THE LATEST ON MIGRAINE

BY ALLAN L. BERNSTEIN, M.D.

MIGRAINE IS THE MOST PREVALENT NEUROLOGIC CONDITION IN THE U.S.

It’s also the one that gets the least notice.

Since it’s not a fatal condition — or one that leads to long hospitalizations — it tends to be dismissed as “just a headache,” in spite of producing severe pain, nausea, light sensitivity, sound sensitivity and fatigue.

Migraine affects 20 percent of adult women, 10 percent of adult men and 10 percent of children. It’s most common between the ages of 16 and 6, thus having a major impact on school and work for a significant portion of the population. Since there is no animal model, or genetic or laboratory marker for migraine, research in the field has been frustratingly slow.

Migraine is most common between the ages of 16 and 46, thus having a major impact on school and work for a significant portion of the population.

he first migraine-specific medication, dihydroergotamine (DHE), was developed in the 19 0s. he next breakthrough came in the 19 0s with the development of the triptan medications such as sumatriptan (now sold under a variety of prescription names, including Imitrex). Botox for migraine relief was introduced in the 1990s but, due to cost and the need for 20 to 2 injections every three months, it has not become a mainstay of treatment.

The most recent medical advance arrived in the last two years with the observation that a specific chemical in the brain, calcitonin gene related peptide (CGRP), plays a major role in the physiology of migraine events. Multiple pharmaceutical companies have developed medications that block the effect of GRP in the brain, either via pill or injection, as a treatment for acute attacks and, potentially, as a means of preventing onset.

Other areas under investigation include nerve stimulators, psychedelic medications and various cannabis extracts, though these studies are so far inconclusive.

If you suffer from frequent, severe headaches, you should discuss it with your primary care provider to get the proper diagnosis and plan for treatment.