Migraine is one of the most disabling diseases in the world, experts say

Headaches are commonplace – it is estimated that 95% of people will experience at least one episode in their lifetime. Stress, poor eating habits, worries and sometimes even not wearing glasses can cause headaches. However, they can also be related to a number of more serious health problems. According to the World Health Organization, approximately 40% of the world’s population suffers from disorders involving frequent headaches, of which migraine is the most common.

Considered a chronic neurological disease, it is also one of the most disabling, especially in adults under 50 years of age. It is estimated that, in Brazil alone, productivity losses due to migraine are around 67 billion reais per year. O CNN Vital Signs – Dr. Kalil Interview This week, we welcome neurologist Simone Amorim, from the Hospital das Clínicas in São Paulo, and neuropediatrician Thaís Villa, to talk about this topic, with Dr. Roberto Kalil.

“Migraine is a very specific type of headache, in which pain is one of the symptoms. It has several other symptoms associated with pain. Pain is the peak,” explains Simone Amorim. According to her, a migraine attack is divided into phases.

“There is the pre-pain phase, which is the phase in which the patient feels tired, drowsy, fatigued, associated with gastrointestinal symptoms, irritability. So, there are many people who don’t even associate these symptoms that occur the day, sometimes hours before, of a crisis, with the pain that they will experience shortly.”

According to Simone, the patient goes through the crisis itself and, finally, the post-crisis, when there is a kind of brain exhaustion. “It’s as if that brain had worked too hard, it was overexcited, and then it starts to feel exhausted, also drowsy, fatigued, that hangover.”

How long can a migraine attack last?

Neuropediatrician Thaís Villa explains that, if we consider that a headache, in migraine, can last up to three days, if we include the before and after, sometimes the patient can be affected by a single crisis for a week.

Today, according to available data, the prevalence of migraines in the Brazilian population is considered high – around 15%, equivalent to more than 30 million people. According to neurologists, there is an important hereditary component, but more important than that is learning to detect the signs of the disease, which are not necessarily linked to headaches.

“Women suffer much more from headaches than men, because the hormone estrogen is an important pain facilitator. As she experiences typical peaks, extremely debilitating crises, she ends up being diagnosed more often. In men, the problem is the diagnosis. Because as he has much less pain than women, he ends up being diagnosed less.”

Children, who also have much fewer episodes involving pain, may also end up having wrong diagnoses.

“Children often feel nauseous and vomit a lot. When they travel, ride in a car or bus, they vomit a lot. Sometimes a smell bothers them. And it can also be very dysfunctional. It’s the kind of child whose mother is called to pick up from school, and they need to stay there alone because the light and noise are disturbing,” says Simone.

Thaís also warns of the importance of looking at other symptoms. “Because the child develops a migraine condition with sleep disturbances, a lot of bruxism – it is a very common symptom in childhood – and attention deficit at school. And here comes the trap. She has all this and she doesn’t have a pain crisis. And then come the misdiagnoses: ADHD, sleep disorders, learning disorders. And in fact, migraine is the disease behind all of this,” he says.

According to neurologists, migraine treatment requires patient training. “The patient has to understand that he or she needs treatment to protect the brain,” says Thaís.

Painkillers, foods with caffeine and chocolate can worsen migraines

And the use of painkillers and the consumption of foods with stimulants, such as caffeine and chocolate, can worsen the condition. “If you think that we are talking about a disease in which the brain is very excited, adding a stimulant is adding fuel to the fire of the disease.”

Adding this to the use of common painkillers, which often contain caffeine in their composition, what is created is a relationship of dependence of the brain on the dopamine that these substances produce in the body, according to the doctors. This vicious cycle causes a lot of suffering to the brain in the long term, according to Thaís.

“There are already studies showing that there is neuronal loss, which in the future increases the risk of dementia. A suffering brain will precipitate several complications. Including dementia, risk of Parkinson’s, among others.”

Therefore, Simone and Thaís advocate treatment with non-drug options, so that the patient can only use medication on an occasional basis and with specific substances to treat migraines, not headaches. They also explained the use of botulinum toxin, botox, to control those who have a crisis for more than 15 days in a month.

“It’s a very tough journey. It can take a patient a lifetime to gain even a modicum of control over this. If it were just the pain, as my patients say… but it’s a sleep disorder, mood problems, very severe cognitive deficits, attention deficits, memory problems, dizziness,” says Thaís.

“It’s not just a headache, there’s no point in taking painkillers and caffeine, you have to understand that it’s a disease, and you can control this disease. And today we have a treatment scenario that was unthinkable 10, 15 years ago. So no one today needs to suffer from the disease anymore. It needs to be treated”, reinforces Simone.

“CNN Sinais Vitais – Dr. Kalil Interview” will air on Saturday, June 29, at 7:30 pm, on CNN Brasil.

Migraine: learn about the symptoms, causes and how to identify attacks