Migraine is a common disabling primary headache disorder. Many epidemiological studies have documented its high prevalence and socio-economic and personal impacts. In the Global Burden of Disease Study2010 (GBD2010), it was ranked as the third most prevalent disorder in the world. In GBD2015, it was ranked third–highest cause of disability worldwide in both males and females under the age of 50 years.
Migraine has two major types: Migraine without aura is a clinical syndrome characterized by headache with specific features and associated symptoms. Migraine with aura is primarily characterized by the transient focal neurological symptoms that usually precede or sometimes accompany the headache.
This week we will focus on migraine without aura. Previously, called a common migraine, it is a recurrent headache disorder manifesting in attacks lasting 4-72 hours. Typical characteristics of the headache are unilateral location, pulsating quality, moderate or severe intensity, aggravation by routine physical activity and association with nausea and/or sensitivity to light and sound.
Diagnosis requires a history of at least 5 attacks, lasting 4-72 hours with a least two of the following: unilateral location, pulsating quality, moderate or severe pain, or aggravation by routine physical activity. During the headaches the patient must exhibit nausea and/or vomiting or light and sound sensitivity.
Migraine headache in children and adolescents (aged under 18 years) is more often bilateral than is the case in adults; unilateral pain usually emerges in late adolescence or early adult life. Migraine without aura often has a menstrual relationship. Very frequent migraine attacks are now distinguished as a Chronic migraine. When there is associated medication overuse, both diagnoses, Chronic migraine and Medication-overuse headache, should be applied. Migraine without aura is the disease most prone to accelerate with frequent use of symptomatic medication.
