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www.AmericanHeadacheSociety.org - American Headache Society (AHS) • www.AmericanMigraineFoundation.org - American Migraine Foundation (AMF)http://ahma.memberclicks.net/ - American Headache and Migraine Association (AHMA) • www.headachejournal.org- Headache: The Journal of Head and Face Pain
MIGRAINE
References1. HeadacheClassificationSubcommitteeoftheInternationalHeadacheSociety.InternationalClassificationofHeadacheDisorders,3rdeditionbeta.Cephalalgia.2013;33:629-808.2. CharlesA.“HeadTalks:Pathophysiology.”ScottsdaleHeadacheSymposium,November21,2014.3. LiptonRB,BigalME,DiamondM,FreitagF,ReedML,StewartWF;AMPPAdvisoryGroup.Migraineprevalence,diseaseburden,andtheneedforpreventivetherapy.Neurology.2007;68:343-9.4. RobbinsMS,LiptonRB.Theepidemiologyofprimaryheadachedisorders.SeminNeurol.2010;30:107-19.5. VosT,FlaxmanAD,NaghaviMetal.Yearslivedwithdisability(YLDs)for1160sequelaeof289diseasesandinjuries1990–2010:asystematicanalysisfortheGlobalBurdenofDiseaseStudy2010.Lancet.2012;380:2163-96.6. Wöber-BingölC.Epidemiologyofmigraineandheadacheinchildrenandadolescents.CurrPainHeadacheRep.2013;17:341.7. StewartWF,StaffaJ,LiptonRB,OttmanR.Familialriskofmigraine:apopulation-basedstudy.AnnNeurol.1997;41:166-72.8. SilbersteinSD,HollandS,FreitagF,DodickDW,ArgoffC,AshmanE;QualityStandardsSubcommitteeoftheAmericanAcademyofNeurologyandtheAmericanHeadacheSociety.Evidence-basedguidelineupdate: pharmacologictreatmentforepisodicmigrainepreventioninadults:reportoftheQualityStandardsSubcommitteeoftheAmericanAcademyofNeurologyandtheAmericanHeadacheSociety.Neurology.2012;78:1337-45.9. HollandS,SilbersteinSD,FreitagF,DodickDW,ArgoffC,AshmanE;QualityStandardsSubcommitteeoftheAmericanAcademyofNeurologyandtheAmericanHeadacheSociety.Evidence-basedguidelineupdate:NSAIDsandother complementarytreatmentsforepisodicmigrainepreventioninadults:reportoftheQualityStandardsSubcommitteeoftheAmericanAcademyofNeurologyandtheAmericanHeadacheSociety.Neurology.2012;78:1346-53.
10.MarmuraMJ,SilbersteinSD,SchwedtTJ.Theacutetreatmentofmigraineinadults:theAmericanHeadacheSocietyevidenceassessmentofmigrainepharmacotherapies.Headache.2015;55:3-20.11.BuseDC.Multidisciplinarymigrainemanagement.PainMedNews.2014;12:14-25.12.CampbellJK,PenzienDB,WallEM;USHeadacheConsortium.Evidence-basedguidelinesformigraineheadache:behavioralandphysicaltreatments.Accessedathttp://tools.aan.com/professionals/practice/pdfs/gl0089.pdf13.BigalME,SerranoD,BuseD,ScherA,StewartWF,LiptonRB.Acutemigrainemedicationsandevolutionfromepisodictochronicmigraine:alongitudinalpopulation-basedstudy.Headache.2008;48:1157-68.14.LiptonRB,SollarsMS,BuseDC.Migraine:Epidemiology,Progression,PrognosisandComorbidity.In:RobbinsMS,GrosbergBM,andLiptonRB(Eds.).NeurologyInPractice:Headache,1sted.London:Wiley-Blackwell;2013:64-87.15.LiptonRB,FanningKM,SerranoD,ReedML,CadyR,BuseDC.Ineffectiveacutetreatmentofepisodicmigraineisassociatedwithnew-onsetchronicmigraine.Neurology.2015;84:688-95.16.ReedML,FanningKM,SerranoD,BuseDC,LiptonRB.Persistentfrequentnauseaisassociatedwithprogressiontochronicmigraine:AMPPStudyResults.Headache.2015;55:76-87.17.AshinaS,SerranoD,LiptonRB,MaizelsM,ManackAN,TurkelCC,ReedML,BuseDC.Depressionandriskoftransformationofepisodictochronicmigraine.JHeadachePain.2012;13:615–624.18.AshinaS,BuseDC,MaizelsM,ManackA,SerranoD,TurkelCC,LiptonRB.Self-reportedanxietyasariskfactorformigrainechronification:resultsfromtheAmericanMigrainePrevalenceandPrevention(AMPP)study.Headache.2010;50(Suppl.1):4.19.MartinVT,FanningKM,SerranoD,BuseDC,ReedML,BernsteinJA,LiptonRB.Chronicrhinitisanditsassociationwithheadachefrequencyanddisabilityinpersonswithmigraine:resultsoftheAmericanMigrainePrevalenceandPrevention(AMPP) Study.Cephalalgia.2014;34:336-48.
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PRODROME
AURA
HEADACHE
POSTDROME
WHAT ARE MIGRAINE SYMPTOMS?1,2
HOW IS MIGRAINE TREATED?8-12
ACUTE MEDICATION TREATMENT OF ATTACKS
Specific medications for migraineNonspecific medications for pain
Anti-nausea medications
MANAGE WHAT MAKES MIGRAINE WORSE
LIFESTYLE AND NON-MEDICATION TREATMENTSKeeping a diary
Avoiding triggersCognitive behavioral therapy
Biofeedback, Relaxation training, Stress management
PREVENTATIVE TREATMENTS
Prescription medicationsSupplements
InjectionsDevices
• A common and disabling neurological condition• Attacks of headache and other symptoms because of an abnormally sensitive brain
HOW COMMON IS MIGRAINE?3-6
1 billion worldwide
1 in 5 women
1 in 4 homes
1 in 11 children
1 in 16 men
WHAT IS AURA?1
• One-third of people with migraine• Reversible attacks of neurological symptoms• Usually last from a few minutes up to an hour
Light sensitivity, sound sensitivity, nausea, fatigue, yawning, increased urination, cravings, mood change,
neck pain
Change in vision such as seeing spots, stars, lines, flashing lights, zigzag lines, or waves
Numbness and tingling
Difficulty speaking or understanding others
Throbbing pain on one or both sides of the head
Worse with movementNausea, vomiting, sensitivity to light, sound
and odors
WHAT IS MIGRAINE?1
IS MIGRAINE INHERITED?6,7
If 1 parent has migraine: 50% chance of a child having it too
If both parents have migraine: 75% chance of a child having it too
CAN MIGRAINE GET WORSE OVER TIME?13-19
• 2-3% of people with episodic migraine every year develop chronic migraine • Chronic migraine indicates headache happening on half of all days for 3 or more months • Risk factors for chronic migraine
Stressful life eventsHead injuryExcessive caffeine useOveruse of opioids and barbituratesNot having an optimized acute treatment planMore headache days per monthPersistent frequent nausea with migraineSnoring and sleep apneaOther pain conditionsDepressionAnxietyAllodynia (skin and scalp sensitivity to touch)Allergic rhinitis
Fatigue, difficulty concentrating, weakness, dizziness,
lightheadedness, decreased energy