taking all preventive medication as prescribed, avoiding known triggers, including foods, stress, and environmental factors, keeping a headache journal to help track and identify additional triggers. […] Preventive medications may include: beta-blockers to relax blood vessels in the brain, anticonvulsants to help prevent a migraine, tricyclic antidepressants to help prevent migraine. […] People could also make lifestyle changes, such as: avoiding alcohol, avoiding caffeine, managing high blood pressure, quitting smoking, discontinuing any oral contraceptives.

• #1 Migraine: Causes, Symptoms, and Treatment

  https://patient.info/brain-nerves/migraine-leaflet

  Migraine attacks in women may be triggered by periods. Treatment of each migraine attack is no different than usual. However, there are treatments that may prevent period-related migraine attacks from occurring. […] There are also various treatments you can take to prevent migraine attacks, if you have frequent or severe attacks. It may not stop all attacks, but their number and severity are often reduced. Medicines for preventing migraines are taken every day. They are not painkillers and are different to those used to treat each migraine attack. […] General things that can help to prevent migraines include: Sticking to a daily routine for eating and sleeping. Try to have regular meal times and avoid skipping meals if you can. Changes in sleeping patterns can also trigger migraine – try to get into a consistent sleep routine where you go to sleep and wake up at the same times every day. Staying hydrated. Dehydration can trigger migraines. Try sipping on water throughout the day. Aim to drink about 1.5 to 2 litres of water a day. Minimising, or avoiding, alcohol. Any type of alcohol can trigger migraines, although some drinks can be more of a trigger than others – red wine is a common culprit. Controlling caffeine intake. The links between caffeine and migraines are complicated. Caffeine is actually one of the treatments for a migraine attack. Some people, though, find that caffeine can trigger migraines for them. There is also some evidence that people who consume high amounts of caffeine regularly are more likely to get migraines. Caffeine withdrawal can also trigger migraines. So, whilst you don’t need to cut out caffeine completely, it’s a good idea to limit your consumption. Managing stress. Stress can be a major trigger for migraines. Try to minimise stress – where possible – and consider relaxation techniques or meditation to cope with stressful situations. Exercising regularly. Getting regular exercise can reduce the frequency of migraines, as well as making them less severe if they do happen. Strenuous exercise, particularly if you’re not used to it, can be a migraine trigger – so aiming for regular, short sessions of moderate intensity exercise is best, at least to start with. Controlling computer use. Many people find that computer screens can trigger migraines. Take regular breaks when using screens. Consider fitting an anti-glare screen to your monitor. Ensure your screen is neither too bright nor too dim – it should ideally be of a similar brightness to the area around the screen. It’s also possible to take regular preventative medicines to reduce the number of migraines you get.

• #1 Migraine Headache Prophylaxis | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0101/p17.html

  The complementary treatments petasites, feverfew, magnesium, and riboflavin are probably effective. Nonpharmacologic therapies such as relaxation training, thermal biofeedback combined with relaxation training, electromyographic feedback, and cognitive behavior therapy also have good evidence to support their use in migraine prevention. […] Several medications have been studied for the prevention of episodic migraines. Based on guidelines from the American Headache Society and the American Academy of Neurology, agents with the most quality evidence to support their use should generally be considered first for migraine prevention. […] Propranolol is effective for migraine prevention. […] Divalproex (Depakote) is effective for migraine prevention. […] Topiramate (Topamax) is an antiepileptic supported by substantial data for migraine prevention.

• #1 Managing Migraine Headache

  https://www.reviewofoptometry.com/article/managing-migraine-headache

  The goals of preventive therapy are to reduce attack frequency, severity or duration, improve responsiveness to acute attacks and reduce general disability. Many medications are used to treat migraine prophylactically, including antiepileptic drugs, beta and calcium channel blockers, several subtypes of antidepressants and some antihypertensives, as well as supplements, herbs and vitamins. […] Many prophylactic meds for migraine work by inhibiting cortical spreading depression (CSD), which is considered the basis of migraine aura. Others have antiadrenergic or serotonin modulatory effects, or enhance the effect of the neurotransmitter gamma-aminobutyric acid, leading to a decrease in neuronal firing. […] Studies have demonstrated the effectiveness of the herb butterbur (Petasites hybridus) in preventing migraines. Patients on butterbur require monitoring of liver enzymes. Other natural supplements such as riboflavin (vitamin B2), coenzyme Q10, melatonin and magnesium appear to be effective and well tolerated for migraine prophylaxis as well.

