Migraine is a common, underdiagnosed, undertreated, chronic recurrent disease that can significantly impact the quality of life of those affected.

In a WHO Global Burden of Disease study, migraine currently ranks 7th out of 289 diseases worldwide. Migraine occurs with a prevalence of 10 to 15% in adults and 3 to 10% in children. Women between 25 and 55 are up to three times more likely to be affected than men.¹

Characteristic of the neuronal disease is the severe, usually unilateral pulsating-pounding headache. Acute attacks are often accompanied by loss of appetite, nausea, vomiting, photophobia, phonophobia, and osmophobia.² Pathophysiologically, neurogenic inflammation develops in the area of the dural vessels, triggered by activation of the trigeminovascular system.

In migraine treatment, a distinction is made between acute therapy and migraine prophylaxis, with drug and non-drug treatment methods being used in each case.¹ The aim of prophylaxis is to reduce the number of migraine days by up to 50%. The beta-blockers propranolol and metoprolol, the calcium antagonist flunarizine, and the antiepileptic drugs topiramate and valproic acid are considered the first-choice substances for this purpose. Even at lower doses than in their original indication, they reduce the sensitivity of cells of the cortex to form a “cortical spreading depression”.²

¹ Wöber C., DFP literature: diagnosis and therapy of migraine. CliniCum neuropsy, issue 02/2014, pp.30-36.

² German Society of Neurology, Guidelines for diagnosis and therapy in neurology. Headache and other pain: therapy of migraine. (Status: March, 2013)