Migraine

Migraine - the facts

What is migraine?

Migraine is a debilitating and recurrent neurological disorder, characterized by a throbbing headache that is usually made worse by movement and is often associated with nausea, vomiting, photophobia and phonophobia. It is increasingly recognized as a disorder that seriously undermines patients’ ability to work, study and have a normal family life. Its debilitating nature and its prevalence (9-16% of the Western population, typically between the ages of 25 and 55) result in a great personal and social burden, with consequent economic effects. For example, the annual cost of lost labour due to migraine in the USA is estimated to range from $5.6 to $17.2 billion.

Who suffers from migraine?

About one in ten people suffer from migraine, although the prevalence varies with age. Most migraine sufferers experience their first attacks during childhood or as teenagers, but migraines can sometimes begin during adult life. Studies have shown that, the age of onset is earlier in boys than in girls. Migraine can affect people at any age, but it is most common from 25 to 55 years of age, when work and family commitments are maximal. Migraine prevalence also varies with gender. Migraine is two to three times more common in women than in men. The higher prevalence in women may be explained in part by hormonal factors. However, it is not just a ‘women’s disorder’; over one in every 20 men also suffer from migraine.

Estimates of migraine prevalence worldwide

Migraine is common in all races. However, current evidence suggests that migraine prevalence is higher in Caucasians than in Africans or Asians.

Migraine sufferers may experience the burden of other associated illnesses on top of the burden of their migraines. They are at an increased risk from psychiatric illnesses, particularly depression and anxiety disorders. Migraine has also been associated with stroke, epilepsy and asthma.

What causes a migraine?

The exact mechanisms that cause migraines are not known and, indeed, may be numerous. Many people believe that certain factors ‘trigger’ their attacks. These may include too much or too little sleep, strong light, weather changes and specific foods.

In women, hormonal changes at certain times of life or at the onset of menstruation can trigger migraines.
Many people mistakenly believe that migraine is a psychological disease. This is not true. Migraine is an organic neurological disease and headache is one of its symptoms.
A number of theories have been put forward to explain the biological mechanisms involved in a migraine attack.
One of the most popular theories is that a migraine is caused when a physiological trigger, or triggers, cause vasodilation (expansion of the blood vessels) in the cranial blood vessels, which activates trigeminal nerve endings in the brain. This activation of the ‘trigeminovascular system’ is thought to cause the release of chemical substances called neurotransmitters, of which the neurotransmitter serotonin (also known chemically as 5-hydroxytryptamine or 5-HT) is an important factor in the development of migraine. During a migraine attack, inflammation of the tissue surrounding the brain (neurogenic inflammation) worsens the pain.

Migraine Disability Website http://www.midas-migraine.net/default.asp