The aim of this study was to explore clinical-epidemiological characteristics of migraine in Latvia and the disability of migraine patients, to determine the optimal options for care of these patients. Patients selected from three headache centres were asked 40 questions by phone. Among 116 patients, the dominant age group was 25-34 (41.4%) and most patients were women (87.9%). 52.6% of patients were highly educated, and 53.4% had a job involving communication with people. In 56.9% of cases headaches started at the age of 15-24. About 25% migraine attacks lasted for 25-48 hours. The diagnosis “Migraine with aura” was confirmed in 50% of the patients. Headaches were quite frequent: 4-8 times a month or more in 22.4% of patients and 2-4 times a month in 29.3%. As medication, 50.9% used selective serotonin 5-HT (5- hydroxytryptamine) receptor agonists for migraine attacks treatment, 35.3% - nonsteroidal anti-inflammatory drugs (NSAIDs) and 30.2% - acetaminophen-containing medicines. The average quality of life estimated by migraine disability assessment questionnaire (MIDAS) was 13.0, which equates to moderate disability. According to our study clinical characteristics of migraine in Latvia do not differ significantly from that of other European countries. Most of the patients are educated, working women of childbearing age. Migraine diagnosis and treatment seems to be appropriate, but nevertheless, too many sufferers have frequent and persistent headache attacks that require further investigation.

Invasive and Non-invasive Methods in Diagnostic of Migraine: a Literature ReviewMigraine is one of the most common neurological disorders worldwide. Prevalence varies in different reports but on average it is up to 15% of adults, mostly women, and up to 14,5 % in school age children. Although the diagnosis of migraine in children is not easy, migraine prevalence of migraine in childhood is very high. Morbidity of migraine is strongly related to positive family history and it illustrates ascertain close relation to genetic matter. Medical and social burden of migraine is tremendous since it affects all range of ages, starting from young children to seniors, and severe attacks can be even as disabling as quadriplegia. Despite there are thousands of trials done, indisputable cause of migraine as well as pathophysiological treatment is not clear. There are several forms of migraine, two of which are the most common- migraine without aura and migraine with aura. Diagnosis of migraine is based mainly on anamnesis data and clinical symptoms according to The International Classification of Headache Disorders (ICHD), neuroimaging is recommended only in case of so called red flag symptoms and is oriented to exclude secondary headache. Invasive investigations such as lumbar puncture and angiography with contrast are integral parts of investigational plan when migraine has to be differentiated from subarachnoid haemorrhage or pulmonary and cardiac right-to-left shunts. Modern neuroimaging reveals migraine as a kind of neurodegenerative disease that in severe and/or frequent form leads to brain white matter lesions, subclinical infarcts in the posterior circulation and increased iron deposition in brain. On the scientific laboratory level, it is possible now to diagnose migraine on affirmative base, and this is believed to be the future of neuroimaging in clinical practice regarding migraine.