• #1 Migraines in Children and Teens – Hello Pediatrics

  https://hellopediatrics.com/migraines-in-children-and-teens/

  Prevention and avoiding common triggers. If your child has a history of migraine headaches, it is important to emphasize a good sleep routine, nutrition, and hydration. Keeping regular routines including a regular sleep and eating schedule is important. Avoid skipping meals and high sugar drinks such as soda and juices. Always encourage lots of water for hydration. Certain foods are more likely to trigger migraines, including chocolate, caffeine, artificial sweeteners, aged meats and cheeses, MSG, and some red and yellow food dyes. Stress, weather changes, menstrual cycles, and bright sunlight can also trigger migraine symptoms. […] There are also several types of preventative medications that are sometimes prescribed for children and teens who have frequent or particularly severe migraines.

• #1 Migraine with aura – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/migraine-with-aura/diagnosis-treatment/drc-20352077

  Medications can help prevent frequent migraines, with or without aura. Your doctor might recommend preventive medications if you have frequent, long-lasting or severe headaches that don’t respond well to treatment. […] Preventive medication is aimed at reducing how often you get a migraine headache with or without aura, how severe the attacks are, and how long they last. Options include: […] Blood pressure-lowering medications. These include beta blockers such as propranolol (Inderal, InnoPran XL, others) and metoprolol tartrate (Lopressor). Calcium channel blockers such as verapamil (Verelan) can be helpful in preventing migraines with aura. […] Ask your doctor if these medications are right for you. Some of these medications are not safe to take during pregnancy. If you’re pregnant or trying to get pregnant, don’t use any of these medications without first talking with your doctor.

• #1 What is an Ocular Migraine? | Headache TMJ – Los Angeles Pain Clinic

  https://www.headachetmj.com/blog/migraine/what-is-an-ocular-migraine/

  Preventive Measures: […] – Lifestyle Modifications: Implement changes based on identified triggers […] – Medical Intervention: Consider preventive medications like calcium channel blockers (nifedipine or verapamil) when recommended […] – Regular Health Monitoring: Maintain consistent communication with healthcare providers […] – Stress Management: Develop effective coping strategies for emotional triggers […] While complete prevention may not always be achievable, this structured approach to trigger identification and management can significantly reduce the frequency and severity of ocular migraine episodes.

• #1 Managing Migraine Headache

  https://www.reviewofoptometry.com/article/managing-migraine-headache

  Retinal migraine, a form of migraine with aura, is a rare cause of transient monocular visual loss. It is characterized by repeated attacks of unilateral visual disturbances, including scintillations, scotomata or blindness, all associated with the headache. Researchers have noted cases of permanent monocular visual loss associated with retinal migraine. Appropriate investigations are required to exclude other causes of transient monocular blindness. […] Preventative medication. Some form of medication or other treatment is almost always necessary for those with chronic migraine. Roughly 3% to 13% of migraine sufferers are using preventive therapy, although research suggests the need is much greater, with estimates that 38% of patients with migraine would benefit from a preventive agent.

• #1 When To Worry About Retinal Migraine: Duration, Symptoms

  https://www.medicinenet.com/when_should_i_be_worried_about_a_retinal_migraine/article.htm

  Retinal migraine is usually not a medical emergency. In most people, the condition is harmless, and vision returns to normal after some time. […] If you experience a partial or complete loss of vision in one eye for the first time, it is important to seek urgent medical help. […] The is no fixed treatment protocol for retinal migraine. For attacks that do not come often, your doctor may treat your retinal migraine as they treat other types of migraine. […] Depending on your habits, lifestyle, and any underlying medical conditions, your doctor may also ask you to do the following: Manage your stress, Quit smoking, Take steps to keep blood pressure under check, Discontinue hormonal contraceptive pills, Avoid traveling to places located at high altitude, Drink plenty of water to avoid dehydration, Have frequent, small meals to avoid hypoglycemia, Avoid exposure to excessive heat.

• #1 Types of Migraine | Nuvance Health

  https://www.nuvancehealth.org/health-tips-and-news/what-are-the-types-of-migraine

  A retinal migraine, also called an ocular migraine, causes visual disturbances in only one eye before the headache phase of migraine. This type of migraine is different from one with aura because the visual disturbances are coming from the eye. Visual disturbances from a migraine with aura come from the brain. Visual problems from a retinal migraine may include: […] Someone with chronic migraines may benefit from preventive treatment in addition to avoiding triggers and rescue medication. […] A headache specialist can help you: […] Develop a prevention and treatment plan that may include medications or other therapies such as injections, dietary supplements called nutraceuticals, and wearable devices called electroceuticals. […] Knowing the type of migraine you have can help you manage and treat it as best as possible. A headache specialist can help determine the type of migraine and develop a prevention and treatment plan that is right for you.

