Migraine: The 7th Disabler

Migraine: The 7th Disabler

Imagine an excruciating throbbing pain down one or both sides of the head, sensitivity to light, dizziness, distorted vision, possible hallucinations, muscular problems and a feeling of nausea with possible continuous vomiting. Now imagine this lasting anywhere from four to 72 hours+ and a pain so severe that it may even prompt a visit to the emergency room. It’s not just a bad headache. It’s a migraine and anyone who suffers will recognise the symptoms and understand the magnitude of its effect on life.

Did you know…every 10 seconds someone in the US visits the emergency room with a migraine! 

Migraines are a complex neurological disorder, currently with no known cause and no known cure. Many who have not experienced a migraine show little sympathy and understanding of how debilitating migraine can be for sufferers.  

The World Health Organisation (WHO) recognise migraine as one of the most disabling conditions, with severe migraines comparable to dementia. WHO listed migraine as the 19th cause of disability in the world but the data collected was found to massively incomplete as many nations (such as China, India & countries in South East Asia weren't represented at all) One in four U.S. households include someone with a migraine and over 10% of the US population suffer. This means migraines are more prevalent than epilepsy and asthma combined. Migraine is ranked seventh highest among specific cases of disability globally and in the top ten causes of disability in 14 of the 21 world regions.*

Sadly, despite the negative impact migraine can have on a person’s work, family and social life, awareness and understanding around migraine is low. It is also the least funded of all neurological diseases, despite the huge impact it has on economies across the world. According to figures from the Migraine Research Foundation, in the US alone, it is estimated that 113 million workdays are lost each year due to migraine and this causes employers to lose an estimated $13 billion a year in productivity. 

Migraine Awareness Week 2015 is approaching from 6 to 12 September. Here, people across the world will be rallying to raise awareness and collect donations to support the scientific and medical work carried out in helping the millions of migraine sufferers. It’s an opportunity for employers to recognise migraines as a serious condition and to help the cause by displaying posters, organising fundraising events and showing general support. 

Migraine Awareness Week is organised by The Migraine Trust (TMT). Since 1965 TMT have funded over 138 medical research projects into the cause and effect of migraines. The key objectives of researchers around the globe are to understand migraine better, examine the biology of the condition including how changes in the brain cause migraine to take effect as well as how to improve the management and treatment of migraine. Ultimately, TMT, as well as work carried out by similar organisations The National Headache Foundation and Migraine Research Foundation, hopes to find a cure for migraine sufferers. 

This is a long way off though as progress has unfortunately been very slow. It is believed now that migraine disorder involves nerve pathways and brain chemicals and that genetics plays a part. Evidence links a number of genes and if one parent suffers from migraine there is a 40% chance their child will too. If both parents suffer then the risk increases to 90%. 

Hormones can also influence migraine with 10-14% of women in the US reporting a menstrual migraine which is more severe than at other times of the month. Estrogen influences the brain receptors that play a role in the development of a migraine. Women are therefore more prone to migraine with 27 million female sufferers in the US alone, broadly three times as many as men.  

Migraine-Brain-Image Scientists have identified that waves of electrical changes move across the brain (from back to front) during a migraine attack.  Brainstem activation can also be seen at the beginning of a migraine and shows up brightly on PET scans when a migraine begins.  The raphe nucleus and locus coeruleus maintain our mood and how we experience pain.  These areas, plus the substantial nigra and red nucleus (normally associated with movement) also appear to play a part in headache pain.  Our understanding of the cause and progression of migraine is frustratingly limited but we can see that overly-stimulated neurons and the trigeminal nerve play a significant part in transmitting pain

In the meantime, whilst research continues, migraines can be managed in order to improve daily life. Many people treat themselves with over the counter medicine and some preventative drugs are available too. Complementary treatment includes relaxation techniques, acupuncture, a good exercise regime and a healthy diet.  Others, however, require prescription medication such as triptans which help to return swollen blood vessels in the brain to their normal size and anti-sickness medication to combat nausea/vomiting. As Migraines slow down the activity of the gastrointestinal tract, sufferers often find it difficult for oral medication to be absorbed. Anti-emetic medication can help with this but other drugs are available via a medicated 'wafer' melted on the tongue or self-administered intra-muscular injections or pessaries.

However, with depression and anxiety being three times more likely with migraine sufferers and one third of people reporting discrimination problems at work, it’s a serious condition that needs a solution. 

If you have experienced migraines or know someone who does, you could help the cause to raise awareness to reduce stigma around migraines, by joining the thousands of other campaigners for Migraine Awareness Week.

*Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3606966/

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