This research paper presents a discussion of migraines that includes classification and clinical presentation, epidemiology, general treatment approaches, and the drugs Zomig and Imitrex used for treatment. Discussion also offers treatment comparisons regarding cost, effectiveness, safety, and alternatives.
Migraines are found in all civilizations. A reliable description of migraine without aura (MO) dates back to the first century AD and descriptions of migraine with aura (MA) date from the seventeenth century. MO is characterized by a headache attack that lasts between four and 72 hours; it is usually severe, unilateral, pulsating, aggravated by physical activity, and accompanied by nausea, vomiting, photo- and phonophobia. MA is initiated by aura, for example reversible visual, sensory, motor, and/or aphasic symptoms; the headache is similar to that of MO (12:683).
Migraine etiology is largely unknown, however a gene was mapped for familial hemiplegic migraine to chromosome 19. Information regarding inheritance of more common types of migraine is less clear. The diagnosis of migraine currently relies on the headache history; measurements of urine excretion of 5-hydroxyindololacetic acid and cerebral blood flow are not used for diagnostic purposes. A lack of precision leaves individual interpretation which leads to false conclusions regarding genetic factors. The diagnostic criteria of the International Headache Society are currently used worldwide and have been adopted by the International Classification of Diseases, Neurological Adaptation (12:683-686).
Headache classification distinguishes between MO and MA however each is regarded as subtypes of migraine. Whether they are separate entities or not is a subject of controversy; clinical and pathophysiological differences suggest they are distinct entities. Differences are found regarding age of onset, influence of female hormones, precipitation by bright light...