• #2 Migraine Variants: Overview, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1142731-overview

  Retinal migraine (also called ophthalmic or ocular migraine) is a fairly common cause of transient monocular blindness in young adults. This disorder is manifested by recurrent attacks of unilateral visual disturbance or blindness lasting from minutes to 1 hour, associated with minimal or no headache. This phenomenon is frightening to patients, who usually seek medical help to exclude amaurosis fugax due to ischemia of the retinal arteries. […] Retinal migraine is thought to result from transient vasospasm of the choroidal or retinal arteries. A history of recurrent attacks of transient monocular visual disturbance or blindness, with or without a headache and without other neurologic symptoms, is suggestive of retinal migraine. A personal or family history of migraine confirms the diagnosis. […] Pharmacologic prophylaxis has only anecdotal support; when it is considered, calcium channel blockers are preferred.

• #2 Retinal migraine

  https://www.nhs.uk/conditions/retinal-migraine/

  Treatment for retinal migraines is not usually needed if you do not have them very often. […] If you have them frequently, a GP may suggest: […] trying to avoid things that cause your migraines, such as cutting down on caffeine or alcohol […] medicines to help prevent migraines, such as topiramate or amitriptyline […] There are things you can do if you get retinal migraines. A GP may suggest trying them before recommending other treatments. […] avoid things you know can trigger migraines like caffeine and alcohol.

• #2 Migraine Prophylaxis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507873/

  Recurrent migraines can be functionally disabling and can impair quality of life. After treating acute migraines, all migraine patients should be evaluated for preventive therapy. Preventive therapy aims to decrease the frequency, severity, and duration of migraine attacks. Furthermore, preventative therapy can increase responsiveness to acute migraine therapy and improve the quality of life. Prophylactic treatment is not curative, and most patients will still need abortive medications for acute migraine. Before starting prophylactic medications, it is imperative to evaluate if patients are using proper and adequate abortive therapies. Overuse of abortive medications can cause rebound headaches. […] Prophylactic migraine treatment should be considered in patients with more than three monthly episodes or at least eight headache days in one month. Patients with severe debilitating headaches despite appropriate acute treatment or those who are intolerant or have contraindications to acute therapy. Prophylaxis should also be considered in patients with medication overuse headaches, certain migraine subtypes like hemiplegic migraine, basilar migraine, migraine with prolonged aura, or if the patient prefers.

• #2 Managing Migraine Headache

  https://www.reviewofoptometry.com/article/managing-migraine-headache

  The goals of preventive therapy are to reduce attack frequency, severity or duration, improve responsiveness to acute attacks and reduce general disability. Many medications are used to treat migraine prophylactically, including antiepileptic drugs, beta and calcium channel blockers, several subtypes of antidepressants and some antihypertensives, as well as supplements, herbs and vitamins. […] Many prophylactic meds for migraine work by inhibiting cortical spreading depression (CSD), which is considered the basis of migraine aura. Others have antiadrenergic or serotonin modulatory effects, or enhance the effect of the neurotransmitter gamma-aminobutyric acid, leading to a decrease in neuronal firing. […] Studies have demonstrated the effectiveness of the herb butterbur (Petasites hybridus) in preventing migraines. Patients on butterbur require monitoring of liver enzymes. Other natural supplements such as riboflavin (vitamin B2), coenzyme Q10, melatonin and magnesium appear to be effective and well tolerated for migraine prophylaxis as well.

• #2 Medications for Migraine Prophylaxis | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0101/p72.html

  Sufficient evidence and consensus exist to recommend propranolol, timolol, amitriptyline, divalproex, sodium valproate, and topiramate as first-line agents for migraine prevention. […] Following appropriate management of acute migraine, patients should be evaluated for initiation of preventive therapy. Factors that should prompt consideration of preventive therapy include the occurrence of two or more migraines per month with disability lasting three or more days per month; failure of, contraindication for, or adverse events from acute treatments; use of abortive medication more than twice per week; and uncommon migraine conditions (e.g., hemiplegic migraine, migraine with prolonged aura, migrainous infarction). […] The goal of preventive therapy is to improve patients quality of life by reducing migraine frequency, severity, and duration, and by increasing the responsiveness of acute migraines to treatment.

