By Brenda Owen

Daily Journal

For the more than 23 million Americans who suffer from them, a migraine is more than just a giant headache; it is an often debilitating and misunderstood disease.

Although there is no cure for migraine, much has been learned to manage the disease, including effective treatment programs, said Dr. Kenneth Gaines, a neurologist with Baptist Memorial Hospital - North Mississippi.

"Certain factors such as diet, environment and medications which trigger attacks can be eliminated or minimized," Gaines said. There are also medications which can be taken once an attack has started to alleviate much of the pain and discomfort of symptoms, he said. But, he added, there is no complete cure.

"Most people think of migraine as just a really bad headache, but it is more than that," Gaines said.

Migraine is a disease than can cause pain so bad many sufferers have wished they were dead during an attack. Unfortunately, the symptoms of migraine are often discounted as not serious, especially among young adults.

In a nationwide survey of 1,007 migraine sufferers, conducted by the Gallup Organization, researchers found that approximately half of respondents feel that their friends and family do not understand how serious and painful migraine is.

- Nearly three-quarters reported impairment of at least one type of activity. Of these everyday activities, approximately half said that leisure and socializing were affected and 45 percent said that driving was limited or impaired.

- Thirty percent of respondents says that migraine has hurt their career progress or earnings to a degree.

Signs and symptoms

Migraine is characterized by multiple symptoms including severe, recurrent pain, usually on one side of the head, Gaines said.

"Headache is not the only symptom of migraine," he said.

The head pain is usually accompanied with one or more of a variety of symptoms. The most commonly associated symptoms are nausea and vomiting. One recent study showed that 87 percent of migraine patients experience nausea and 56 percent experience vomiting. Other symptoms include increased sensitivity to light, sound and smells, scalp tenderness, malaise, and diarrhea. The associated symptoms may be more incapacitating than the head pain.

One migraine myth is that all people who suffer from migraine have "aura." Sufferers with aura may see light flashes, blind spots, zigzag lines, shimmering lights, and may experience head pain and other associated migraine symptoms.

Migraine can be broken into two general categories:

- Migraine without aura approximately 80 to 90 percent of all sufferers experience this type of migraine.

- Migraine with aura approximately 10 to 20 percent of migraine headache sufferers experience this type of migraine.

Migraine afflicts both men and women, although women tend to experience migraine more commonly than men by a ratio of approximately three to one. Peak prevalence for migraine in both genders is between the ages of 18 and 44.

On the attack

Research indicates that migraine does have physical triggers and causes, and 70 percent of sufferers are found to have a hereditary influence. If both parents have migraine, their children have a 75 percent chance of getting migraine, and a 50 percent chance if only one parents suffers from migraine.

"Typically, migraine sufferers experience an average of one attack per month, lasting anywhere from four to 72 hours," Gaines said.

Until very recently the cause of a migraine attack was largely a mystery, but Dr. Robert Smith, director of the Cincinnati Headache Institute, said in a recent article that many scientists now believe that migraine is caused by a sequence of events that cause blood vessels in the brain to tighten then relax, resulting in the throbbing pain of a migraine.

Migraine is a difficult disease to diagnose, treat and live with because it affects people differently, with symptoms and triggers varying by individual, Smith said. Approximately 20 percent of all migraine sufferers have a sensitivity to a specific food or foods. It is believed dietary factors account at least in part for the 60 percent increase in migraine prevalence over the last decade.

Gaines cited other triggers such as emotions, especially stress, anger, depression, resentment, anxiety and fatigue.

"Attacks may also be brought on by such changes in the environment as bright lights, strong odors, loud noises, temperature changes and cigarette smoke," he said.

Affect on family

In many cases, migraines not only affect the sufferer but family members become victims of the disease as well.

Opinion Research Corporation conducted a study for Glaxo Wellcome Inc. of 350 migraine sufferers and 77 of their non-sufferer spouses to learn how migraine impacts the individual sufferer's family.

More than 23 percent of sufferers with children surveyed reported that migraine has had a negative impact on their relationship with their children and 73 percent reported having missed activities with children because of migraines.

Data from the Centers for Disease Control (CDC) National Health Interview Survey indicated that migraine victimizes people living in all regions of the country, and extends across all occupations.

Migraine has a substantial impact on worker productivity. Based on a study of 648 migraine sufferers who sought treatment and met criteria for diagnosing migraine, it is estimated that the annual lost labor due to migraine may reach $6,864 per working male and $3,600 per working female. Some sufferers have even chosen less challenging career paths because their migraine attacks are so unpredictable and severe.

Despite the havoc wreaked by migraines, however, many people with migraine never seek treatment. Of those who participated in the same study, an average of 85 percent of men and 68 percent of women who reported having one or more headaches in the prior year had never consulted a physician about their headaches. The typical migraine sufferer waits an average of 3.5 years before consulting a doctor for treatment for their headache.

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