MIGRAINE: CURRENT CONCEPT AND CLINICAL MANAGEMENT

Shubham Kumar Pathak*, Dr. Meenakshi Tyagi

Migraine is a chronic and persistent neurovascular illness characterized by repeated attacks of moderate to severe headaches, often accompanied by nausea, vomiting, photophobia, and phonophobia. It is acknowledged as one of the most common neurological disorders in the world, having significant consequences for the affected individuals' quality of life, everyday activities, and socioeconomic productivity. According to the World Health Organization, migraine is one of the top causes of disability, especially among young adults and women. Migraine's precise pathogenesis is complex and multifaceted, involving trigeminovascular system activation, cortical spreading depression, inflammatory neuropeptide release, and neurotransmitter dysregulation such as serotonin and calcitonin gene-related peptide (CGRP). Migraines are caused by a variety of genetic, environmental, hormonal, nutritional, and psychological variables. Migraine is usually characterized as migraine with or without aura, although various different subtypes have been identified, including chronic migraine, vestibular migraine, and hemiplegic migraine. The diagnosis is primarily clinical, based on criteria defined by the International Classification of Headache Disorders (ICHD). Migraine treatment includes both acute and preventative measures. Nonsteroidal anti-inflammatory drugs (NSAIDs), triptans, ergot derivatives, beta-blockers, antidepressants, calcium channel blockers, and antiepileptic medications are examples of conventional pharmacological therapy. In recent years, there have been significant advances in migraine management with the introduction of CGRP antagonists, monoclonal antibodies, gepants, ditans, and neuromodulation approaches. Non-pharmacological therapies such as lifestyle change, stress management, dietary regulation, sleep hygiene, yoga, and cognitive behavioral therapy can also help reduce the frequency and intensity of migraines. The current study examines current ideas about migraine pathophysiology, classification, clinical symptoms, diagnosis, and modern therapeutic approaches. New medicines and recent advancements in clinical management have received special attention, as they have the potential to improve treatment outcomes and patient quality of life.