• #2 The state of migraine: An update on current and emerging treatments

  https://www1.racgp.org.au/ajgp/2021/december/the-state-of-migrain

  Key to limiting the disability of migraine and progression to chronic migraine is addressing modifiable risk factors, including implementing effective preventive treatment and avoiding overuse of acute treatment. […] Counselling and management of lifestyle risk factors for migraine are key components of effective migraine prevention, focusing on sleep, stress, exercise, diet, mental health and obesity. Identifying and minimising potential triggers to migraine are also important. […] Pharmacological treatment is indicated if individual attacks are refractory to acute treatment or there are more than four migraines/month. […] Preventive medication is indicated for patients with more than four attacks per month or if individual attacks are hard to treat, both to limit the morbidity of the disease and reduce the risk of medication overuse. […] The aim of preventive therapy is at least a 50% reduction in headaches after eight weeks.

• #2 Migraine Headache Prophylaxis | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0101/p17.html

  Preventive therapy should be considered in patients having four or more headaches a month or at least eight headache days a month, significantly debilitating attacks despite appropriate acute management, difficulty tolerating or having a contraindication to acute therapy, medication overuse headache, patient preference, or the presence of certain migraine subtypes (i.e., hemiplegic migraine; migraine with brainstem aura; migrainous infarction; or frequent, persistent, or uncomfortable aura symptoms). […] Divalproex (Depakote), topiramate (Topamax), metoprolol, propranolol, and timolol are effective for migraine prevention and should be offered as first-line treatment. […] Behavioral treatments, such as relaxation training, thermal biofeedback combined with relaxation training, electromyographic biofeedback, and cognitive behavior therapy, are effective options for migraine prevention.

• #2 Retinal migraine: Causes, symptoms, and treatment

  https://www.medicalnewstoday.com/articles/314917

  Prevention of retinal migraine is similar to prevention of regular migraine. It can include a combination of medication and lifestyle changes. […] Some preventive measures a person can take include: taking all preventive medication as prescribed, avoiding known triggers, including foods, stress, and environmental factors, keeping a headache journal to help track and identify additional triggers. […] Preventive medications may include: beta-blockers to relax blood vessels in the brain, anticonvulsants to help prevent a migraine, tricyclic antidepressants to help prevent migraine. […] People could also make lifestyle changes, such as: avoiding alcohol, avoiding caffeine, managing high blood pressure, quitting smoking, discontinuing any oral contraceptives.

• #2

  https://www.prevention.com/health/a20455575/types-of-migraines/

  Ocular migraine (aka retinal migraine) […] How to treat it: Though this type of migraine can be extremely frightening, they’re typically harmless and resolve on their own without medication within 20 to 30 minutes, says Heiting. If you deal with these often, avoid potential migraine triggers, such as too little or too much sleep, stress, skipping or delaying meals, odors, certain foods and alcohol, says Dr. Grosberg. […] How to treat it: A couple days before you anticipate a headache, take neproxin (a preventive migraine medication) and continue taking it five days through your cycle, says Dr. Rosen. If you don’t see results, try nonprescription nonsteroidal anti-inflammatory drugs, or speak to your doctor about targeted anti-migraine meds if your symptoms don’t respond to adequate doses of NSAIDs. […] In May 2018, the U.S. Food and Drug Administration approved a new class of drugs to prevent chronic migraine. It reduces the number of migraines in people who get them often, but it’s unlikely the drug would eradicate them altogether, so it may be used in combination with other therapies.

• #2 The comparative effectiveness of migraine preventive drugs: a systematic review and network meta-analysis | The Journal of Headache and Pain | Full Text

  https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-023-01594-1

  CGRP(r)mAbs have the best safety and efficacy profile of all drugs for migraine prophylaxis, followed closely by gepants. […] We show that CGRP(r)mAbs have the highest efficacy and the lowest incidence of adverse events compared to placebo, closely followed by gepants. […] Our results suggest that CGRP(r)mAbs and gepants are the most effective and better tolerated drugs for migraine prophylaxis. However, different international guidelines and national reimbursement policies only support these drugs for patients who have not responded to other prophylactic drugs. […] CGRP(r)mAbs are the most effective and tolerated treatment for migraine prophylaxis, followed closely by gepants. Commonly used older classes of drugs appear to not only be less effective than CGRP(r)mAbs and gepants, but they are also associated with substantially higher risk of adverse events.

