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WHAT IS MIGRAINE?

Migraine is a chronic neurological disorder causing sufferers to experience moderate or severe headaches.1,2

Other common symptoms of a migraine attack include:1

  • Light sensitivity
  • Sound sensitivity
  • Touch sensitivity
  • Nausea and vomiting
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HOW IS MIGRAINE DIFFERENT TO OTHER TYPES OF HEADACHES?

migraine

Migraine

  • Moderate to severe4
  • Persistent throbbing4
  • With or without aura (visual disturbance)4
  • Pain is often on 1 side (unilateral), occasionally on both sides (bilateral)5
  • Associated with nausea, vomiting and/or sensitivity to light, sound or smell1,4
  • Lasts up to 72 hours4
tension headache

Tension headache4

  • Rarely severe enough to impact daily activities
  • Aching or pressure-like pain
  • Feels like the head has a tight band around it
cluster headache

Cluster headache4

  • Extremely severe
  • Short duration (15 minutes to 3 hours)
  • Pain on 1 side (unilateral)
  • Associated with teary, bloodshot eyes, drooping eyelids and a runny nose
Medication-overuse headache

Medication-overuse headache4

  • Headaches occur 15 days per month or more
  • Caused by regular use of painkiller/s for more than 3 months
Sinus headache

Sinus headache

  • Pain and pressure around the sinus area6
  • A stuffy or runny nose6
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WHAT CAUSES MIGRAINE?

We don’t know exactly why some people get migraine, but doctors think it could happen when the brain is extremely reactive to certain types of stimuli.8

Migraine may be genetic, so people with a family history of migraine are more likely to be affected,8,9 and women are more likely to get migraine headaches compared to men.2,8,9

Other risk factors for migraine include:

  • Obesity8,9
  • Stress8,9
  • History of head or neck injury9
  • Comorbid (coexisting) pain disorders9
  • Sleep disorders like insomnia, snoring and sleep apnea8
  • High caffeine consumption9
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MIGRAINE TREATMENT AND PREVENTION

Migraine can be prevented and managed with a combination of lifestyle habits and medication.10

Lifestyle habits or changes that may help to manage migraine include:

  • Following a regular meal routine8,10
  • Practising good sleep hygiene8,10
  • Getting regular exercise8,10
  • Using relaxation techniques and reducing stress8
  • Identifying and avoiding your specific migraine triggers8,10

Different factors can trigger migraine in different people, so keeping a personal ‘headache diary’ may help you to identify your triggers.8 Triggers may include caffeine, alcohol or certain foods, smells, altitudes or weather conditions.8

TREATING MIGRAINE WITH MEDICATION

There are several different types of medications that can be used to treat migraine, including triptans, ergots, non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, acetylsalicylic acid (ASA), acetaminophen, opioids and anti-emetics.8,11

Triptans have been shown to have favourable outcomes compared to other medications like ergots, and equal or better results compared to NSAIDs, ASA and acetaminophen.11

What are triptans?

Triptans are a type of medication designed specifically to treat migraine.12,13 They are not general painkillers.13 Research shows that they are effective for patients suffering from migraine attacks.8,11

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How do triptans work?

During a migraine attack, it’s believed that the blood vessels in the head (cranial vessels) become inflamed and widened (‘vasodilation’).1,16

Triptans help to counteract vasodilation by:

  • constricting the cranial blood vessels (‘vasoconstriction’);17,18,19
  • interacting with serotonin receptors in the brain (serotonin is a chemical messenger that regulates pain perception and is also a vasoconstrictor).17,18,20,21

This helps to treat the symptoms of migraine, including pain and nausea.17,22

*Based on the global prevalence of migraine sufferers

 

References

References:

1. Dodick DW. Migraine. Lancet. 2018;391:1315-1330. doi:10.1016/S0140-6736(18)30478-1.

2. Cutrer FM. Pathophysiology, clinical manifestations, and diagnosis of migraine in adults. UpToDate. Accessed September 29, 2022. https://www.uptodate.com/contents/pathophysiology-clinical-manifestations-and-diagnosis-of-migraine-in-adults.

