7/15/2024
Headaches are prevalent in the general population. At any given time, nearly 16% of all people in the world have a headache, according to an article in The Journal of Headache and Pain.
When the headache is the disease itself, it is a primary headache. When the headache is a symptom of another disease, such as a brain tumor or infection, it is a secondary headache.
The most common primary headache is tension-type headache. Almost everyone has had this type of headache at some point in their lives. These headaches are not severe, not associated with light and noise sensitivity, and not associated with nausea and vomiting. Most people do not seek medical attention for these headaches, because they are not disabling. Common trigger factors include lack of sleep, skipping meals and stress.
The second most common headache is migraine. They are more severe and likely to lead a person to seek a medical evaluation. Migraine is defined by severe individual headache episodes and by the presence of light and noise sensitivity, nausea and vomiting. Not all individual headache episodes are severe, though; some may be mild.
Migraine is a neurologic disease caused by a genetic predisposition for severe headaches. They are not life-threatening, but they can be significantly disabling and result in a poor quality of life. According to the American Headache Society, approximately 18% of all females and 6% of all males have migraines. In males, they are more common before puberty.
While there is no cure for migraines, there are many medications that can provide some relief.
Preventive medications can decrease the number of days a patient has headaches and minimize the frequency of migraines. These include non-migraine specific medications for treating seizures, depression and high blood pressure. Migraine specific medications include so called “gepants” and calcitonin-gene related peptides monoclonal antibodies (CGRP mAb).
To treat individual headache episodes and minimize the associated pain and disability, over-the-counter medications such as ibuprofen or acetaminophen are recommended. The goal is to alleviate the pain within two hours. For those who do not find relief with these medications, prescription drugs such as sumatriptan and rizatriptan may be prescribed. There are also “gepants” approved for treating the headache itself, when it comes.
Before talking with your physician, track the frequency of total headaches versus the frequency of migraine episodes. This information will help your physician determine a treatment plan tailored for you.
Migraine is also common in the pediatric population. The options to minimize the frequency of headaches and to treat the headaches themselves, when they come, are limited. Marshall Neurology is conducting several clinical trials aiming to find out whether there are medications that are effective and safe in this age population.
J. Ivan Lopez, MD, is a Marshall Health neurologist, professor at the Marshall University Joan C. Edwards School of Medicine and fellow of the American Academy of Neurology and American Headache Society. Additional information about clinical trials in migraine in children and adolescents, please call 304.691.1836.
This content was previously published in The Herald-Dispatch.
Michele McKnight
Assistant Director of External Affairs
304-691-1713
mcknigh4@marshall.edu
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