Migraine and Functional Impairment

Abstract

Migraine is a leading cause of disability worldwide; approximately half of those affected have such severe attacks that they cannot function normally in routine daily activities. Research is beginning to focus upon the burden of migraine between attacks, referred to as interictal burden. This burden encompasses worry and expectation of future attacks that consequently may be associated with limitations in social and family interactions, as well as work capacity. This review aims to increase physician awareness of the degree and scope of functional impairment associated with migraine. Physicians are in a position to assess the true impact of migraine in their patients using techniques such as open-ended questions during visits, and paper-based migraine assessment tools such as the Migraine Disability Assessment questionnaire. Eliciting such information on interictal burden may help the physician prescribe the most appropriate therapy based on their patients' degree of impairment. This article also describes the instruments most widely used for measuring migraine-related functional impairment, summarizes studies assessing the effects of migraine on indicators of health-related quality of life and presents data on how preventive migraine treatment may beneficially influence migraine-related functional impairment.

Odors as triggering and worsening factors for migraine in men

“…These values have been systematically reported in several countries 1 , including Brazil 2 , thus highlighting the need for efficient approaches towards this condition. Migraine has a significant impact on the quality of life 3 , on health resources 4 , and on patients' professional and personal activities 5 .…”

A case study utilizing Vojta/Dynamic Neuromuscular Stabilization therapy to control symptoms of a chronic migraine sufferer

“…It has been found that nearly half the world's population has an active headache disorder and according to the American Migraine Prevalence and Prevention study of 2004 (Lipton et al, 2007), migraine in particular has a prevalence of 12% in the general population, 18% in women, and 6% in men (Robbins and Lipton, 2010). Migraine is reported to be among the top 20 causes of disability worldwide, as more than half of those affected have such severe symptoms that they cannot function normally in their routine daily activities, including work, school, and social activities (Brandes, 2009). 48.2% of migraineurs reported some level of impairment, 22.1% were severely disabled, and more than half reported the need for bed rest (Lipton et al, 2007).…”

“…48.2% of migraineurs reported some level of impairment, 22.1% were severely disabled, and more than half reported the need for bed rest (Lipton et al, 2007). In addition, during the periods between attacks, worry, stress, and expectation of future attacks may also lead to functional impairment, a phenomenon known as the interictal burden (Brandes, 2009).…”

“…Migraine sufferers typically try a multitude of interventions in an effort to reduce the frequency and severity of their attacks as well as to improve function and reduce disability (Brandes, 2009). There are numerous pharmacological interventions, including beta-blockers, antidepressants, anticonvulsants, calcium channel blockers and serotonin antagonists, but side effects and contraindications because of co-morbidities can complicate treatment (Sprenger and Goadsby, 2009).…”

Taking the headache out of migraine

“…13 Even when it is accurately diagnosed, health care professionals may not identify the levels and dimensions of functional impairment imposed by migraine. 14,15 Migraine is not immediately life-threatening, there is generally no objective physical disability, and the person may appear well between attacks. Migraine is comorbid with psychiatric disorders (e.g., depression and anxiety 16 ), cardiovascular disease (e.g., angina and myocardial infarction 17 ), metabolic syndromes (e.g., obesity 18 ), other neurologic disorders (e.g., epilepsy 19 and sleep disorders 20 ), and gastrointestinal disorders (e.g., irritable bowel syndrome 21 ) and lacks a specific disease biomarker.…”