Migraine
by
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In general 70% of headaches are tension-type headache, 30% of headaches are migraine and less than 1% of headaches are something else such as acute bacterial sinusitis, a brain tumor, or some other organic type of headache.
In the clinical interview at the start of this chapter the patient fits the pattern of migraine without aura. In general 70% of migraines are migraine without aura and 30% are migraine with aura. Many patients who lack the typical visual symptoms of migraine with aura doubt they have a diagnosis of migraine, perhaps because of the media’s stress on visual aura type symptoms.
Migraine is familial in occurrence and about 80% of patients who have migraine will have someone in their family with it. The problem here is accurate diagnosis and many patients will state their mother had "sinus headache" not knowing that these may really be migraine. The clinical historian has to be vigilant and inquire about the gamut of pseudo names migraine may be called to get the history straight.
Migraine occurs in women about three times as often as men. Studies of the US population have revealed about 30 million American migraine sufferers, with a female to male ratio of 3:1. The prevalence of migraine in the US is 1 person with migraine for every 4 households. Migraine is a disabling condition and is more prevalent than diabetes and asthma combined. About 18% of the US population of women has migraine, while 6% of men have it. Patients with migraine are generally first seen by their primary care doctor. The median pain intensity of a migraine attack is said to be 8, on a scale of 1-10 and the median duration of an attack is 18-24 hours. About one third of patients with migraine miss at least one day of work every 3 months. Migraine is said to be the most common chronic human health problem for women. Migraines occur with an estimated mean frequency of 1 to 2 per month. Headache severity is described as “severe” or “very severe” by 60% to 80% of migraine sufferers. Migraine has been stated by the World Health Organization to be one of the world’s most disabling medical illnesses.
In opposition to the great economic and quality of life impact due to the frequency and intensity of migraine headache, only about 56% of patients have ever had a medical diagnosis, and in the year 2000 only 17% had been given prescription drugs.
People with migraine often have motion sickness either in childhood or adulthood.
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About the Book
Migraine is an enormous health problem and is the most common medical condition for women. Most books on headache have short chapters on migraine but this is a comprehensive textbook written from an evidence based medical perspective. Teaching type patient dialogues are included for the clinical chapters on migraine along with an up to date review of current therapy. Cutting edge issues such as medication overuse headache and an indepth summary of the history of migraine are included. The author has also written on unusual and rare migraine associated conditions such as: Footballer's migraine, Retinal migraine, Vertigo and migraine, Primary headache associated with sexual activity, and Confusional migraine.
About the Author
Dr. Daniel trained in neurology at the Mayo Clinic and is a member of the American Academy of Neurology and the American Headache Association. He has been practicing in Dallas Texas since 1982. He recently published as ebooks 2 novels: If Thine Eye Offend Thee, the first in a series about a mystery solving physician and his side kick, and Titanic: Answer From the Deep, a 960 page transgenerational story about a medical family who emigrates to America aboard the doomed Titanic. Recently Dr. Daniel published another neurologic textbook: Transient Global Amnesia reviewing the literature and clinical status of the most strange and unusual clinical syndrome in Neurology--Transient Global Amnesia.>