• #2

  https://111.wales.nhs.uk/retinalmigraine/

  Retinal migraine is caused by the blood vessels to the eye suddenly narrowing (constricting), reducing the bloodflow to the eye. […] Treatment for retinal migraine usually just involves taking pain relief for any headaches and reducing exposure to anything that might be triggering the retinal migraine. […] Your doctor may sometimes prescribe medication, such as: aspirin to reduce pain and inflammation, a beta-blocker which may help relax blood vessels, a calcium channel blocker which may help prevent blood vessels constricting, a tricyclic antidepressant which may help prevent migraine, anti-epileptics which may help prevent migraine. […] However, there’s still a lack of research about the best way to treat or prevent a retinal migraine.

• #2 Ocular Migraines: Causes, Symptoms, Diagnosis, Treatment

  https://www.webmd.com/migraines-headaches/ocular-migraine-basics

  Ocular Migraine Prevention […] The first step to preventing migraines is to avoid your triggers. To do that, you must know what your triggers are. To help determine what your triggers are, try keeping a journal with: […] What you were doing before you got an ocular migraine […] What you ate or drank before your migraine […] How you felt before your migraine […] If you have migraines regularly, ask your doctor about preventive medicines such as calcium channel blockers. Nifedipine or verapamil seem to work the best for people with ocular migraine. […] […] It’s rare, but people who have these types of migraine may have a higher risk of permanent vision loss in one eye. Experts don’t know whether medications that prevent migraines — such as tricyclic antidepressants or anti-seizure medications — can help prevent that vision loss. But if you have ocular migraine, even if it goes away on its own, it’s a good idea to talk to your doctor about your symptoms.

• #2 Retinal Migraine: Symptoms, Diagnosis, Treatments

  https://www.webmd.com/migraines-headaches/retinal-migraine

  If you have retinal migraines, you may want to try to stay away from certain triggers, such as: […] Emotional stress […] High blood pressure […] Contraceptive pills […] Smoking […] Dehydration […] Being at higher altitudes […] Low blood sugar […] Hyperthermia.

• #2 Migraine Headache Prophylaxis | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0101/p17.html

  Erenumab (Aimovig) was approved by the U.S. Food and Drug Administration in May 2018 for migraine prevention. […] Petasites, an extract of the butterbur plant, is effective for the prophylactic treatment of migraines in dosages of 50 to 75 mg twice a day. […] A U.S. Headache Consortium meta-analysis concluded that relaxation training, thermal biofeedback combined with relaxation training, electromyographic biofeedback, and cognitive behavior therapy may be considered as treatment options for the prevention of migraine.

• #2 Migraine | healthdirect

  https://www.healthdirect.gov.au/migraine

  If you get migraines often, maintaining a healthy lifestyle and taking a preventive medicine can make them less frequent and severe. […] There’s no known way to prevent yourself from developing migraine, but you can help prevent a migraine attack. […] There are some lifestyle measures and complementary therapies that may help prevent migraine attacks. These include: avoiding any triggers, getting enough sleep, eating a healthy diet and maintaining a healthy weight, getting regular exercise, acupuncture, relieving stress through relaxation techniques, such as yoga and meditation, or psychological therapies such as cognitive behavioural therapy, taking magnesium, riboflavin or coenzyme Q10 supplements. […] If you get more than 4 migraine episodes a month, your doctor might suggest you try a preventive medicine.

• #2 Migraine – Neurologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/neurologic-disorders/headache/migraine

  Monoclonal antibodies and gepants that are used to prevent migraines block the activation of calcitonin gene-related peptide (CGRP), which can precipitate migraines. […] Neuromodulatory treatments can also help. Transcutaneous supraorbital nerve stimulation, using a device applied to the forehead, can reduce the frequency of migraines. Transcranial magnetic stimulation, using a device applied to the back of the skull, is indicated for the acute and prophylactic treatment of migraine headache in adolescents and adults.

• #2 Visual Migraines – Optometrists.org

  https://www.optometrists.org/general-practice-optometry/guide-to-eye-conditions/guide-to-blurry-vision-and-headaches/visual-migraines/

  Retinal migraines are rare, affecting 1 in 200 migraine sufferers. […] Retinal migraines should be suspected if repeated temporary blindness or vision loss occur in one eye. This occurs due to sudden changes in tiny blood vessels in the back of the eye, known as the retina which transfers visual signals to the brain. […] Retinal migraines can be an indication of a serious hidden health problem, retinal disease or other eye disease. These are considered a medical emergency. […] Retinal migraines may be caused by a more serious condition, such as retinal disease and should be treated immediately. […] Seek emergency medical care there is any type of sudden vision loss. […] An eye doctor may recommend the latest medicines for treating migraines, including medicines designed to prevent future attacks.

