Title : Clinical profile of migraine in South Asian countries: A systematic review
Abstract:
Background and Aims: Migraine, a condition causing moderate to severe headaches, ranks as the second most burdensome neurological disorder among Asians in regards to DALYs. It is usually associated with trigger factors like photophobia, phonophobia, or nausea and vomiting. The paucity of knowledge from our part of the world regarding migraine profiles made the commencement of this study imperative.
Methodology: We conducted a systematic review in line with PRISMA guidelines. English articles with descriptive studies done in the South Asian population with diagnosed cases of adult migraine patients were screened. The final review included 36 articles - 18 studies from India, 10 from Pakistan, 5 from Bangladesh, and 3 from Nepal.
Results: Patients suffering from migraine are mostly in their 30s, with high female preponderance. Urban dwellers and those with a family history also seem to be predisposed to migraine episodes. From the 32 studies that studied trigger factors, the commonest triggers were lack of sleep, stress, missed or irregular meals, specific smells, specific foods, and menstruation. Unilateral or hemicranial pulsatile headaches were found to be the most common occurrences. Most patients complained of morning headaches, usually resolved within a day. Migraine without aura was more commonly reported, with visual aura being the most prevalent among those with aura. The most commonly associated features were photophobia, phonophobia, nausea, vomiting, vertigo, dizziness, neck pain, and vision problems. Most studies reported that medications like NSAIDs, acetaminophen, triptans, opioids, or combination of these aided in relief of symptoms. While adequate sleep, staying in quiet room and rest were most commonly accepted non-pharmacological relievers, few studies revealed patients found solace post vomiting, after food intake and change in posture.
Conclusion: As young females and urban dwellers are reported to be the common demographics, it highlights the role of genetics and environment in the etiology of migraine. It emphasizes our need for targeted strategies for managing and preventing migraine headaches. Behavioral elements like stress, lack of sleep, fatigue, and diet habits being common triggers underscore the importance of identifying and preventing acute attacks with multispecialty care.
Audience Take Away Notes:
- The demographic profile of migraine in South-Asian countries
- Its clinical features and associated features that are frequently associated with it.
- The variation in trigger factors among western and eastern countries and the possible causes of why there is such variation in triggers.
- The coping mechanism of patients suffering from migraine in South Asian countries and how it differs from western countries.
