National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru plans to establish headache centres and train primary care physicians to treat migraine cases that are on the rise. The Institute views that migraine produces maximum disability during the productive years of life. Therefore patients should access medical attention.
Migraine is 7th in the list of causes of years of life lived with disability as per the data from Global Burden of Disease survey 2010. The condition is not a chronic disorder but starts at the age of 20-30 years in majority. It is not only more prevalent in women, but also associated with greater symptoms, higher impact and poorer quality of life than in men, Dr. Girish Baburao Kulkarni, additional professor of neurology, NIMHANS told Pharmabiz.
Now NIMHANS supported by ‘Lifting the Burden’ (LTB) and WHO, conducted a population based study among patients with 1-year prevalence of migraine. It was reported that 25 per cent of the population in Bengaluru district indicated this condition and its impact was and higher among women and those from rural areas, he added.
The purpose of this study is because of a large gap of knowledge on headache disorders from many parts of world including India. LTB is a charitable company in the UK, which along with WHO has unveiled a global campaign against headache globally. NIMHAN has actively contributed in leading the Global Campaign against Headache and its burden. The study was funded by LTB to know the prevalence of headache disorders in India.
Global prevalence is 14.7 per cent–18 per cent. The age-standardized 1-year prevalence of migraine in Bengaluru at 25.2 per cent, was well above the global average, he said.
In another study comprising 330 patients of migraine seen at NIMHANS Bengaluru, only one in six accessed appropriate treatment to prevent the recurrence, stated Dr. Kulkarni.
In an article on ‘Why suffer from migraine when you can treat it’, Dr. Kulkarni also pointed out that while a headache has troubled the humans from the dawn of civilization, migraine is the commonest disabling disorder. These headaches which are moderate to severe in intensity, with nausea, vomiting and sensitivity to light and sound make the person unable to carry routine work.
The migraine treatment consists stalling the acute headache attack and preventing its recurrence. Majority of patients do not require brain scans with CT or MRI unless the treating doctor strongly suspects another disease which may mimic migraine. Unfortunately, not many people know that migraine is a treatable condition and they need not suffer in silence and darkness. With the right medical support and slight modification in lifestyle, a migraineur can live easily with prolonged migraine free days, he said.
There are tablets, injections, nasal or oral sprays or medicated patches. Usually analgesics like diclofenac, ibuprofen, naproxen and paracetamol helps in majority of patients. For instant relief in severe pain, a specific class of agents called as triptans are prescribed. Apart from the pain relief patient, benefits from rest, anti-vomiting and anti-vertiginous drugs, explained Dr. Kulkarni.
Around 50-80 per cent of patients suffering 3-4 attacks of severe headache per month, are seen to find relief. Other methods to reduce the migraine attack is to avoid known triggers, prevent dehydration, stress control and ensuring adequate sleep. Now NIMHANS sees the need for dedicated clinics going by the rise in cases, he said.