Migraine epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

Overview

Migraine is widespread in the population. The majority of migraine (as it is referred to commonly) is actually mixed Headache. In the U.S., 18% of women and 6% of men report having had at least one migraine episode in the previous year[1] According to reports, 10% of people have been diagnosed with migraine and 5% have migraine but have not been diagnosed, with seriousness varying from a rare annoyance to a life-threatening and/or daily experience.

Epidemiology and Demographics

Migraine is an extremely common condition which will affect 12-28% of people at some point in their lives.[2] However this figure — the lifetime prevalence — does not provide a very clear picture of how many patients there are with active migraine at any one time. Typically, therefore, the burden of migraine in a population is assessed by looking at the one-year prevalence — a figure that defines the number of patients who have had one or more attacks in the previous year. The third figure, which helps to clarify the picture, is the incidence — this relates to the number of first attacks occurring at any given age and helps understanding of how the disease grows and shrinks over time. Based on the results of a number of studies, one year prevalence of migraine ranges from 6-15% in adult men and from 14-35% in adult women.[3] These figures vary substantially with age: approximately 4-5% of children aged under 12 suffer from migraine, with little apparent difference between boys and girls.[4] There is then a rapid growth in incidence amongst girls occurring after puberty,[5][6][7] which continues throughout early adult life.[8] By early middle age, around 25% of women experience a migraine at least once a year, compared with fewer than 10% of men.[9][10] After menopause, attacks in women tend to decline dramatically, so that in the over 70s there are approximately equal numbers of male and female sufferers, with prevalence returning to around 5%.[2] At all ages, migraine without aura is more common than migraine with aura, with a ratio of between 1.5:1 and 2:1.[11][12] Incidence figures show that the excess of migraine seen in women of reproductive age is mainly due to migraine without aura.[13] Thus in pre-pubertal and post-menopausal populations, migraine with aura is somewhat more common than amongst 15-50 year olds[14][15]Geographical differences in migraine prevalence are not marked. Studies in Asia and South America suggest that the rates there are relatively low,[16][17] but they do not fall outside the range of values seen in European and North American studies.[18][19]The incidence of migraine is related to the incidence of epilepsy in families, with migraine twice as prevalent in family members of epilepsy sufferers, and more common in epilepsy sufferers themselves.[20]

References

  1. . Silberstein S. "Migraine". Lancet 2004;363:381-391
  2. 2.0 2.1 Stovner LJ, Zwart J-A, Hagen K, et al. "Epidemiology of headache in Europe". Eur J Neurol 2006;13:333-45
  3. name="Stovner"
  4. 3. Mortimer MJ, Kay J, Jaron A. "Epidemiology of headache and childhood migraine in an urban general practice using ad hoc, Vahlquist and IHS criteria". Dev Med Child Neurol 1992;34:1095-1101
  5. Linet MS, Stewart WF, Celentano DD et al. "An epidemiologic study of headache among adolescents and young adults". JAMA 1989;261:2211-16
  6. Ziegler DK, Hassanein RS, Couch JR. "Characteristics of life headache histories in a nonclinic population". Neurology 1977;27:265-269
  7. Selby G, Lance JW. "Observations on 500 cases of migraine and allied vascular headache". J Neurol Neurosurg Psychiat 1960;23:23-32
  8. Anttila P, Metsahonkala L, Sillanpaa M. "Long-term trends in the incidence of headache in Finnish schoolchildren". Pediatrics 2006;117:e1197-e1201
  9. name="Stovner"
  10. name = "Lipton">Lipton RB,.Stewart WF. Migraine in the United States: a review of epidemiology and health care use. Neurology 1993;43:S6-10
  11. Rasmussen BK,.Olesen J. "Migraine with aura and migraine without aura: an epidemiological study". Cephalalgia 1992;12:221-8
  12. Steiner TJ, Scher AI, Stewart WF, et al. "The prevalence and disability burden of adult migraine in England and their relationships to age, gender and ethnicity". Cephalalgia 2003; 23:519-27
  13. Rasmussen BK,.Olesen J. "Migraine with aura and migraine without aura: an epidemiological study". Cephalalgia 1992;12:221-8
  14. Anttila P, Metsahonkala L, Sillanpaa M. "Long-term trends in the incidence of headache in Finnish schoolchildren". Pediatrics 2006;117:e1197-e12017,10
  15. Bigal ME, Liberman JN, Lipton RB. "Age-dependent prevalence and clinical features of migraine". Neurology 2006;67:246-51
  16. Wang SJ. "Epidemiology of migraine and other types of headache in Asia". Curr Neurol. Neurosci. Rep. 2003;3:104-8
  17. Lavados PM,.Tenhamm E. "Epidemiology of migraine headache in Santiago, Chile: a prevalence study". Cephalalgia 1997;17:770-7
  18. name="Stovner"
  19. Lipton RB,.Stewart WF. "Migraine in the United States: a review of epidemiology and health care use". Neurology 1993;43:S6-10
  20. [1]'Comorbidity of migraine and epilepsy', Ottman, R and Lipton, R, Neurology, 1994

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