Episodic Migraine (EM)
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An Episodic Migraine (EM) is a Migraine that exists sporadically on a continuum of different attack frequencies at undetermined time intervals for a short time period.
- Example(s):
- a migraine with attack frequency 15 days/month.
- an Episodic Abdominal Migraine,
- …
- Counter-Example(s):
- See: Headaches, Nausea, Photophobia, Hyperacusis, International Classification of Headache Disorders (ICHD), Neurological Disorder, Migraine Physical Function Impact Diary (MPFID).
References
2022
- (Wikipedia, 2022) ⇒ https://en.wikipedia.org/wiki/migraine Retrieved:2022-2-2.
- "Migraine exists on a continuum of different attack frequencies and associated levels of disability."[1] For those with occasional, episodic migraine, a "proper combination of drugs for prevention and treatment of migraine attacks" can limit the disease's impact on patients' personal and professional lives. "Migraine Information Page: Prognosis Template:Webarchive," National Institute for Neurological Disorders and Stroke (NINDS), National Institutes of Health (US).</ref> But fewer than half of people with migraine seek medical care and more than half go undiagnosed and undertreated.[2] "Responsive prevention and treatment of migraine is incredibly important" because evidence shows "an increased sensitivity after each successive attack, eventually leading to chronic daily migraine in some individuals." Repeated migraine results in "reorganization of brain circuitry," causing "profound functional as well as structural changes in the brain." Brennan, KC; Pietrobon, D (March 2018). "A systems neuroscience approach to migraine". Neuron 97 (5): 1004–1021. doi:10.1016/j.neuron.2018.01.029. PMC 6402597. PMID 29518355. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=6402597.</ref> "One of the most important problems in clinical migraine is the progression from an intermittent, self-limited inconvenience to a life-changing disorder of chronic pain, sensory amplification, and autonomic and affective disruption. This progression, sometimes termed chronification in the migraine literature, is common, affecting 3% of migraineurs in a given year, such that 8% of migraineurs have chronic migraine in any given year." Brain imagery reveals that the electrophysiological changes seen during an attack become permanent in people with chronic migraine; "thus, from an electrophysiological point of view, chronic migraine indeed resembles a never-ending migraine attack." Severe migraine ranks in the highest category of disability, according to the World Health Organization, which uses objective metrics to determine disability burden for the authoritative annual Global Burden of Disease report. The report classifies severe migraine alongside severe depression, active psychosis, quadriplegia, and terminal-stage cancer.[3]
Migraine with aura appears to be a risk factor for ischemic stroke[4] doubling the risk.[5] Being a young adult, being female, using hormonal birth control, and smoking further increases this risk. There also appears to be an association with cervical artery dissection.[6] Migraine without aura does not appear to be a factor.[7] The relationship with heart problems is inconclusive with a single study supporting an association. Migraine does not appear to increase the risk of death from stroke or heart disease.[8] Preventative therapy of migraines in those with migraine with aura may prevent associated strokes.[9] People with migraine, particularly women, may develop higher than average numbers of white matter brain lesions of unclear significance.[10]
