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Emmanuella Otabil

Cell Biology

Professor Steel

April 24, 2017

The diagnosis and Treatment of Chronic Migraine

The topic I chose to write about is chronic migraine and how it affects the cells in our

body. Im interested in this topic because chronic migraine is the most common disabling brain

disorder. Chronic migraine, a condition characterized by the experience of excessive and extreme

headache at least 15 days per month, and is highly disabling. Patients with chronic migraine

present to primary care, are often referred for management to secondary care, and make up a

large proportion of patients in specialist headache clinics. Many patients with chronic migraine

also have medication overuse, defined as using a compound analgesic, opioid, triptan or ergot

derivative on at least 10 days per month. All doctors will encounter patients with chronic

headaches. A research was conducted to identify the causes and what triggers a migraine attack

and the effect migraine has in the brain.

Migraine affects over 20% of people at some point in their lives; epidemiological studies

have shown that 4.5% of the population of western Europe has headache on at least 15 days per

month. The first step to diagnosing migraine is the recognition of the pattern; when assessing a

patient with chronic headaches, it is important from the outset to ascertain how the headaches

originally developed. According to PubMed, there are two typical patterns. In one case, the

patient has a pre-existing primary headache disorder until they reach a stage they do not recover.

The second set is when patients start to have a headache one day and it simply never goes away.
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It is important to recognize a pattern and study because some migraines have a genetic basis. An

accurate history taking is vitally important in the diagnosis of migraine. It is important to give

patients time to describe their attacks fully (it may well be the first time that anyone has listened

to them talk about their pain), and to clarify the history with specific questions aimed at filling

out the gaps in what the patient has told you spontaneously. The diagnosis of migraine lies in the

history, and that the purpose of examination is primarily to look for other problems that may be

intensifying an underlying tendency to migraine. Migraine is clinically heterogeneous within and

across individuals. Individuals with migraine can experience a different combination of

symptoms, often related to severity, and at different periods in their life time. For example, some

attacks may be mild, with mild nausea or photophobia only. If untreated this attack may escalate

into a typical migraine headache as per definition. Epidemiological and experimental evidence

suggests that these milder headaches, which are often defined as tension-type headaches, are

biologically migraine headaches.

Per Dr. Yurgelun-Todd, individuals who have migraines are experiencing a

neurobiological change that cause cells to die. Loss of tissue may not have an effect at first, but if

you have enough, you may end up being less efficient cognitively. Although migraines dont

necessarily have a cure, they are manageable and migraine-induced volume loss is reversible

with treatment. Knowing that each migraine has a (mostly) permanent effect on your brain

structure, the best thing you can do is start writing down patternsincluding what you ate, your

environment, and where you are in your menstrual cycle to determine what triggers your

migraines. It is vital to make a diagnosis and ensure that any concomitant medical or

psychological conditions are treated in parallel with interventions aimed at reducing the

biological tendency to headaches.

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Works Cited

Bahra, Anish. "Primary Headache Disorders: Focus on Migraine." Reviews in Pain. SAGE

Publications, Dec. 2011. Web. 24 Apr. 2017.