Migraine disorder

At a Glance

Migraine disorder is a headache disorder characterized by recurrent moderate to severe pulsating or throbbing headaches.

Typically, unilateral pulsating headache occurs, which may be accompanied by sensitivity to light, sound, and smell, as well as nausea and vomiting.

How the disease works

Genetic predisposition may be involved, and triggers can include stress, changes in sleep, hormonal changes, sensory stimuli, changes in caffeine intake, skipping meals, and medication overuse.

Migraine is understood as a complex neurobiological process in which the brain's sensory processing and pain control networks are abnormally activated.

Variations in presentation among individuals

It may be more common in women, individuals with a family history, and those with depression, anxiety, bipolar disorder, sleep disorders, or epilepsy, but it can occur in anyone.

The broad framework of diagnosis and management

An attack can progress through the prodrome, aura, headache, and postdrome phases, but not all stages appear every time, and an aura may occur without a headache.

Diagnosis centers on confirming medical history and symptom patterns through neurological examination, with additional tests performed as needed to exclude other causes.

Current status of treatment

There is no single specific test that definitively confirms a migraine diagnosis; therefore, the progression of symptoms and accompanying findings must be synthesized, and the possibility of secondary headache must be evaluated.

Management involves simultaneously considering symptom relief during attacks, reduction in attack frequency and burden, and control of triggers and lifestyle habits.

Current treatment focuses on alleviating attacks and preventing further episodes rather than curing migraines.

How to read clinical trials

Although an observational study called the COMPETE Cohort Study associated with migraine disorders is registered on ClinicalTrials.gov, the registration information alone cannot be used to determine treatment efficacy or whether it represents standard care.

Points to verify during clinical consultations

In clinical practice, it is important to confirm the frequency, duration, location, and intensity of headaches, as well as aura and accompanying symptoms, relationships with menstruation, sleep, diet, caffeine, and medications, as well as the frequency of intake and sudden changes in presentation.