- "Migraine exists on a continuum of different attack frequencies and associated levels of disability."[1] For those with occasional, episodic migraine, a "proper combination of drugs for prevention and treatment of migraine attacks" can limit the disease's impact on patients' personal and professional lives. "Migraine Information Page: Prognosis Template:Webarchive," National Institute for Neurological Disorders and Stroke (NINDS), National Institutes of Health (US).</ref> But fewer than half of people with migraine seek medical care and more than half go undiagnosed and undertreated.[2] "Responsive prevention and treatment of migraine is incredibly important" because evidence shows "an increased sensitivity after each successive attack, eventually leading to chronic daily migraine in some individuals." Repeated migraine results in "reorganization of brain circuitry," causing "profound functional as well as structural changes in the brain." Brennan, KC; Pietrobon, D (March 2018). "A systems neuroscience approach to migraine". Neuron 97 (5): 1004–1021. doi:10.1016/j.neuron.2018.01.029. PMC 6402597. PMID 29518355. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=6402597.</ref> "One of the most important problems in clinical migraine is the progression from an intermittent, self-limited inconvenience to a life-changing disorder of chronic pain, sensory amplification, and autonomic and affective disruption. This progression, sometimes termed chronification in the migraine literature, is common, affecting 3% of migraineurs in a given year, such that 8% of migraineurs have chronic migraine in any given year." Brain imagery reveals that the electrophysiological changes seen during an attack become permanent in people with chronic migraine; "thus, from an electrophysiological point of view, chronic migraine indeed resembles a never-ending migraine attack." Severe migraine ranks in the highest category of disability, according to the World Health Organization, which uses objective metrics to determine disability burden for the authoritative annual Global Burden of Disease report. The report classifies severe migraine alongside severe depression, active psychosis, quadriplegia, and terminal-stage cancer.[3]
- ↑ Stephen D.Silberstein, Lulu Lee, Kavita Gandhi, Timothy Fitzgerald, Jvawnna Bell, and Joshua M. Cohen (2018). "Health care Resource Utilization and Migraine Disability Along the Migraine Continuum Among Patients Treated for Migrain" In: Headache: The Journal of Head and Face Pain, 58(10):1579–1592. DOI:10.1111/head.13421. PMID:30375650. S2CID:53114546.
- ↑ "Facts and Figures". https://www.migrainetrust.org/about-migraine/migraine-what-is-it/facts-figures/.
- ↑ World Health Organization (2008). "Disability classes for the Global Burden of Disease study" (table 8), The Global Burden of Disease: 2004 Update, p 33.
- ↑ "Migraine and cardiovascular disease: systematic review and meta-analysis". BMJ 339: b3914. October 2009. doi:10.1136/bmj.b3914. PMC 2768778. PMID 19861375. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2768778.
- ↑ "Migraine and stroke: a complex association with clinical implications". The Lancet. Neurology 11 (1): 92–100. January 2012. doi:10.1016/S1474-4422(11)70266-6. PMID 22172624.
- ↑ "Migraine, migraine aura, and cervical artery dissection: a systematic review and meta-analysis". Cephalalgia 31 (8): 886–96. June 2011. doi:10.1177/0333102411401634. PMC 3303220. PMID 21511950. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3303220.
- ↑ "The association of migraine with ischemic stroke". Current Neurology and Neuroscience Reports 10 (2): 133–9. March 2010. doi:10.1007/s11910-010-0098-2. PMID 20425238.
- ↑ "Migraine and mortality: a systematic review and meta-analysis". Cephalalgia 31 (12): 1301–14. September 2011. doi:10.1177/0333102411415879. PMC 3175288. PMID 21803936. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3175288.
- ↑ "Stroke and migraine". Current Cardiology Reports 9 (1): 13–9. March 2007. doi:10.1007/s11886-007-0004-y. PMID 17362679.
- ↑ "Migraine and structural abnormalities in the brain". Current Opinion in Neurology 27 (3): 309–14. June 2014. doi:10.1097/wco.0000000000000086. PMID 24751961.
2021
- (Lanteri-Minet et al., 2021) ⇒ Michel Lanteri-Minet, Peter J. Goadsby, Uwe Reuter, Shihua Wen, Peggy Hours-Zesiger, Michel D. Ferrari, and Jan Klatt (2021). "Effect of erenumab on functional outcomes in patients with episodic migraine in whom 2–4 preventives were not useful: results from the LIBERTY study". In: Journal of Neurology, Neurosurgery & Psychiatry, 92(5), 466-472.