• #2 Ocular migraine treatment and prevention

  https://www.mymed.com/diseases-conditions/ocular-migraine-retinal-or-ophthalmic-migraine/ocular-migraine-treatment-and-prevention

  Preventative medications used over a period of time will be well-monitored by a treating doctor. He or she will have discussed usage benefits over potential risks and side-effects before prescribing an option which can help to achieve the desired result. […] If during diagnosis, a doctor is able to identify a trigger (or multiple triggers) for ocular migraine, he or she will advise that the affected person actively avoids all that are within their own control in order to reduce risk or prevent potential attacks in the future. […] Making an effort to maintain a nutritious and balanced diet, and get plenty of sleep and regular exercise will not only improve a persons overall health condition, but can also contribute to keeping future ocular migraines at bay (especially if emotional stress is a trigger).

• #2 Retinal Migraine: Symptoms, Causes and Treatment

  https://lonestarneurology.net/blog/retinal-migraine/

  Atrial scotoma is not one of the diseases that can be permanently cured. The only way to cope with the disease is to reduce the risk of exacerbation through lifestyle adjustments and regular medication. The goal of treatment is to prevent status sick headache a particularly severe and prolonged ocular sick headache attack, requiring urgent hospitalization of the patient and intensive care. […] For the prevention of ocular migraine, it is important to: have an active lifestyle; get enough sleep; establish a balanced diet; follow the daily routine; try not to overwork; avoid stress; quit smoking and do not abuse alcohol; be more often in the forest and outside the city. […] Timely examination and treatment prescribed by doctors are mandatory prevention of the disease. Regular visits to specialists will help alleviate or prevent ocular migraine attacks.

• #3 Migraine Headache Prophylaxis | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0101/p17.html

  Preventive therapy should be considered in patients having four or more headaches a month or at least eight headache days a month, significantly debilitating attacks despite appropriate acute management, difficulty tolerating or having a contraindication to acute therapy, medication overuse headache, patient preference, or the presence of certain migraine subtypes (i.e., hemiplegic migraine; migraine with brainstem aura; migrainous infarction; or frequent, persistent, or uncomfortable aura symptoms). […] Divalproex (Depakote), topiramate (Topamax), metoprolol, propranolol, and timolol are effective for migraine prevention and should be offered as first-line treatment. […] Behavioral treatments, such as relaxation training, thermal biofeedback combined with relaxation training, electromyographic biofeedback, and cognitive behavior therapy, are effective options for migraine prevention.

• #3 Ocular Migraines: Causes, Symptoms, Diagnosis, Treatment

  https://www.webmd.com/migraines-headaches/ocular-migraine-basics

  Ocular Migraine Prevention […] The first step to preventing migraines is to avoid your triggers. To do that, you must know what your triggers are. To help determine what your triggers are, try keeping a journal with: […] What you were doing before you got an ocular migraine […] What you ate or drank before your migraine […] How you felt before your migraine […] If you have migraines regularly, ask your doctor about preventive medicines such as calcium channel blockers. Nifedipine or verapamil seem to work the best for people with ocular migraine. […] […] It’s rare, but people who have these types of migraine may have a higher risk of permanent vision loss in one eye. Experts don’t know whether medications that prevent migraines — such as tricyclic antidepressants or anti-seizure medications — can help prevent that vision loss. But if you have ocular migraine, even if it goes away on its own, it’s a good idea to talk to your doctor about your symptoms.

• #3 Migraine | A Guide to Your Eye Health | Guide Dogs

  https://www.guidedogs.org.uk/getting-support/information-and-advice/eye-health/migraine/

  Botulinum toxin type A (botox) – chronic migraine sufferers for whom other treatments havent worked may be offered botox under the care of a specialist. Botox is injected into specific muscles in the head and neck muscles. […] Amitriptyline – this antidepressant, although not licensed for treating migraines, is sometimes given by medics. […] Monoclonal antibodies – this treatment is given by injection every month or few months if you have severe migraines and at least three other preventative treatments have been unsuccessful.

