Abstract:
Migraine is a familial disorder characterized by recurrent attacks of headache widely
variable in intensity, frequency and duration. Attacks are commonly unilateral and are
usually associated with anorexia, nausea and vomiting".A subtype of vascular
headaches characterized by periodic unilateral pulsatile headaches which begin in
childhood, adolescence, or early adult life and recur with diminishing frequency
during advancing years. The two major subtypes are classic migraine (i.e., migraine
with aura) and common migraine (i.e., migraine without aura). Migrainous episodes
may be associated with alterations in cerebral blood flow. Migraine is most likely a
heterogeneous disorder and has trigger factors and multiple physiologic causes like
fatigue or emotional stress, Secondary to brain dysfunction, Specific foods or alcohol
etc. Symptoms of migraines are the result of a constriction and dilation or widening of
arteries in the brain. This process results in the classic symptoms of migraine, which
include a severe, throbbing persistent headache that increases in intensity. The first
step in getting correct treatment is to get a correct diagnosis. Differential diagnosis of
mlgrame may include medical history, headache diary, migraine triggers,
investigations (only to exclude secondary causes), EEG, CT Brain etc. Advances in
our understanding of the pathophysiology of migraine have resulted in important
breakthroughs in treatment. For example, understanding of the role of serotonin in the
cerebrovascular circulation has led to the development of triptans for the acute relief of migraine headaches, and the identification of cortical spreading depression as an
early central event associated with migraine has brought renewed interest m
antiepileptic drugs for migraine prophylaxis. However, migraine still remains inadequately treated. Indeed, it is apparent that migraine is not a single disease but
rather a syndrome that can manifest itself in a variety of pathological conditions. The
consequences of this may be that treatment needs to be matched to particular patients.
The management approach of migraine is to reducing the attack frequency and
severity, avoiding escalation of headache medication, educating and enabling the
patient to manage the disorder, improving the patient's quality of life. Clinical
research needs to be devoted to identifying which sort of patients benefit best from
which treatments, particularly in the field of prophylaxis. We propose four patterns of
precipitating factors (adrenergic, serotoninergic, menstrual, and muscular) which may
be used to structure migraine prophylaxis. Finally, little is known about long-term
outcome in treated migraine. It is possible that appropriate early prophylaxis may modify the long-term course of the disease and avoid late complications.
Description:
This thesis submitted in partial fulfillment of the requirements for the degree of Bachelor of Pharmacy (B.Pharm) in East West University, Dhaka, Bangladesh.