“Phoenix’s problem: he seemed to see flashes like lightning in his eye, mostly the right. And when he had suffered that a short time, a terrible pain developed toward his right temple and around his whole head…” reads an account of ancient Hippocratic medical writings. Not until the late 19th century did these symptoms come to be generally recognized in the medical community as the chronic neurological disorder called migraine. Today, 29.5 million Americans suffer from these episodes of crippling headache attacks, nausea, vomiting, and light sensitivity. The odds an adult has had a migraine in the past 3 months are 1 in 8.16. One-third of migraineurs experience, like Hippocrates’s Phoenix, sudden visual or auditory distortions, or “aura,” a premonition of imminent headache pain.

World-narrowing pain is far more than a headache. Many times, all a headache requires is a meal, a break from the computer screen, or aspirin and a nap. But migraine attacks last 4 to 72 hours and require treatment with over-the-counter migraine pain relievers, prescription anti-inflammatory drugs, or long-term anticonvulsant medications. Migraine, which seems to be genetic, occurs when over-excited brain cells trigger the trigeminal nerve to release certain chemicals that cause the surface of the brain to swell. The swollen blood vessels send pain signals to the brain stem, pain that often requires bed rest.

Migraine sufferers notice that certain things, such as cured meats, bright lights, television, stress, or allergic reactions trigger the headache. A major trigger for women is hormone fluctuations. The National Headache Foundation reports that 60% of female sufferers notice a connection between migraine and their menstrual cycle. Not coincidentally, migraine hits women the hardest, affecting nearly 18% of women and 6% of men. Women commonly experience a decrease in migraine symptoms after menopause.

A diagnosis of a migraine disorder is not a painful life-sentence, according to studies that track sufferers’ courses of illness. The American Migraine Prevalence and Prevention (AMPP) Study, the largest study of migraine sufferers ever conducted, follows about 20,000 Americans age 12 and older with severe headaches. Thus far, the researchers report that out of the people experiencing episodes of migraine in 2005, around 10% had a complete 1-year clinical remission by 2006 and 3% underwent a partial remission. 84% of sufferers were still experiencing migraine episodes, and 3% worsened to chronic cases.

The prevalence of migraine peaks during the ages of 25 to 55 years, and so the missed workdays and medical expenses of disabled workers impose a heavy economic burden. Nationally, indirect costs to employers amount to a $12 billion annually. Researchers conclude that a deeper understanding of migraine triggers could help people stay out of the darkest, quietest room in the house.

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