- They explain that this disorder “is not just an intense headache”; It is the second cause of disability and mainly affects young people of working and reproductive age, which influences their quality of life.
- They remember that their diagnosis is clinical and warn against the stigma associated with migraine. “Our nervous system is much more complex than previously thought”
More than five million people suffer from migraine in Spain, and it is estimated that this intense, in many cases disabling, pain affects more than 1% of the world's population. Neurologists of the health group Ribera They assure, however, that “we increasingly have more therapeutic and pharmacological options for patients.” The head of the hospital's Neurology Service Ribera Povisa (Vigo), Dr. José Ramón Lorenzo explains that there are treatments for moments of acute pain and others to try to prevent or minimize the number and intensity of the episodes. In any case, he assures, "the diagnosis of migraine is clinical and imaging tests are performed to rule out other causes that could cause headaches, not to diagnose that a person suffers from migraine."
Dr. Pilar Alcántara, neurologist at the Torrejón University Hospital, explains that “a migraine is not just an intense headache; It is the second cause of disability in Spain and affects especially young people of working and reproductive age, greatly interfering with their professional fulfillment, as well as their family and personal enjoyment.” “Patients suffer a considerable loss of quality of life and have a strong feeling of incomprehension by the rest of the population,” he adds.
Regarding advances in pharmacological treatments, Dr. Lorenzo explains that “at the time of pain, NSAIDs, triptans, benzodiazepines and antiemetics are prescribed to try to control it; and when the patient has headaches for many days a month, we recommend preventive medication, depending on the patient and the case, benzodiazepines, calcium antagonists, beta blockers or antiepileptics.” In addition, he adds, "subcutaneous infiltrations can be used in trigger sites in the skull, with local anesthetics or botulinum toxin," he explains, while recalling that a new generation of drugs has recently been released that try to reduce the number of days of headache, with a human monoclonal antibody, which binds to the calcitonin gene-related peptide receptor: CGRP.
The head of the Neurology Service at the Ribera Povisa hospital (Vigo), Dr. José Ramón Lorenzo, assures that migraine “is a complex neurological disorder, which is characterized by episodes of headache and other neurological symptoms that can also occur also between the theoretically migraine-free periods, known as the interictal phase.”
Migraine phases
Dr. Lorenzo gives a brief description of the phases of migraine, each with its characteristic symptoms, which he classifies as:
- Prodromal or premonitory: yawning, food cravings, polyuria, mood swings, irritability, photosensitivity, neck pain and cognitive dysfunction.
- Visual aura: vision of lights or lines or loss of vision, tingling and paresthesia, numbness or swelling of the hands, face or tongue.
- Pain: usually unilateral (hemicranial), pulsating or throbbing. It gets worse with regular physical activity. It is associated with nausea and vomiting and is bothered by light and noise.
- Postdromic: tiredness, difficulty concentrating, neck stiffness, nausea and discomfort due to light or noise.
Advances in Neuroscience
Pilar Alcántara, neurologist at the Torrejón University Hospital, emphasizes the advances in Neuroscience, which are helping a lot to improve the understanding of pain. “Pain is an unreliable indicator of the existence or extent of damage: there can be enormous damage without perceived pain, or absence of damage with very disabling pain,” she says. In fact, he explains, the most characteristic symptom of migraine is “a very intense unilateral headache with a pulsating or throbbing quality that usually worsens with head movements and is sometimes accompanied by nausea, vomiting, sensitivity to light, sounds, and odors, dizziness, blurred vision, concentration difficulties and hypersensitivity of the scalp.”
Dr. Alcántara warns that sometimes there is a tendency to minimize its severity and disability when comparing it with other diseases that are more socially accepted. “Sometimes it is unfairly labeled as a purely psychological problem and the relationship with stress makes many patients feel guilty,” although it is an “obsolete view of the pathology.”
The Neurology Service of the Torrejón Hospital has launched a Patient School to help those who suffer from these episodes, in order to improve their quality of life. Anyone can sign up for this link.
