R.W.M. van den Broek

2002-03-13

Migraine is defined as an idiopathic, paroxysmal neurological disorder with moderate tosevere attacks of unilateral, throbbing headache exacerbated by physical activity. Themigraine attack is accompanied by associated features such as nausea, vomiting,photophobia and phonophobia (Headache Classification Committee of the InternationalHeadache Society, 1988). Since migraine is a common illness, it imposes a tremendoushealth burden on both patient and society (Solomon & Price, 1997). Prevalence rates ofmigraine vary geographically and its occurrence is dependent on age (most common fromage 25-55 years), gender (three times more common in women than in man) and income(affecting lower socio-economic groups more, see Lipton & Stewart, 1997; Silberstein &Lipton, 1996). In about one third of patients (Rasmussen & Olesen, 1992), an aura mayprecede the migraine headache within one hour (migraine with aura), consisting of focalneurological (scintillating scotoma), sensory (pins or needle feeling or numbness) and/ormotor (weakness or paralysis) symptoms. The majority of patients, however, do notpresent such symptoms (migraine without aura) (Ferrari, 1998).Migraine attacks per se are not necessarily an abnormal feature, considering thatanyone may experience one or two migraine attacks in life. Migraine patients aretherefore defined as individuals who have had at least two attacks with aura or at least fiveattacks without aura. To study migraine scientifically, the International Headache Society(IHS) provided some strict and uniform criteria to determine whether a patient is sufferingfrom migraine (Headache Classification Committee of the International Headache Society,1988) (see Table 1.1 for migraine with and without aura).