3. Stovner LJ, Hagen K, Linde M, et al. The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates. J Headache Pain. 2022;23:34. doi:10.1186/s10194-022-01402-2.

3b. Statistics South Africa. Statistical release: mid-year population estimates. 2022. https://www.statssa.gov.za/publications/P0302/P03022022.pdf.

4. Ahmed F. Headache disorders: differentiating and managing the common subtypes. Br J Pain. 2012;6(3):124-132. doi:10.1177/2049463712459691.

5. Evans RW. The clinical features of migraine with and without aura: updates on the clinical features of migraine, especially migraine with aura. Pract Neurol. April 2014:26-32.

6. Kaymakci M, Cikriklar HI, Pay G. The aetiology underlying sinus headaches. J Int Med Res. 2013;41(1):218-223. doi:10.1177/0300060513475382.

7. Stovner LJ, Nichols E, Steiner TJ, et al. Global, regional, and national burden of migraine and tension-type headache, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2018;17:954-976. doi:10.1016/S1474-4422(18)30322-3.

8. Collins TA. Migraine headaches in adults. BMJ Best Practice. Accessed September 29, 2022. https://bestpractice.bmj.com.

9. Garza I, Schwedt TJ. Chronic migraine. UpToDate. Accessed September 29, 2022. https://www.uptodate.com/contents/chronic-migraine.

10. Schwedt TJ, Garza I. Preventive treatment of episodic migraine in adults. UpToDate. Accessed September 29, 2022. https://www.uptodate.com/contents/preventive-treatment-ofepisodic-migraine-in-adults.

11. Cameron C, Kelly S, Hsieh SC, et al. Triptans in the acute treatment of migraine: a systematic review and network meta-analysis. Headache. 2015;55:221-235. doi:10.1111/head.12601.

12. Schwedt TJ, Garza I. Acute treatment of migraine in adults. UpToDate. Accessed October 4, 2022. https://www.uptodate.com/contents/acute-treatment-of-migraine-in-adults.

13. Cologno D, Mazzeo A, Lecce B, et al. Triptans: over the migraine. Neurol Sci. 2012;33:S193-198. doi:10.1007/s10072-012-1066-1.

14. Láinez MJ. The treatment of migraine. Neuropsychiatr Dis Treat. 2006;2(3):247-259. doi:10.2147/nedt.2006.2.3.247.

15. Goldstein J, Ryan R, Jiang K, et al. Crossover comparison in migraine. Headache. 1998;38(10):737-747. doi:10.1046/j.1526-4610.1998.3810737.x.

16. Vasodilation. In: The Free Dictionary. Accessed December 12, 2022. https://medical-dictionary.thefreedictionary.com/vasodilation.

17. Humphrey PPA. The discovery and development of the triptans, a major therapeutic breakthrough. Headache. 2008;48(5):685-687. doi:10.1111/j.1526-4610.2008.01097.x.

18. Zanchin G, Roncolato M, Fabbri L. Triptan (50 and 100 mg) in repeated migraine attacks: a patient preference study. J Headache Pain. 2000;1(1):33-38. doi:10.1007/s101940050007.

19. Migraine - treatment. NHS UK. Accessed December 12, 2022. https://www.nhs.uk/conditions/migraine/treatment/.

20. Medical definition of serotonin. MedicineNet. Accessed December 12, 2022.

21. Goadsby PJ, Lipton RB, Ferrari MD. Migraine – current understanding and treatment. N Engl J Med. 2002;346(4):257-270. doi:10.1056/NEJMra010917.

22. Láinez MJ, García-Casado A, Gascón F. Optimal management of severe nausea and vomiting in migraine: improving patient outcomes. Patient Relat Outcome Meas. 2013;4:61-73. doi:10.2147/PROM.S31392.