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)