Under-diagnosed but very treatable: Expert explains how migraines can be managed

Neuro-ophthalmologist Deborah Friedman, former president of the North American Neuro-Ophthalmology Society, detailed lifestyle changes and new treatment options to tackle migraines

Migraine is a common but under-diagnosed disease, affecting one in every five women and one in 10 men, says Deborah Friedman, neuro-ophthalmologist and headache medicine specialist from the United States. Though there is no known cure, migraine is the most treatable among all neurological diseases, she says.

A former member of the Board of Directors of the American Headache Society and former president of the North American Neuro-Ophthalmology Society, Dr. Friedman was in Hyderabad to deliver a lecture at the ongoing four-day annual conference of the Indian Academy of Neurology (IANCON 2024).

Symptoms differ among patients

“Migraine symptoms differ from person to person. About 25% of patients experience an ‘aura’, which is like a warning before a migraine attack. These include visual disturbances, slurred speech, difficulty in coming up with the right words, sensitivity to light, neck pain and uncontrollable yawning for no reason,” Dr. Friedman told The Hindu on the sidelines of IANCON meeting.

Awareness plays a key role in the early diagnosis and treatment of migraine. Triggers should be identified and have to be avoided, she said.

“Lifestyle changes such as sticking to a strict sleep schedules, maintaining meal timings, staying hydrated and stress management play a vital role in controlling migraines,” she said.

“While there is no known cure for migraine, new treatments are available like CGRP inhibitors, drugs such as lasmiditan and triptans, which can reduce the severity and frequency of attacks. Devices like Nerivio, a band that can be worn on the upper arm for a specific time period, also provide relief from pain. There are peptides, which can provide pain relief too,” she said.

Migraine in children

Migraine in children is another area that is neglected most of the time, she pointed out. This may be due to parents thinking that their children are looking for excuses to skip school or other work. The prodrome (early symptoms) can occur days before an actual migraine attack. These can include unexplained mood swings – either good or bad – and light sensitivity.

Among children, the incidence of migraine is seen more among boys compared to girls. However, post-puberty, it is seen more in girls, she said.

Published - October 18, 2024 09:12 am IST