• #3 What is an Ocular Migraine? | Headache TMJ – Los Angeles Pain Clinic

  https://www.headachetmj.com/blog/migraine/what-is-an-ocular-migraine/

  Prevention of ocular migraines centers on a systematic approach to identifying and managing individual triggers that requires careful observation and documentation of circumstances surrounding each episode. The development of effective preventive strategies often begins with maintaining a detailed migraine journal, which can reveal patterns and connections between lifestyle factors and migraine onset, though it may take time to establish clear correlations. Essential components of migraine prevention include: […] Journaling and Trigger Identification: […] – Activity Documentation: Record all activities preceding migraine onset […] – Dietary Tracking: Note consumption patterns of food and beverages […] – Emotional State Monitoring: Document stress levels and emotional conditions […] – Environmental Factors: Track external conditions and potential triggers

• #3 When To Worry About Retinal Migraine: Duration, Symptoms

  https://www.medicinenet.com/when_should_i_be_worried_about_a_retinal_migraine/article.htm

  Retinal migraine is usually not a medical emergency. In most people, the condition is harmless, and vision returns to normal after some time. […] If you experience a partial or complete loss of vision in one eye for the first time, it is important to seek urgent medical help. […] The is no fixed treatment protocol for retinal migraine. For attacks that do not come often, your doctor may treat your retinal migraine as they treat other types of migraine. […] Depending on your habits, lifestyle, and any underlying medical conditions, your doctor may also ask you to do the following: Manage your stress, Quit smoking, Take steps to keep blood pressure under check, Discontinue hormonal contraceptive pills, Avoid traveling to places located at high altitude, Drink plenty of water to avoid dehydration, Have frequent, small meals to avoid hypoglycemia, Avoid exposure to excessive heat.

• #3 Ocular Migraine: Symptoms, Prevention, And Management

  https://www.ojaseyehospital.com/blog/ocular-migraines-symptoms-of-ocular-migraine-causes-of-ocular-migraine-prevention-of-ocular-migraine/

  You can prevent ocular migraines by identifying and avoiding the triggers. Make a note or activities you were doing before the start of a migraine. This will help you in identifying and avoiding the triggers. […] Take proper sleep and reduce the stress by various stress-reducing techniques. Eat a healthy diet and avoid directly looking at glaring or flickering lights. […] You may be prescribed certain medications that will reduce your frequency of ocular migraines. Keep those medications handy. Avoid being in the environment of strong perfume or cigarette smoke odour.

• #3 What Is an Ocular Migraine?

  https://www.verywellhealth.com/ocular-migraine-overview-and-more-5205087

  A retinal migraine affects only one eye and can occur before or during a headache. The symptoms, which can be more serious than those for a migraine with aura, may include temporary blindness or decreased vision. […] If you have retinal migraines, avoid using triptans or ergots, as they can increase the risk of complications. Also, people with retinal migraine should stop hormonal birth control and stop smoking.

• #3 Managing Migraine Headache

  https://www.reviewofoptometry.com/article/managing-migraine-headache

  The goals of preventive therapy are to reduce attack frequency, severity or duration, improve responsiveness to acute attacks and reduce general disability. Many medications are used to treat migraine prophylactically, including antiepileptic drugs, beta and calcium channel blockers, several subtypes of antidepressants and some antihypertensives, as well as supplements, herbs and vitamins. […] Many prophylactic meds for migraine work by inhibiting cortical spreading depression (CSD), which is considered the basis of migraine aura. Others have antiadrenergic or serotonin modulatory effects, or enhance the effect of the neurotransmitter gamma-aminobutyric acid, leading to a decrease in neuronal firing. […] Studies have demonstrated the effectiveness of the herb butterbur (Petasites hybridus) in preventing migraines. Patients on butterbur require monitoring of liver enzymes. Other natural supplements such as riboflavin (vitamin B2), coenzyme Q10, melatonin and magnesium appear to be effective and well tolerated for migraine prophylaxis as well.

• #3 ocular-migraines-natural-treatment – Makari Wellness

  https://makariwellness.com/ocular-migraines-natural-treatment/

  Ocular migraines are not well understood as it is rare for a physician to be present during the ocular migraine attack. […] Some research suggests that 29-50% of people with ocular migraines have a history of other types of migraine. However, there are some things patients can do to reduce the risk of migraine occurrence: […] Acupuncture and massage can help release the tight areas and relax muscles.

