Migraine, now shown to be a genetic neurological disease as opposed to a vascular condition, is one of the most debilitating and widespread conditions, affecting roughly 10 percent of people around the world. The Institute of Medicine just reported that 100 million people in America have chronic pain and about 40 million suffer with Migraine. Migraine pain can reduce a person's quality of life and impact their physical, social and work schedules.
Dr. David Dodick, Migraine specialist, and professor of neurology and director of the headache center of the Mayo Clinic in Scottsdale, Arizona, confirmed this thinking, saying,
"Today we know that Migraine is a largely inherited disorder characterized by physiological changes in the brain, and, if attacks occur with high frequency, structural alterations in the brain. This is a neurological disease with systemic implications."
Because episodic Migraine can morph into chronic Migraine, it's important that Migraineurs modify risk factors to help reduce future attacks. According to Dr. Dodick, some potentially troublesome medications that increase the risk of Migraine include barbiturates, opioids, over-the-counter pain relievers and triptans if used in excess. Triptans, a common abortive medication for Migraine, were developed to help decrease swelling in the membranes of the brain and spinal cord, and to reduce blood vessel constriction.
Snoring, head trauma, depression, being overweight and too much caffeine can be risk factors as well. Dodick went on to say people who are obese have a five times greater risk for getting Migraines than those of healthy body weight and people with depression are at a three times greater risk than those who do not have depression.
These risk factors need to be taken into account when coming up with a Migraine prevention plan. Primary care doctors can manage some of these risk factors, but need to be educated about how to help Migraineurs accomplish this. According to Dr. Dodick, physicians can use the new guidelines established in April by the American Academy of Neurology and the American Headache Society. "Physicians should use the guidelines to individualize treatment - based on coexisting and comorbid conditions which may be present in their patients - with medications that have the highest level of evidence." The guidelines support a preventive plan that include blood pressure medication, antidepressants and even plant extracts such as butterbur and feverfew.
Alarmingly, Dr. Dodick reports that close to 40 percent of Migraineurs should be on a preventive regime, but that only 10 percent actually are, saying,
"Doctors just want to treat the pain because they have little time to spend with patients to explore other options. They need to start thinking about the treatment of Migraine in a disease model context, in much the same way as hypertension or diabetes."
Abortive treatments can be used at the first sign of a Migraine attack, while preventive medications are used to help prevent a Migraine. Dodick also that, in certain studies, people who are on a preventive regime can reduce their Migraine attacks in half, dramatically improving quality of life.
American Pain Society. "Risk Factor Management Helps Prevent Migraine Attacks." Press Release. Glenview, IL. May 17, 2012.
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© HealthCentral Network, 2012.
Last updated May 22, 2012.
Published On: May 23, 2012