Migraine affects over 13% of the global population with females 2 times more likely than males (~18 vs 10%) to suffer from the disease.
An individual is said to have migraine if within his/her lifetime there have occurred 5 or more attacks of headache, each lasting 4-72 hours, severe enough to restrict routine daily activity, and accompanied by nausea or light/sound sensitivity.
Only 20-25% of migraineurs experience aura, and in that minority who do there are relatively few who experience aura with each and every attack.
The headache of migraine may not be intense on every occasion; some migraine attacks may involve no headache (aura without headache), and many attacks may involve headache that is mild in intensity and more suggestive of tension type headache than migraine.
The aetiology of migraine is multifactorial and influenced by diet, lifestyle factors, and hormonal changes. Migraine has a clear tendency to run in families and this suggests a strong genetic component.
The risk for the common forms of migraine-migraine with aura and migraine without aura- is increased when a first degree relative has migraine with heritability estimates of 50-65%.
The disorder likely reflects a genetically induced hypersensitivity involving neurons located within the central nervous system. If a genetically primed neuron is triggered by a change in the external environment (eg drop in barometric pressure) or internal environment (eg sudden drop in oestrogen level), that neuron may activate and trigger its neighboring neurons to join in, inducing the pathways in the brain that conduct head pain to produce a migraine attack.
Headache, The Journal of Head and Face Pain, Rothrock, 2008
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