• #3 Ocular Migraine (Retinal Migraine) vs. Migraine Aura

  https://www.allaboutvision.com/conditions/ocular-migraine/overview-of-retinal-migraine/

  Retinal migraines, migraine auras and migraine headaches can be triggered by many of the same things. […] Finding and avoiding your triggers may help you have fewer migraines, whether they come with headaches or not. Some triggers can be harder to avoid than others. […] Certain medications and supplements may help some people get fewer migraines. Many of these medications were originally used to manage different conditions, such as high blood pressure or depression. […] A doctor can help you decide which ones to try. They might recommend: Antidepressants, Blood pressure medicine, Anti-seizure medicine, Vitamin, mineral or herbal supplements, Botox injections, Devices that temporarily slow down brain activity, Monoclonal antibodies (CGRP). […] Always talk to your doctor before you take new drugs or supplements, even if you can buy them without a prescription. Some can aggravate certain conditions or interact with other medications. They can also lead to rebound headaches or even organ damage if you use them too much.

• #4 Migraine Prophylaxis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507873/

  Recurrent migraines can be functionally disabling and can impair quality of life. After treating acute migraines, all migraine patients should be evaluated for preventive therapy. Preventive therapy aims to decrease the frequency, severity, and duration of migraine attacks. Furthermore, preventative therapy can increase responsiveness to acute migraine therapy and improve the quality of life. Prophylactic treatment is not curative, and most patients will still need abortive medications for acute migraine. Before starting prophylactic medications, it is imperative to evaluate if patients are using proper and adequate abortive therapies. Overuse of abortive medications can cause rebound headaches. […] Prophylactic migraine treatment should be considered in patients with more than three monthly episodes or at least eight headache days in one month. Patients with severe debilitating headaches despite appropriate acute treatment or those who are intolerant or have contraindications to acute therapy. Prophylaxis should also be considered in patients with medication overuse headaches, certain migraine subtypes like hemiplegic migraine, basilar migraine, migraine with prolonged aura, or if the patient prefers.

• #4 Retinal Migraine: Causes, Symptoms, Treatment, and More

  https://www.healthline.com/health/migraine/retinal-migraines

  If retinal migraine isn’t experienced frequently, doctors or optometrists may prescribe medications typically used to treat other forms of migraine. […] Additionally, doctors may look at your individual triggers and try to deal with them actively to prevent future episodes. […] An eye specialist may sometimes prescribe specific medications for a retinal migraine including a beta-blocker such as propranolol, an antidepressant such as amitriptyline, or an anticonvulsant such as valproate or topiramate. […] More research needs to be done in this area to come up with a more definitive treatment.

• #4 Ocular Migraines – True Eye Experts

  https://trueeye.com/what-you-need-to-know-to-help-world-blindness/

  A simple solution to prevent ocular migraines may be to avoid migraine triggers. For instance, you may recognize that you experience migraines when you are under stress or have low blood sugar. […] Migraine triggers include: […] Changing your diet, staying hydrated, and exercising are all important. However, if you have tried everything without success, you have options. Discuss your migraine symptoms with your medical doctor and eye doctor.

• #4 Migraine | healthdirect

  https://www.healthdirect.gov.au/migraine

  There are many different medicines that can reduce how often you get a migraine attack and how severe they are. […] If medicines don’t help, you might try a series of injections of onabotulinum toxin A (Botox) into your head and neck. […] It’s best to maintain a healthy weight, as obesity can increase your risk.

• #4 Patient’s Guide to Visual Migraine – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/neurology/neuro-ophthalmology/visual-migraine

  Many patients with isolated visual migraines, without severe headaches, have relatively infrequent episodes that do not require specific preventive treatments. […] In patients where the pattern of migraines includes frequent, severe headaches, it is very reasonable to consider additional preventive treatments. The main goal for any of these strategies is to reduce the overall frequency and severity of the headaches. […] There are numerous medications that can be used as a preventive treatment for migraine. […] One medication that is used commonly, particularly because it has no side effects, is vitamin B2 (riboflavin). […] Other herbal medications used to reduce migraine headaches include petasites (butterbur) and feverfew. […] Some commonly tried medications include amitriptyline, gabapentin, and topiramate.

• #5

  https://111.wales.nhs.uk/retinalmigraine/

  Retinal migraine is caused by the blood vessels to the eye suddenly narrowing (constricting), reducing the bloodflow to the eye. […] Treatment for retinal migraine usually just involves taking pain relief for any headaches and reducing exposure to anything that might be triggering the retinal migraine. […] Your doctor may sometimes prescribe medication, such as: aspirin to reduce pain and inflammation, a beta-blocker which may help relax blood vessels, a calcium channel blocker which may help prevent blood vessels constricting, a tricyclic antidepressant which may help prevent migraine, anti-epileptics which may help prevent migraine. […] However, there’s still a lack of research about the best way to treat or prevent a retinal migraine.

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