Various studies indicate that about 12% of the Spanish population suffers from migraine. This percentage rises to 18% in the case of women. And the result is that this pain has become the first cause of disability in people under 50 years of age, especially in middle-aged women.
It is a disease that occurs in several phases. As the doctor explains Ana Gago Veiganeurologist responsible for the Headache Unit of “although pain is one of the most disabling symptoms of a migraine attack, it is not the only one. Unfortunately, a migraine attack encompasses much more.”
The phases of migraine
As Dr. Gago explains, what we could call the first phase of migraine occurs 48 hours before the onset of pain.
1. “A significant percentage of patients present a series of premonitory symptoms such as changes in character, appetite, fatigue, drowsiness, neck stiffness, yawning, tiredness, concentration problems, feeling of mental slowness, irritability…”
2. “Then some patients have what we call aura, usually visual (image distortion…) but that can also be sensitive or have language impairment. To describe it in the words of the specialists from the Quirón Clinic, in this phase “blind spots appear in the visual field (scotomas), which are sometimes outlined with simple geometric designs, zigzag lines that gradually float through the field of vision, bright spots or stars, vision changes or loss of vision, flashes of light, or other less frequent disturbances such as tingling in one hand or one side of the face, difficulty speaking or language.”
3. And, after the onset of the symptoms prior to the crisis, comes the phase of the pain itself.
A pain that has specific characteristics:
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It gets worse if you move your head.
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Hypersensitivity to light, sounds or smells.
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Nausea and vomiting.
This phase of the headache itself is very disabling, often forcing people to lie down in a dark and quiet place. It can last hours to days, and the worst risk is that it can become chronic and occur daily.
You might think that when these symptoms disappear, the migraine ends, but this is not the case. Many people who have not suffered from it do not know that the fourth phase is still missing, because they are not aware that the migraine does not end suddenly.
4. “After the pain, the patient is left in a kind of hangover, with significant fatigue, discomfort and difficulty concentrating, which can last up to 24 hours,” explains the neurologist.
It’s not just a headache
The characteristics of migraine make it a very disabling pathology.
The appearance of a migraine attack prevents the sufferer from being able to carry out their activity, affecting their work and academic productivity.
This explains the high rate of work absenteeism of up to 14.6 days lost per year for people with chronic migraine.
However, despite its impact, it is a stigmatized pathology.
“An important part of society considers that it is a simple headache, and does not come to consider how disabling a day with a migraine is.
In fact, according to the WHO, a migraine attack can affect as much as a day with dementia or a day with tetraparesis (muscular weakness of the extremities).
For this reason, trying to reduce the stigma of this disease should be a priority objective. Because it supposes an increase in the suffering that our patients already have by themselves,” says Dr. Gago Veiga.
The consequences of failure to diagnose
As the doctor warns Paul Irimiaprofessor of Neurology at the University of Navarra, coordinator of the Headache Study Group of the ,:
“There continues to be a significant delay in the diagnosis of chronic migraine that can reach seven years.”
This situation worsens when patients reach a specialized consultation with the neurologist, since it can take up to 14 years from the first migraine attacks until they reach the specialist.
And these delays, in patients who go through all stages of migraine without diagnosis or treatment, cause many of them to be affected by mental disorders such as stress (51% of people with migraine), the (30% ) and the (22%).
Some factors that if not controlled can worsen the crises in terms of duration, frequency or intensity of pain.
Abandonment of treatments by patients
The long journey of migraine patients means that they may have received several previous treatments before referring them to the clinic.
For this reason, when they finally arrive at the specialized consultation, their distrust of the treatments is usually very pronounced.
And this causes that, as soon as it seems to them that the treatment does not meet their expectations, many patients decide not to do it as it should, or even abandon the treatment.
In this line, it should be noted that it is important to take measures, since there are treatments preventive against migraine that improve the quality of life of those who suffer from this disease.
“It is unrealistic to think that migraine can be cured with preventive treatment. The real goal of treatment is to reduce the frequency and intensity of the episodes and that the attacks respond better to symptomatic treatment,” says Dr. Irimia.