Epidemiology of migraine

Abstract

In the last decade, there have been many studies on epidemiology of migraine. These studies have dealt not only with those aspects that are strictly related to the spread of the disease, such as prevalence and incidence rates, but also with other interesting aspects, such as familial occurrence, comorbidity and disability.In this paper, we deal with migraine incidence and above all with migraine prevalence, but we try to go beyond sheer data and percentage figures in order to provide an in-depth analysis that may help to assess their reliability. Indeed, the availability of reliable data about prevalence is important, not only per se, but also as a starting point to be taken as reference for studies on the risk running in families and on the risk of developing other diseases, as well as studies on the social and economic impact of migraine.Migraine prevalence studies pose a number of methodological problems: some are typical of all prevalence studies in general, while others are specific to migraine; some of these problems have finally been overcome, while others are still difficult to solve. The main obstacle is case definition. Gian Camillo Manzoni Paola TorelliAbstract One-year migraine prevalence rates in the general population for Western countries vary from 4% to 9% in men and from 11% to 25% in women. Non-Western countries report lower figures. Incidence rates for people under 30 years of age vary from 1.5 to 6 per 1000 personyears in men and from 3 to 24 per 1000 person-years in women. Data on the prevalence of migraine in general, on the gender ratio and on the variations in prevalence in the different age ranges are fairly comparable and can be regarded as very close to reality. On the contrary, data on the incidence of migraine, on the prevalence of different migraine subtypes, such as migraine with aura and the so-called migrainous disorder, and on the frequency of migraine attacks show a striking discordance that somewhat undermines their reliability. The main critical points in prevalence and incidence studies are migraine definition and the methodological approaches used for case screening. Even if International Headache Society (IHS) classification is certainly an improvement over previous tools used in epidemiological studies, the diagnostic criteria for migraine without aura are quite scanty and not easily remembered by subjects belonging to the general population, and those for migraine with aura appear not only difficult to translate for use in a questionnaire or an interview, but also too loose. In particular, the lack of any low-end limit for aura duration may cause an overestimation of migraine with aura prevalence.

Male and female sex hormones in primary headaches

“…The female dominance is also seen in migraine with aura. In prevalence studies performed after 1988 it reaches a prevalence of 1.2-3.7% in men and 2.6-10.8% in women [67]. In contrast to menstrual migraine, migraine with aura occurs more frequently with high estrogen levels [68].…”

Migraine Disorder

“…In a Swedish study by Linde and Dahlof (2004), only 45% of self-identified migraineurs had seen a health care provider for diagnosis of their migraines. Manzoni and Torelli (2003) and Lipton and Bigal (2005) reviewed the literature to identify the incidence of migraine, finding only four relevant studies. All of these were conducted between 1991 and 1996 (Breslau, Chilcoat, & Andreski, 1996;Rasmussen, 1995;Stang et al, 1992;Stewart, Linet, Celentano, Van Natta, & Ziegler, 1991).…”

“…All of these were conducted between 1991 and 1996 (Breslau, Chilcoat, & Andreski, 1996;Rasmussen, 1995;Stang et al, 1992;Stewart, Linet, Celentano, Van Natta, & Ziegler, 1991). Incidence rates varied widely between the studies, ranging from 1.5 to 2 per 1,000 person-years for men and approximately 3 to 6 per 1,000 person-years for women about thE author (Manzoni & Torelli, 2003). However, these studies only examined the incidence of migraines in men and women younger than 30.…”

Pain in and Around the Eye: How Big is the Problem?

“…It is estimated that approximately one-fi fth of women and one-tenth of men suff er from migraine of one or other type (Manzoni, 2003). In addition to throbbing pain in the eye or orbit, migraine patients may have nausea and are light and sound sensitive.…”