What are migraines all about?

  Headache is one of the top 10 conditions commonly seen by outpatient physicians, with more than 90% of adults experiencing at least one headache per year, most commonly in young and middle-aged women. Migraine is a type of headache that comes from the ancient Egyptian description of a group of headache syndromes, a common clinical condition characterized by diffuse or unilateral attacks, severe pain, and recurrent episodes. Most people would conceptually misunderstand that a migraine is a migraine. But in fact, although a significant proportion of migraine headaches are indeed on one side, this is by no means the case for all of them. According to statistics, migraine accounts for only 60% of migraine headaches, while others are bilateral.  According to foreign data, the incidence of migraine is 12.9%-17.6% for women and 3.4%-6.1% for men. The prevalence of migraine in China is 985.2/100,000, and the annual incidence is 79.7/100,000. The recurrent attacks of the disease are difficult to be cured and cause great pain to patients.  The causes of migraine are still not well understood, including the vasculogenic theory, neurogenic theory, trigeminal vascular theory and genetic factors theory. Regardless of which theory, there are three key factors, one is the cerebral blood vessels, the second is the trigeminal nerve that innervates the blood vessels, and the third is the feedback loop between the afferent branches of the trigeminal system and the parasympathetic efferent branches. New research suggests that migraine is a disorder of one part of the brain.  Migraine is characterized by throbbing, unilateral episodic headaches, sometimes severe, without aura (formerly known as generalized migraine), usually accompanied by nausea and vomiting, and usually lasting 4 to 72 hours if not treated. Migraine is diagnosed in patients with these clinical features, but not all of them are present in every attack or in every patient.  The treatment of migraine can be divided into treatment during the headache attack and preventive treatment. Prophylactic treatment is a preventive treatment that is taken every day regardless of the migraine attack to reduce the frequency of attacks and reduce the pain level. For those who have more than 3 attacks per month, each attack lasts for more than 12 hours or have particularly pronounced symptoms, medication is needed for prevention. For example, long-term oral administration of Cipro, manufactured by Xi’an Janssen Pharmaceutical Company, can be effective in preventing migraine. Medications for the treatment of migraine attacks can be divided into migraine-specific and non-specific medications. Nonspecific medications such as aspirin, acetylamino acids, non-corticosteroid anti-inflammatory drugs, opiates, and combination pain relievers are used to treat a wide range of painful disorders. Specific medications include ergotamine, dihydroergotamine, and tretinoin, which are effective in the treatment of migraine and cluster headache, but are different from the treatment of other types of pain. Ergotamine and dihydroergotamine are a class of ergotoxine derivatives that have long been used in the treatment of migraine before the introduction of the tretinoin class of drugs. Although these drugs are effective in relieving migraine, their side effects, mainly nausea, abdominal pain and spasms, are more pronounced, especially with ergotamine. In recent years, with the increasing understanding of the pathogenesis of migraine, 5-hydroxytryptamine receptor agonists have been introduced, which are effective in the treatment of acute migraine attacks. Since the first triton drug, sumatriptan, has been used in clinical practice, the research on triton drugs has been flourishing and the prospect is very good.