Headaches and migraines remain serious disorders worldwide. It is estimated
that 36 million men, women and children suffer from migraines alone. Women
are affected more than men, and migraines tend to run in families with
a high likelihood of children experiencing the disorder if one of their
parents suffers from it.
Joey Gee, DO, a neurologist at
Mission Hospital, migraine is a complicated and poorly understood disorder that entails
much more than just pain. “It is a neurological disease that involves
changes in signals within the brain, alterations of the cerebrovasculature
and activation of potent inflammatory chemicals. This cascade leads to
various symptoms of head pain and associated neurological impairment,”
explained Dr. Gee.
Migraine is often characterized as severe head pain, often unilateral and
worsens with movement or activity. Nausea or increased sensitivity to
light and sound can occur. Attacks can last from four to 72 hours. If
pain persists for more than 72 hours, it is referred to as “status
migrainosis.” Migraine treatment is categorized into acute and chronic
preventive therapy. The goal of acute therapy includes fast, effective
treatment without serious side effects or down time. The class of medication
commonly referred to as triptans remains the treatment of choice. These
medicines target migraine pain by binding to serotonergic receptors specific
to the brain. Other treatments include: nonsteroidal anti-inflammatory
medication, ergotamine, and combined medication treatment such as isometheptene
or aspirin/acetaminophen/caffeine compound.
Dr. Gee explained that chronic treatment has been more complex, with lack
of specific and effective treatment over the years. “Lifestyle modification
with improved sleep techniques, the use of complementary medicine, physiotherapy
and biofeedback are becoming necessary to aid in treatment. The most common
treatments include anti-hypertensive medicine, antidepressants and anticonvulsant
medications,” Dr. Gee said.
In addition, Botox injections are proven to provide relief when standard
oral therapies have failed.
Research continues to explore new options in treatment, which include surgical
approaches such as transcranial magnetic stimulation, sphenopalatine ganglion
block, and external and internal nerve stimulators.
Dr. Gee reminds migraine sufferers that the goal of treatment is not to
stop headaches completely, but to improve a patient’s quality of
life with effective acute treatment and long-term management.
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