Migraine Fast Facts

Migraine is Common

• 38-40 million Americans are living with migraine
• Headache is the 2nd most common cause of years lived with disability worldwide, second only to back pain
• Nearly half of all people with migraine have not been diagnosed with migraine

Migraine is More Common in Females

• 1 in every 5 women in the U.S. have migraine
• 1 in every 16 men in the U.S. have migraine
• Migraine is 3:1 more common in adult females than males

Migraine is Disruptive to Everyday Life

• Migraine attacks can generally last from 4-72 hours
• Headaches of migraine attacks are often throbbing or pounding in quality
• Migraine attacks are usually made worse with routine physical activity
• Most people with migraine experience nausea during migraine attacks
• Light and sound sensitivity are usually part of a migraine attack

Phases of Migraine:

• Prodrome - lasts a few hours to a few days: difficulty concentrating, feeling tired, food cravings
• Aura (does not occur in most people with migraine) - visual disturbances like blurred vision or blind spots, among other symptoms
• Headache (4-72 hours) moderate to severe pain with light and sound sensitivity and/or nausea
• Postdrome - lasts a few hours to a few days: “migraine hangover,” difficulty concentrating, feeling tired

Migraine Medications

Acute Medications – taken when a migraine attack occurs

• NSAIDs such as ibuprofen or naproxen
• Triptanssuch as sumatriptan or rizatriptan
• Anti-nausea medications
• Ergots
• Gepants such as ubrogepant (Ubrelvy) or rimegepant (Nurtec ODT) – these medicines are CGRP receptor antagonists (CGRP receptor blockers)
• Ditans such as Lasmiditan (Reyvow)

Prevention Medications – used to prevent the frequency and lessen the severity of migraine attacks

• Antidepressants such as amitriptyline or nortriptyline
• Anti-seizure medications such as topiramate or sodium valproate
• Blood pressure medications such as propranolol or metoprolol
• Botox (onabotulinumtoxinA) injections every 3 months for chronic migraine prevention
• Monoclonal antibodies to CGRP or the CGRP receptor such as Aimovig (erenumab), Ajovy (fremanezumab), Emgality (galcanezumab), or Vyepti (eptinezumab)
• Magnesium
• Vitamin B2 (riboflavin)
• CoEnzyme Q10
• Folate

Non-Drug Treatment Options

• Nerivio – Remote electrical neuromodulation (REN)
• Cefaly

Chronic Migraine

• When a person with migraine has 15 or more headache days per month (eight of which are migraine days), for more than three months, the diagnosis is chronic migraine.
• When a person with migraine changes from having fewer than 15 headache days per month to having 15 or more headache days per month for more than three months, transformation to chronic migraine has occurred.
• People with chronic migraine tend to have greater disability from migraine than those with migraine.

Menstrual Migraine

• Menstrual migraine affects approximately 20% of women in the U.S.
• Often more difficult to treat than other migraine attacks.
• Menstrual migraine is likely triggered by a drop in estrogen that occurs just before the menstrual period.
• Menstrual migraine usually begins 1-2 days before the menstrual period and continues into the menstrual period.
• Menstrual-related migraine refers to migraine attacks around the menstrual period in a person who gets migraine attacks at other times of the month as well.
• Treatment can include both medication to take in the event of a menstrual migraine attack as well as medication taken just around the menstrual period to prevent menstrual migraine attacks.

Post-Traumatic Headache

• Post-traumatic headache develops within seven days of a traumatic event
• Acute post-traumatic headache lasts under three months
• Chronic post-traumatic headache lasts more than three months
• Traumatic Brain Injury (TBI): Each year in the U.S. 1.7million TBIs occur. Headache is the most common symptom of TBI
• Mild head trauma is more likely to lead to post-traumatic headache than is severe head trauma.
• Patients who do not lose consciousness are thought to be more likely to develop post-traumatic headache than those who lose consciousness.
• Anxiety and depression are risk factors for the development of post-traumatic headache.
• Characteristics of post-traumatic headache usually include those seen in migraine or tension-type headache.
• Treatment of post-traumatic headache is often the same as would be used to treat migraine.
• Non-drug approaches to treatment include physical therapy, biofeedback, relaxation, cognitive behavioral therapy, nerve stimulators