MIGRAINE: DIAGNOSTIC METHOD, FUNCTIONALITY IMPAIRMENT AND DISEASE BURDEN ON PATIENTS AND SOCIETY – A REVIEW

Abstract

Among the primary headaches, migraine stands out as the most common one. It also stands out as a significant burden on the daily functioning of patients. A differential diagnosis is certainly indicated in all cases of a clinical doubt, but also in patients with their first occurrence of symptoms not been tested in the past. At the same time, there are some findings from the examination and/or history which increase the likelihood of a secondary cause, which pose a need for diagnostic testing regardless of the clinical picture.
Migraine can cause functional impairment, but it varies considerably in its frequency and intensity from person to person. It is not clear which symptoms have the greatest impact on the quality of life of a patient with migraine. In general, non-communicable diseases, which cause greater impairment in functionality and mortality, such as major headache syndromes, are essentially invisible to measurements based only on mortality and morbidity. Since 2004, the filling of the gaps in epidemiological data, particularly in areas outside North America and Western Europe, has become the top priority of the Global Campaign against Headache. Empirical data has replaced many of the assumptions on which previous estimates had been made, now possible by country from large areas of the globe. According to them, there is no doubt that migraine has a negative influence on the public health in all countries, climates or cultures, as it is consistently ranked in the fifth to eighth place among the leading causes of functional impairment. Migraine is no longer considered as a disease of the wealthy industrialized countries, after the comparison between low- and high-income countries. The correlation of migraine with psychiatric and cardiovascular coherence is now confirmed in the medical literature, although there is no evidence of etiology, as well as the possible mechanisms.