About five million Spaniards (900,000 Catalans) suffer from migraine, a neurological disease that manifests itself as an intense or severe headache. Sufferers take from one average of five years in accessing adequate treatment, due to the underdiagnosis and barriers to prescription. These are the main characteristics of one of the most common diseases in the world. disabling.
What is their incidence?
Migraine, a disease with a certain genetic component, affects a 12% of the world’s population. According to the World Health Organization (WHO), it is the disease. most common disease of mankind. Affects more women than to men, as it is influenced by female hormones. “For example, the drop in estrogen in women, on the 28th day of their period, can cause migraine,” he points out. Robert Belvis, director of the Headache Unit of the Hospital de la Santa Creu i Sant Pau (Barcelona) and secretary of the headache group of the Spanish Society of Neurology (SEN).. Migraine, which usually begins when the person is between 10 and 14 years old and ends after the age of 65, is between the second and the sixth most disabling disease. There are 4% of patients who suffer from chronic migraine who are the ones who go to the hospitals. Physicians call on sufferers to contact the Spanish Migraine and Headache Association (Aemice), on whose web site the book ‘Empower Your Migraine’, by Robert Belvís and Noemí Morollón.
How is it different from headache?
The headache, a type of headache, is a symptom of migraine. Migraine is the disease. “A person with migraine may manifest at times. very disabling attacks, including headache, photophobia [intolerancia a la luminosidad], phonophobia [intolerancia a los sonidos fuertes], vomiting, nausea… It is as if the brain goes into a partial shutdown process, and it is something that lasts for between a few hours and three days.” notes for his part Patricia Pozo Rosich, head of the Headache Unit at Vall d’Hebron Hospital (Barcelona) and head of the Migraine Adaptive Brain center.
What are the symptoms?
The headache is hemicranial (i.e., the whole head does not hurt) and it is usually pulsatile, as a hammer blow. In addition, there are nausea, vomiting, phonophobia, sonophobia, and even osmophobia. (aversion to odors). It is a pain that increases with banal efforts, for example, when moving the head. Dr. Pozo Rosich emphasizes, moreover, that migraine generates a lot of “anticipatory anxiety.” “You never know when you might have an attack. You can’t plan your life. People are totally conditioned by these attacks, generating a absolute life change to be able to adapt to living with this disease,” says the Vall d’Hebron neurologist.
What factors cause migraine?
The origin of migraine is a combination of. environmental and genetic factors. Some families are particularly prone to suffer from it, and genetics influences the type of migraine suffered by affected individuals. “The patient does not get used to the changes, specifically that of stress. Increased stress produces migraine, but so does reduced stress,” says Dr. Belvís. Although stress is the “number one” factor of migraine, there are others. In women, the menstruation may promote migraine. Also the fasting. For this reason, patients should always keep the same meal and sleep schedules, Because when they are altered, a migraine can occur. “That is why it is typical that, in the weekend, There are more cases of migraines, because this is when the rhythms of sleep and meals are altered,” says the Sant Pau physician.
What types of migraine are there?
The migraine with aura, the migraine without aura and the menstrual migraine. “One in four patients suffers from a very specific and spectacular phenomenon that is called aura. It is the vision of little lights in black and white. and lasts approximately less than an hour,” notes Dr. Belvís. Some patients their face and hand fall asleep, And they may have trouble speaking. “It’s called an aura because this phenomenon comes before the headache. Sometimes is mistaken for a stroke”, says the neurologist.
The most common migraine is the one that manifests without aura, in which this phenomenon does not occur, but rather the symptoms described above. On the other hand, the menstrual migraine is related to the abrupt drop in estrogen levels, which usually occurs just before menstruation.
What are the treatments?
If a patient has four migraine attacks per month, should make a preventive treatment: take some daily pills that, although they do not cure, reduce the attacks. If pills are not enough and the patient suffers from migraine 15 days per month, there is a botulinum toxin (botox) treatment. which “paralyzes the pain nerves by sending a relaxation signal to the brain,” explains Belvís. They are a 31 injections around the head and cervical spine. There is also a new treatment of monoclonal antibodies against CGRP, which is the headache protein in migraine. “It’s a self-injection that’s done with a pen similar to a diabetic pen,” says the neurologist.