2023-06-29 16:53:00
Migraine…a complex genetic neurological disorder
Headache and migraine study teams in the world work to raise awareness of migraine during the month of June of each year (Migraine Headache Awareness Month (MHAM)), and they have taken their motto for this year 2023 “Educate Yourself, Educate Others” to help In spreading awareness by holding a wide range of live and virtual events and programmes. What’s more, patients share their migraine stories, and leading medical experts pass on their expertise to help shed light on this disabling and often misunderstood disease.
“sensory” disorder
Migraine at its most basic level is a type of sensory processing disorder, in which the migraine brain overreacts to all kinds of sensory input. The physiology of migraines is complex, and unfortunately not well understood, but when the migraine brain is triggered by sensory overload, it gets excited and triggers a storm of chemicals that trigger a migraine attack, which in turn causes three things: nerve pain in the head and neck, Irritability, spasm of blood vessels in the head. An inflammation occurs in the affected part of the brain. That is, the seizure is a combination of these three, which usually results in a severe headache that may sometimes cause disability and other neurological symptoms.
Dr. Shereen Qureshi
Migraine affects up to 1 in 5 people, affecting more than 42 million people in the United States alone, and currently about half of all migraine sufferers are not diagnosed. Nearly 400,000 Americans suffer from cluster headaches, which are known to be one of the most painful types of migraines a person can have.
In Australia, it is estimated that 20 percent of the Australian population suffers from migraine, and 71 percent of migraine sufferers are women. More than 90 percent of migraine sufferers cannot function normally during an attack.
I spoke to “Your Health”, Dr. Sherine Qureshi, Consultant Neurologist, Associate Professor at Johns Hopkins Medical Center – Aramco Medical Center (Member of the Royal Canadian Fellowship in Neurology, Member of the Board of Directors of the Saudi Society of Neurologists, Member of the Board of Directors of the Saudi Division of Headache Diseases, Member of the Board of Directors of the Saudi Society of Epilepsy) She noted that the World Health Organization reports that migraine is the second leading cause of disability and absence from work worldwide. Despite its negative effects on more than a billion people around the world and up to a third of the population in Arab countries, there is a set of negative and erroneous beliefs about this serious and often debilitating health problem, and these severe symptoms are often ignored as “just a headache.” », which leads to a delay in diagnosis and treatment, which has health and economic consequences.
Causes and symptoms
Dr. adds. Shireen Qureshi says that migraine attacks can last for more than hours, may last for days, and the pain may be so severe that it interferes with daily activities. Some common triggers include stress, lack of sleep, hormonal changes during the menstrual cycle in women, and caffeine and alcohol abuse. These pressures are increasing in many people’s lives with rapid urbanization.
What distinguishes a migraine is that it is a pulsating headache accompanied by other symptoms such as nausea and vomiting, leading to sensitivity to noise and light. Migraine attacks can also affect the brain, spinal cord, and nerves throughout the body, which can cause difficulty concentrating, dizziness, and blurred vision. These symptoms can occur anywhere from 4 to 72 hours. And the unpredictability of it means that migraines can occur at any time, which causes great disruptions in people’s lives.
Despite the disabling effects of migraine, it continues to be overlooked, undiagnosed, and untreated. In fact, only 40 percent of people with migraines or tension-type headaches are professionally diagnosed (according to WHO reports). Misconceptions about migraine being “just” a headache often lead to overlooking its symptoms. Poor treatment outcomes also contribute to this. With this in mind, more than two-thirds of people who suffer from migraines either never consult a doctor or stop doing so because there is little hope for a cure. Therefore, many migraine sufferers are not satisfied with the current standard of care.
health effects
And the impact of untreated migraine on mental health and the economy
“Regardless of the pain it causes, living with a migraine has mental health implications,” says Dr. Shereen Qureshi. People who get migraines are two to four times more likely to be depressed, and to experience feelings of isolation and helplessness in the face of pain. Undiagnosed migraines can lead to misunderstandings, negative beliefs, and a lack of support from family, friends, and the wider community. The unpredictability of a migraine and a lack of awareness or validation from others can also contribute to an increased emotional burden and a sense of isolation.”
