Migraine Headaches, Vision Effects
Ronald Braswell, MD
Joseph Carcione Jr, DO, MBA
Francisco Talavera, PharmD, PhD
James H Halsey, MD
Migraines and Vision Effects Overview
Migraine headache is one of the most common complaints in medicine today. Migraine headaches usually involve one side of the head. Various early symptoms may occur before a typical migraine episode. Other symptoms, together known as an aura, may also occur before a migraine headache, or they may begin when the headache starts. Recent studies show that 23 million Americans, approximately 18% of females and 6% of males, have at least 1 migraine headache a year. Migraine headaches are experienced by 64% of all females and 43% of all males who get severe headaches.
The American Migraine Study showed that more than 85% of women and 82% of men with severe migraines had headache-related disability. The estimated cost of lost productivity is $1-13 billion a year. Male migraineurs (persons who get migraines) required 3.8 bedrest days per year; female, 5.6 days.
Another recent study showed that, among women, 20.4% of whites, 16.2% of African Americans, and 9.2% of Asian Americans met the criteria for migraine.
In men, 8.6% of whites, 7.2% of African Americans, and 4.8% of Asian Americans were considered to have migraine.
In children younger than 10 years, boys appear to have migraines more often than girls. After puberty starts, migraine headaches are much more common in females (female-to-male ratio, 3:1).In general, the rate of migraine occurrence in males drops to a low by age 28-29 years (1 case per 1000 person-years). (Person-years is the product of the number of years times the number of people in a population who have been affected by a certain condition.)
For females, the rate of migraine occurrence with aura peaks at age 12-13 years (3-4 years before that of migraine without aura).
Migraine occurrence among females increases sharply up to age 40 years and then declines gradually. The male peak rate is slightly less and decreases over a broader age range.
The age when migraine headache with aura begins appears to peak at or before age 4-5 years (6.6 cases per 1000 person-years), while the highest rate for migraine without aura occurs at age 10-11 years (10.1 cases per 1000 person-years).
Data suggest that migraine is a chronic (long-term) condition, although long remissions (illness-free periods) are common. One study showed that 62% of young adults were free of migraine headaches for more than 2 years, but only 40% continued to be free of them after 30 years.
The severity and frequency of attacks tend to lessen with age. After 15 years, approximately 30% of men and 40% of women no longer have migraine attacks.
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