Curbing the Impact of Migraines.

• Position: Brief Article

Migraine is a neurobioligical disorder affecting 28,000,000 Americans--equivalent to 13% of the U.S. population. The condition is more common than asthma, diabetes, or congestive heart failure. About one in every four households has a person who is suffering from migraine. Yet, just 48% of those with migraines have ever been diagnosed by a health care provider.

It can be a highly disabling condition that takes a heavy toll on work/ school productivity and may affect household and family/leisure activities. Because the pain pathways and symptoms are similar, migraine often is mistaken as sinus or tension headache.

Headache experts are gaining an increased understanding of what happens when a migraine attack is in progress. It is suspected that an attack is triggered from within the brain itself. Once one begins, it is thought that pain and other symptoms of migraine arise from an inflammatory process resulting from an interaction between the trigeminal nerve and blood vessels in the coverings of the brain. Serotonin, a naturally occurring chemical in the brain, has been implicated in this inflammatory process.

Recent evidence suggests that sensitization of neurons is a feature common to all migraine patients. During a migraine, pain signals from blood vessels inside the head make nerves hypersensitive. The normal pulsing of blood is interpreted as pain. Researchers believe that the neurons respond to the pain of migraine in stages, and, if it can be stopped early, the cascade of pain responses to higher areas of the brain can be halted or controlled. The development and gradual escalation of central hypersensitivity points to the need for early utilization of antimigraine drugs.

Practically anything may trigger a migraine, and triggers are not the same for everyone. In fact, what causes a migraine in one person may relieve it in another. Triggers can include one or more of the following categories: diet (e.g., red wine), environment (bright lights, smoke), emotions (stress, anxiety), activity (irregular exercise, lack of sleep), and hormones (menstrual cycle, oral contraceptives).

Migraine is characterized by a throbbing head pain...