Evaluation of Headache

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Specific Headache Syndromes

Migraine

Migraine is an episodic headache that may be classified into three types:

1. Migraine with aura (old term classic migraine)

2. Migraine without aura (old term common migraine)

3. Migraine variants (retinal migraine, opthalmoplegic migraine, familial hemiplegic migraine)

Migraine is about three times more common in women than men, tends to run in families, and is typically a disorder of young, healthy women.

Migraine without aura is the most common type, accounting for approximately 80 percent of all migraine sufferers.

Pathophysiology

The current state of knowledge in this field suggests that a primary neuronal dysfunction leads to a sequence of changes intracranially and extracranially that account for the phenomenon of migraine, including the three phases of prodrome, aura, and headache. Individuals prone to migraine have a genetic migrainous threshold that renders them susceptible to an acute migraine attack depending upon the balance between excitation and inhibition at various levels of the nervous system.

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