People suffering from migraine often have to shoulder the direct financial cost of doctor visits, hospitalization and medical treatment, and this cost can have disproportionate impacts on destitute communities in the Middle East and Africa who must balance other daily priorities in addition to migraine attacks.
To put things into context, these patients also lose an average of 4.5 working days per month, which adds to the economic cost of living with migraine. According to the results of a global study of disease burden among migraine patients for whom preventive therapies failed, published in the Journal of Headache and Pain (J Headache and Pain. 2018;19).
However, migraine attacks don’t just affect the sufferer. Loss of work productivity and absenteeism in patients with undiagnosed migraines can have a significant economic impact on both employers and society as a whole. Migraine also represents a greater global economic burden than all other neurological conditions combined. Globally, migraines affect women three to four times more often than men, and attacks are often more severe for women. In the Gulf, women are twice as likely to suffer from a migraine.
Delayed diagnosis can drain health care resources, as these patients may visit many doctors in search of help and treatment. Consequently, this may lead to increased utilization of health care, longer waiting times, and less access to care for those in need.
Facts about migraines
From the American Migraine Foundation:
Migraine is one of the 10 most disabling diseases in the world.
* Less than 5 percent are accurately monitored and diagnosed by healthcare providers.
Most migraine sufferers have a few attacks per month, but 2 percent have chronic migraine headaches more than 15 days a month.
Migraines are 3 times more common in women than in men. Migraines affect more than 30 percent of women over a lifetime.
Taking non-specific preventive medications by mouth cut headaches by half in about 40 percent of patients taking these medications.
* It is estimated that up to 148 million people worldwide suffer from chronic migraine.
* It costs more than $20 million each year in the United States due to direct medical expenses and lost productivity.
* More than 80 percent of patients stopped taking their medications after 12 months.
In more than 90 percent of those affected, migraines interfere with education, employment or social activities.
* In 2018, the Food and Drug Administration approved three preventive therapies specifically designed to treat migraines.
Migraine is the third most common disease in the world, affecting 1 in 7 people worldwide.
* Migraine headaches cannot be cured completely, but its symptoms can be managed with a range of appropriate medications and methods.
One-third of migraine patients experience an aura, a group of neurological symptoms such as seeing lines, zigzag patterns, a colorless hole in vision, numbness, weakness, or dizziness, before the headache occurs. Some people only have an aura without the headache.
* People with migraines, especially those with migraines with aura, should be aware that they have a higher risk of having a stroke.
* Many people with migraines may be symptom-free for years and never know they have a migraine. Others have frequent migraine attacks and can be very debilitating. Some people also experience symptoms between episodes.
* People who suffer from migraines are also at risk of developing medication overuse headaches. This occurs when overuse of pain and migraine medications causes rebound headaches, turning migraine attacks into persistent, relentless headaches.
* Most people do not know they have a migraine until they begin to have attacks, which are usually sudden attacks, or attacks that involve a group of neurological symptoms such as severe headaches, sensitivity to light, noise, and smells, nausea, vomiting, and in some cases weakness, numbness, dizziness, and vision problems.
Awareness and care
Finally, Dr. Shereen Qureshi stresses that addressing underdiagnosis of migraine is critical to minimizing these individual and societal effects. In this sense, education and awareness campaigns, improving access to health care services and better training for physicians would contribute to early detection, appropriate treatment and better management of migraine treatment.
In any case, there is still a great deal of work ahead. There is no doubt that we have the ability to enhance migraine detection rates and mitigate the associated effects on individuals and society, by enhancing public awareness and developing the capabilities of our healthcare system. It is critical for individuals, health-care providers, policy-makers and society as a whole to join forces in a unified effort to compensate for the shortcomings of undiagnosed migraine and to enhance the general well-being of those suffering from this disabling condition.
Community medicine consultant
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