Migraine is a very common pathology worldwide, including in Portugal. According to the 2018 Health Portrait, in Portugal, migraine represents the second cause of morbidity in women and the fifth in men. It is more frequent in women (usually in adolescence, reaching its peak in the 3rd decade, then decreasing with advancing age). The onset of migraine after the age of 50 is uncommon.
Migraine is a neurological disease manifest by episodes of severe and disabling headache.
There are two main subtypes: migraine without aura (most frequent) and migraine with aura.
Migraine without Aura
- Headache episodes lasting between 4 and 72 hours
- Usually, unilateral headache
- Moderate to severe pain
- Possibly with a throbbing sensation
- Possibly aggravated during routine physical activity
- Possibly associated with nausea/vomiting
- Possibly associated with photophobia (intolerance to light)
- Possibly associated with phonophobia (intolerance to noise)
Migraine with Aura
In this subtype, in addition to headache episodes with the features mentioned above, patients present transient neurological signs/symptoms referred to as aura.
- These neurological manifestations typically precede or accompany the headache episode and last less than 60 minutes.
- The most frequent aura are visual phenomena, which can be manifest in different ways but in most cases tend to be luminous flashes, dark mosaic-shaped spots or shiny zigzag images. In other cases, the aura could be sensitive - changes in lateral sensitivity or on one side of the body, such as numbness or tingling; and it may affect language or muscle strength.
Unlike episodic migraine, chronic migraine is characterized by more than 15 days per month with headache, and at least 8 of these episodes must have the features mentioned above. Chronic migraine can be associated with secondary headache, associated for example with the abuse of analgesic medication.