![]() ![]() The more accepted theory now is that migraines are caused by a neuronal dysfunction characterized by paroxysmal symptoms migraine attacks are triggered by excessive neocortical cellular excitability. 9 However, there have been regional blood and imaging studies that do not support this theory in its entirety. Migraine attacks were caused by the dilation of intracranial blood vessels, while the aura associated with migraines resulted from vasoconstriction of blood vessels. In the 1940s, the vascular theory was introduced by Harold Wolff, MD. In the past century, there have been two theories that have dominated thought. 8 Although we obviously know that this is no longer the case, the exact pathophysiology of migraine is still unclear. At that time, it was thought that migraines were due to malevolent beings inside the head with treatments consisting of incantations and application of substances to the head to drive out these spirits and demons. Descriptions of headaches date back to roughly 3000 BC. We have come a long way in our understanding of migraine. 7 It is important for pharmacists to understand when and how to use OTC products for the management of migraines as well as when patients require referral to their healthcare provider. They are often the first healthcare professionals that patients will encounter when seeking relief for their migraine as many as 57% of patients self-medicate with OTC products. Pharmacists are in a unique position to help care for patients suffering from migraines. 4,5 In addition, migraine headache is ranked as the sixth highest cause of disability worldwide. 3 It has a major impact on quality of life more than 90% of migraine sufferers find it difficult to work or function normally during an attack, accounting for more than 150 million missed worked days, with an annual cost to employers exceeding $14 billion. ![]() 2 Migraine accounts for the majority of the 5 million headache visits to U.S. ![]() 1 This condition affects more women than men, and prevalence is highest during peak productive years, between the ages of 25 and 55 years. Migraine headache is a common, debilitating condition affecting nearly 1 out of 7 Americans annually. ![]()
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