Migraine: Much More Than Just a Headache

Migraine is not just a headache: it is a chronic neurological disease characterized by recurrent attacks of intense headaches, often accompanied by nausea and sensory hypersensitivity.

Recognizing migraine

Diagnostic criteria

• Unilateral, pulsating headache, moderate to severe intensity
• Duration: 4 to 72 hours
• Worsened by physical activity
• Associated with at least one of the following symptoms: nausea/vomiting, photophobia, phonophobia

Migraine with aura (30% of cases)

Transient neurological symptoms preceding the headache:

• Visual disturbances (scintillating scotomas, zigzag lines)
• Tingling on one side of the body
• Speech disorders

Acute treatment

• NSAIDs: ibuprofen 400 mg, ketoprofen. First-line treatment.
• Triptans: sumatriptan, rizatriptan. Specific migraine treatment, to be taken at the onset of the headache.
• Antiemetics: metoclopramide for significant nausea.

Preventive treatment (if > 4 attacks/month)

• Beta-blockers (propranolol)
• Antiepileptics (topiramate)
• Antidepressants (amitriptyline)
• Anti-CGRP antibodies: revolutionary new therapeutic class (erenumab, galcanezumab)

Daily prevention

• Identify and avoid personal triggers (food, stress, lack of sleep, alcohol)
• Regular sleep and meal schedules
• Sufficient hydration
• Regular physical activity (proven preventive effect)