1 Introduction Migraine Is A Disabling Headache Disorder Characterized By Intermittent Attacks With A Number Of Physiological And Emotional Stress...

820 words - 4 pages

Migraine is a disabling headache disorder characterized by intermittent attacks with a number of physiological and emotional stressors associated with pain, tiredness, nausea, vomiting, photophobia, or phonophobia. [1]. Migraine is multi-mechanistic disease and associated with wide array of symptoms including nausea, vomiting and increased sensitivity to light and sounds. Migraine attacks can be unilateral throbbing headache, worsened by movements and routine daily activities, and lasting from 4 to 72 h. The underlying mechanisms of migraine interspersed with acute symptoms of attack appear to be increasingly complex. An important aspect of migraine heterogeneity is comorbidity with other neurological diseases, cardiovascular disorders, and psychiatric illnesses [2]. Migraine associated aura is associated with peripheral sensitization is an acute, chemical-induced form of functional plasticity, which converts high-threshold nociceptors into low-threshold sensory neurons. This form of sensitization occurs in migraine attacks where the nerve terminals (meningeal nociceptors) of the neurons of the trigeminal ganglion are soaked with the "inflammatory" soup (prostaglandin E2, bradykinin, serotonin and cytokines) along with the vasculature of the cerebral dura mater [3].
Pharmacological treatment for migraine falls into two main categories: symptomatic (acute) and prophylactic [4]. Despite the pharmacological advances for the treatment of migraine headaches, patients are forced to endure symptoms until the medications take effect and so experience a poor quality of life despite an aggressive regimen of pharmacotherapy [5]. Current acute symptomatic therapy for migraine includes NSAIDS, and migraine specific therapies such as triptans and ergot derivatives play important role in aborting the migraine attacks [6]. Such symptomatic treatments can be quick and effective for pain relief and disappearance of associated symptoms (nausea, photophobia and phonophobia). However, inability to provide complete full pain relief and contraindications such as cardiovascular diseases [7] limits the use of symptomatic treatments. Therefore, prophylactic (preventive) treatment of migraines is recommended for patients with frequent and/or disabling attacks. Most of the drugs recently used in migraine prophylaxis have been identified by serendipity and they have been originally approved for other indications [8]. Most notable amongst them are antidepressants [9]., beta-adrenergic blockers, calcium channel blockers and antiepileptic drugs for migraine prevention [8] . However, use of these agents is limited by inconclusive evidences on targets of migraine prophylaxis (reduction in frequency and intensity of attacks and to decrease disability related to chronic headache) and dose limiting side-effects.
Stress is reported to impact the migraine sufferer on many levels...

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