The Who, What, When, Where and Why of Migraine More than just a “bad headache,” migraine is a legitimate, biological disease affecting 28 million Americans – equivalent to 13 percent of the U.S. population. According to data released by the National Headache Foundation, this is equal to one migraine sufferer in every four U.S. households.
While there are no definite answers as to the causes of migraine, health care professionals are gaining an understanding of what happens when a migraine attack is in progress. It is thought a migraine attack is triggered within the brain itself. Once an attack begins, it is thought the pain and other symptoms of migraine arise from an inflammatory process resulting from an interaction between the trigeminal nerve and blood vessels in the coverings of the brain. Serotonin (or 5-hydroxytryptamine or 5-HT), a naturally occurring chemical in the brain, has been implicated in this inflammatory process.
Practically anything may trigger a migraine, and triggers are not the same for everyone. In fact, what causes a migraine in one person may relieve it in another. Triggers may include one or more of the following categories:
- Diet (e.g. cheese, red wine)
- Activity (e.g. irregular exercise, lack of sleep)
- Environment (e.g. bright lights, smoke)
- Hormones (e.g., menstrual cycle, oral contraceptives)
- Emotions (e.g. stress, anxiety)
- Medications (e.g. overuse of over-the- counter analgesics/pain relievers)
Migraine is a legitimate, biological disease characterized by throbbing head pain, usually located on one side of the head, often accompanied by nausea and sensitivity to light and/or sound. Migraine is more common than asthma, diabetes or congestive heart failure. The combination of disabling pain and associated symptoms often prevents sufferers from performing daily activities. Attacks occur periodically and can last from 4 to 72 hours. Symptoms, incidence and severity vary by individual and by attack.
In addition, a small number of sufferers experience what is known as “aura.” They may see light flashes, blind spots, zigzag lines, shimmering lights and may experience vision loss and numbness prior to the head pain and other symptoms. A common misperception is that most patients with migraine experience aura before the onset of headache, when in fact, 80-90 percent of sufferers do not.
Migraine afflicts both men and women, although women experience migraine more often than men, at a ratio of 3:1. Peak prevalence for migraine is between the ages of 20 and 45 for both genders.
Migraine is a chronic, recurrent condition. Typically, sufferers experience an average of one attack per month, which can last anywhere from 4 to 72 hours.
Migraine can be effectively managed. With the help of a physician, patients can identify and alleviate their symptoms with an appropriate treatment regimen. Medications generally fall into two categories:
- Prophylactic: Taken on a daily basis, prophylactic – or preventative – medications can help reduce the number of attacks in patients who experience more than two migraines per month.
- Acute: Acute therapy treats the symptoms of migraine after the attack begins. Many medications available to treat an acute attack must be taken as soon as the attack occurs, otherwise they may be less effective.
Migraine runs in families, as 70 percent of sufferers are found to have a hereditary influence. In fact, a child has a 50 percent chance of becoming a sufferer if one parent suffers and a 75 percent chance if both parents suffer. (Source: National Headache Foundation)
According to a study published in the April 1999 issue of the Archives of Internal Medicine, migraine costs American employers $31 billion per year due to missed work and reduced productivity.
It is estimated that 157 million workdays are lost annually because of the pain and associated symptoms of migraine. (Source: National Headache Foundation)