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Migraine and Its complications

NITIN SAMPAT

 Migraine is a familial episodic pulsatile throbbing headache which can be moderate to severe in intensity & is very disabling. A lot of man hours are lost as the patient is so miserable due to the frequent headaches often accompanied by vomiting and/or photophobia, as the patient cannot attend office or school or the housewife cannot carry out her activities of daily living. This loss is colossal as the prevalence is 12% of the general population starting from childhood. Furthermore efficacy of the present treatment is quite low.Calcitonin gene related peptide (CGRP) levels are higher in migraineurs & rises during an attackhence it may act as a marker. On administering cgrp infusion an attack may be precipitated. Now cgrp antagonists ( gepants) are available for acute attack & a more efficacious monoclonal antibody is available for a once monthly or once three monthly prophylaxis against this disabling headache , to alleviate the misery of the migraineur.