- QUOTE: Erenumab is a fully human monoclonal antibody that inhibits the canonical calcitonin gene-related peptide (CGRP) receptor[1]. Clinical studies have demonstrated the efficacy and safety of erenumab in patients with episodic migraine (EM)[2] [3] and chronic migraine (CM)[4] including in those with prior preventive migraine treatment failures[5][6]. Results from the Phase 3b LIBERTY study confirmed that erenumab is a potential treatment for the management of patients with EM in whom 2–4 preventives were not useful[7].
- ↑ Shi L, Lehto SG, Zhu DXD, et al. Pharmacologic characterization of AMG 334, a potent and selective human monoclonal antibody against the calcitonin gene-related peptide receptor. J Pharmacol Exp Ther 2016;356:223–31.DOI:10.1124/jpet.115.227793. PMID:26559125.
- ↑ Dodick DW, Ashina M, Brandes JL, et al. Arise: a phase 3 randomized trial of erenumab for episodic migraine. Cephalalgia 2018;38:1026–37. DOI:10.1177/0333102418759786. PMID:29471679
- ↑ Goadsby PJ, Reuter U, Hallström Y, et al. A controlled trial of erenumab for episodic migraine. N Engl J Med 2017;377:2123–32. DOI:10.1056/NEJMoa1705848. PMID:29171821.
- ↑ Tepper S, Ashina M, Reuter U, et al. Safety and efficacy of erenumab for preventive treatment of chronic migraine: a randomised, double-blind, placebo-controlled phase 2 trial. Lancet Neurol 2017;16:425–34. DOI:10.1016/S1474-4422(17)30083-2. PMID:28460892
- ↑ Ashina M, Tepper S, Brandes JL, et al. Efficacy and safety of erenumab (AMG334) in chronic migraine patients with prior preventive treatment failure: a subgroup analysis of a randomized, double-blind, placebo-controlled study. Cephalalgia 2018;38:1611–21. DOI:10.1177/0333102418788347. PIMD:29984601
- ↑ Goadsby PJ, Paemeleire K, Broessner G, et al. Efficacy and safety of erenumab (AMG334) in episodic migraine patients with prior preventive treatment failure: a subgroup analysis of a randomized, double-blind, placebo-controlled study. Cephalalgia 2019;39:817–26. DOI:10.1177/0333102419835459. PMID:30982348
- ↑ Reuter U, Goadsby PJ, Lanteri-Minet M, et al. Efficacy and tolerability of erenumab in patients with episodic migraine in whom two-to-four previous preventive treatments were unsuccessful: a randomised, double-blind, placebo-controlled, phase 3B study. Lancet 2018;392:2280–7. DOI:10.1016/S0140-6736(18)32534-0. PMID:30360965.
2020
- (Evidera, 2020) ⇒ https://www.evidera.com/migraine-physical-function-impact-diary-mpfid/
- QUOTE: The Migraine Physical Function Impact Diary (MPFID) is a 13-item self-report questionnaire, developed to measure the subjective impact of migraine on physical functioning (everyday activities and physical impairment) in the past 24 hours. It is intended for use in adults (age 18 or older) with episodic migraine (EM) or chronic migraine (CM), with or without aura. The diary was developed using methods consistent with the regulatory guidance on patient-reported outcome (PRO) measures to support label claims about the benefit of treatments.
The MPFID was designed to be completed every day to capture the day-to-day variability of the impact of migraine, on migraine and non-migraine days.
The MPFID was conceptually designed to capture both ‘acts’ and ‘tasks’ associated with the impact of migraine on functioning. The MPFID includes multiple domains to assess the impact of migraine on physical functioning:
- QUOTE: The Migraine Physical Function Impact Diary (MPFID) is a 13-item self-report questionnaire, developed to measure the subjective impact of migraine on physical functioning (everyday activities and physical impairment) in the past 24 hours. It is intended for use in adults (age 18 or older) with episodic migraine (EM) or chronic migraine (CM), with or without aura. The diary was developed using methods consistent with the regulatory guidance on patient-reported outcome (PRO) measures to support label claims about the benefit of treatments.