What is migraine?
Migraine is a genetic disorder characterized by a type of headache that throbs, ranging from moderate to severe intensity, usually accompanied by other symptoms such as nausea, vomiting, and sensitivity to light and sound. It is a neurological condition that affects millions of people worldwide, about 15% of the global population, and it is not just a simple headache.
Symptoms
The typical symptoms of a migraine include:
- Intense headache, which often switches sides, affecting either one side of the head or both, and if untreated, can last from four to 72 hours
- Nausea and sometimes vomiting
- Photophobia (sensitivity to light) and phonophobia (sensitivity to sound)
- Worsening of pain when engaging in physical activities
- About 30% of migraine sufferers will experience neurological symptoms such as visual changes or tingling, which typically occur before the headache and should not last more than an hour, known as migraine aura
Causes
Migraine is a genetic disorder. Some rare forms may be caused by the presence of a single altered gene, but most sufferers will be affected by the combination of multiple genes that, when associated, can trigger the disorder. About 70% of migraine sufferers have family members with the same symptoms, meaning they also have migraines.
A common misconception is attributing the presence of a facilitator or trigger for a migraine attack as the cause of the migraine. Mood changes, such as depression or excessive anxiety, can be associated with increased frequency of attacks but cannot be considered the cause of the disorder. The same applies to alcohol use or other stimulants, sleep pattern changes, and hormonal changes observed in women's menstrual cycles.
Diagnosis
The diagnosis of migraine is clinical, meaning it does not rely on tests or exams. To diagnose migraine, several steps are essential:
- Anamnesis: An interview conducted with the patient in which the healthcare professional asks detailed questions about the symptoms, including the description of the headache, the frequency and duration of episodes, the location of the pain, the presence of symptoms, and any factors that trigger a migraine attack
- Physical examination: Conducted to rule out other medical conditions that might cause the symptoms
- Medical history: Reviewing the patient's personal and family medical history to identify genetic risk factors and other medical conditions that might be related to migraine
Treatment
Migraine treatment can be divided into acute and preventive. It is important to discuss treatment options with a responsible professional who can find the best option according to your needs.
Acute treatment is simply the treatment of the attack itself and should be initiated as soon as the attack is identified. Many migraine sufferers delay the start of treatment, hoping the pain will resolve on its own, which will not happen.
The main medications for acute migraine treatment are:
- Analgesics
- Anti-inflammatories
- Triptans (specific migraine medications that can help relieve pain and other symptoms)
- Gepants (a new category of specific medications not yet available in Brazil)
Prevention
Preventive treatment should be considered whenever the frequency of migraines exceeds three to four days per month or in cases where the disability caused by the attacks is significant.
Generally, preventive treatment is done using medications, which can be administered orally, subcutaneously (in the case of anti-CGRP monoclonal antibodies), or intramuscularly (in the case of Botulinum Toxin Type A). Its main goal is to reduce the frequency, intensity, and duration of headaches, consequently reducing the disability caused by the disorder and improving the quality of life, and it usually lasts around 12 months.
General measures such as sleep hygiene, healthy eating, physical activity, adequate hydration, and stress management can help control the headaches.
References
You may also like to read about:
Chronic Migraine: A condition that causes severe and throbbing headaches. The patient experiences 15 or more headache days per month for at least 3 months
Headache: Pain that can occur in different parts of the head. Its causes include tension, fatigue, or illnesses
Head and Neck Cancer: A tumor that appears in the upper part of the respiratory and digestive systems, such as lips, mouth, throat, and nose. It usually does not cause symptoms in the early stages and is linked to smoking and alcohol consumption