MIGRALEVE
TECHNIQUES OF MICROSURGERY
Microsurgery started with ophthalmic surgeons, whose demands for more delicate
operating instruments led to the adoption ofthe operating microscope. The results
were so favourable that surgeons working in other specialties began to use the
technique for intricate operations.
The operating microscope
This surgeon is performing microsurgery
with the aid of an operating microscope.
The photograph below shows a blood
vessel as seen through the microscope.
S p e c u l u m
S i t e o f
s u r g e r y
S u r g e o n
E y e p i e c e
Replantation microsurgery
A major application of microsurgery is the
replantation of severed fingers, toes, hands, feet,
or even entire limbs. This is successful only if the
severed blood vessels and nerves are accurately
rejoined so that regeneration occurs.
m id a z o la m
A
b e n z o d i a z e p i n e d r u g
that is used as
p r e -
m e d i c a t i o n .
Adverse effects of midazolam
include confusion, drowsiness, and diz-
ziness. If benzodiazepines are taken for
a long time,
d e p e n d e n c e
may result.
m id b ra in
The top part of the
b r a i n s t e m ,
situated
above the pons. The midbrain is also
called the mesencephalon.
m id d le e a r
See
e a r
.
m id d le -e a r e ffu s io n , p e rs is te n t
See
g l u e e a r
.
m id d le -e a r in fe c tio n
See
o t i t i s m e d i a .
m id -life c r is is
A popular term for the feelings of dis-
tress that affect some people in early
middle age when they realize that they
are no longer young. Counselling and
support are usually effective in helping
people to come to terms with aging.
m id w ife ry
The profession concerned with assisting
women in pregnancy and childbirth,
and in the weeks just after a birth.
m ife p ris to n e
A
s e x h o r m o n e
drug that is used to
induce medical termination of a very
early pregnancy (see
a b o r t i o n , i n d u c e d
).
Possible adverse effects include malaise,
faintness, nausea, rash, and, rarely, uter-
ine
bleeding. Women
over
3 5
who
smoke should not be given the drug.
m ig ra in e
A
severe
headache,
typically
lasting
from four to
7 2
hours, accompanied by
light and noise sensitivity and/or nau-
sea and vomiting. Migraine attacks are
due to spasm, followed by excessive
dilation, of blood vessels in the brain.
CAUSES
There is no single cause of migraine,
although it tends to run in families.
Stress-related, food-related, or sensory-
related factors (such as eating cheese
or chocolate, or drinking red w ine)
may trigger attacks. In women,
m e n -
s t r u a t i o n ,
o r a l
c o n t r a c e p t i v e s ,
and
H R T
may also be triggers.
TYPES AND SYMPTOMS
There are two types: migraine with aura
(an impression of flashing lights and/or
other neurological symptoms such as
numbness and tingling) and migraine
without aura. In migraine without aura,
there is a slowly worsening headache,
often on one side of the head, with
nausea and sometimes vomiting and/or
light and noise sensitivity.
In migraine with aura, there may be
visual disturbances for up to an hour, fol-
lowed by a severe, one-sided headache,
nausea,
vomiting,
and
sensitivity
to
light and noise. Other temporary neu-
rological symptoms, such as weakness
in one half of the body, may occur.
DIAGNOSIS AND TREATMENT
Diagnosis is usually made from the
history and a normal outcome from
any
physical
examinations
between
attacks. Treatment for an attack is an
a n a l g e s i c d r u g
such as
a s p i r i n
,
p a r a c e t a -
m o l ,
or a
n o n s t e r o i d a l a n t i - i n f l a m m a t o r y
d r u g ,
with an
a n t i e m e t i c d r u g ,
if needed.
If this is not effective, drugs called
5
H T 1
agonists (see
s e r o t o n i n a g o n i s t s ) ,
such as
s u m a t r i p t a n ,
may be prescribed.
These drugs are taken as early as possi-
ble at the start of an attack, and may
prevent
the development
of a
full-
blown attack. Sleeping in a darkened
room may hasten recovery.
For frequent attacks, preventive treat-
ment may be required. Keeping a diary
can help people to identify trigger fac-
tors, and prophylactic drugs may be
prescribed. Drugs that contain
e r g o t a -
m i n e
may prevent an attack if taken
before the headache begins, but are
now rarely used; they have largely been
replaced by
s e r o t o n i n a n t a g o n i s t s
such as
p i z o t i f e n . B e t a - b l o c k e r d r u g s ,
or low doses
of tricyclic
a n t i d e p r e s s a n t
d r u g s ,
may
also be used to prevent attacks. (See also
c l u s t e r h e a d a c h e s . )
m ig ra in o u s n e u ra lg ia
See
c l u s t e r h e a d a c h e s .
M ig ra le v e
A brand-named drug for migraine relief
that contains the
a n a l g e s i c d r u g s
(pain-
killers)
p a r a c e t a m o l
and
c o d e i n e
and the
a n t i e m e t i c d r u g
buclizine.
M
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