Chronic migraine needs early diagnosis, timely attention and lifestyle management, neurologists say

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One out of every seven people suffers from migraine and the chronic kind affects two per cent of the world population. Migraine is the manifestation of our stressful lifestyles and the shooting pain associated with it can be as debilitating as an acute physical injury. So much so that it is still among the most common causes of lost work time and lowered quality of life in 90 per cent of sufferers with an attack lasting anything from four hours to three days.

However, with the right awareness, pain and lifestyle management protocols, one can get through the phase. As part of the migraine awareness month, experts at a webinar debated the need to identify the signs, triggers and avoid dependence on painkillers. Most sufferers get a painful attack once or twice a month. If the condition is chronic, an individual gets headaches more often. Chronic migraine lasts for 15 or more days in a month, for at least three months, and intensifies for at least eight days. It is the second most disabling condition worldwide, the experts added.

Headache disorders are among the top ten causes of disability and are some of the most frequent medical complaints: almost everybody has experienced them, at least 10% of adults everywhere are sometimes disabled by headaches and up to 3% live with them on more days than not. Hence, experts feel, there is a need for early diagnosis and specialised care.

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Dr Anil Venkitachalam, Consultant – Neurology and Movement Disorders, Nanavati Max Super Specialty Hospitals, told The Indian Express that migraine has always been prevalent but nowadays the awareness and knowledge about it had increased . “As a result, more affected individuals are coming to seek medical help. The numbers are increasing due to lifestyle issues, improper diet and stress. Lack of exercise is also another contributory factor,” he said.

He, however, ruled out that migraines cause a stroke . “Migraines generally do not cause a stroke . In fact the association between stroke and migraine is weak and a few anecdotal reports have been noted. However, since both migraine and stroke share similar symptoms, they are often confused or misdiagnosed. Very rarely overuse of drugs that are used to treat a migraine attack like ergot or triptan-containing medication can lead to a stroke,” the neurologist said.

According to the International Classification of Headache Disorders, third edition, headaches are classified into 14 categories with further subclassifications. It is therefore imperative to differentiate a chronic Migraine from the rest. It usually begins with less frequent headaches that progress to a more frequent pattern. Several other risk factors have been implicated with migraine pain progressing into persistent pain.

“Chronic migraine develops over time and is a result of factors such as obesity, excessive consumption of caffeine, irregular sleeping patterns, stress and genetic disposition amongst others,” Dr Venkitachalam said. He further emphasised how it affected more women than men. “Women are three times more affected by chronic migraine than men. Typically, women are worst hit in their thirties, when the consequences of days lost to the debilitating pain can be tremendous. This is due to the fluctuation of a hormone called estrogen, which in women, contributes to the development of chronic migraines. While in childhood, the migraine is more prevalent in boys. However, with the influence of estrogen, the prevalence in women rises,” he said while addressing the webinar.

Dr Rishi Jain, Medical Director, AbbVie, said that chronic migraine is an under-recognized and an under-treated condition. A timely diagnosis and appropriate supervision can significantly improve the quality of life. Chronic migraine treatment starts with managing lifestyle changes such as adopting an exercise plan, managing stress, staying hydrated along with identifying headache triggers. It is important to keep a headache diary which is useful in recording details of your migraine attacks or headache, such as possible triggers, duration, severity. This diary can prove helpful during a diagnosis, Dr Jain advised.

Patients, who frequently self-medicate with analgesics and painkillers to treat headache episodes, must contact a specialised neurologist early to avoid headache chronification and medication overuse disorders, the experts suggested.

(June is headache and migraine awareness month)



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