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Epidemiology of migraine

 

Migraine is a painful, disabling, and common disorder that imposes a substantial burden on individual headache sufferers and society at large (10). Most individuals with migraine suffer severe pain and disability, however many do not seek medical care (11). Only about 50% of migraine sufferers seek medical attention for their headaches. Of these consulters, approximately half receive a physician diagnosis of migraine (12)

Migraine creates a significant and chronic burden for the patient in terms of pain and its effects on functional capacity and quality of life during and between attacks. (13,14) Patients with chronic headache have a lower quality of life than do healthy people (15) and often function less well than do patients with arthritis, diabetes, depression, or back problems.

The indirect costs of migraine are far greater than the direct costs. The U.S. annual direct medical costs for migraine were about $1 billion. Of the direct medical expenses, physician visits comprised 60% of the costs. (16)

 

Incidence

 

Few studies of migraine incidence have been performed. One study reported that the rate of migraine is 17.0 per 1,000 person / year (24.0 women, 6.0 men) however these data are limited by the  relatively narrow age range .

 

A population-based study conducted by Rasmussen showed that the annual incidence of migraine is  3.7 per 1,000 person years (women 5.8; men 1.6). Neither age-specific incidence nor incidence by migraine subtypes was reported. (17)

 

 

 

 

Prevalence

In a meta-analysis of international studies during the years 1962 to 1992, estimated prevalence for migraine ranged from 13% to 17% of women and 7.6% to 14% of men, depending on the sample (18).

In the United States (US), migraine occurs in approximately 12% of the population. (18) In the first American Migraine Study (AMS-1) (1989), 17.6% of women and 6% of men had had one migraine attack in the previous year (18). The second American Migraine Study, done 10 years later, had similar prevalence estimates (18.2% in women and 6.5% in men). (19)

Migraine prevalence varies by age, gender, race, and income in US. Before puberty, migraine prevalence is approximately 4%. As adolescence approaches, prevalence increases more rapidly in girls than in boys (20). It increases until approximately age 40, and then declines. The prevalence is inversely related to income (i.e. migraine prevalence falls as household income increases). (21, 19)

 

In France overall lifetime prevalence for migraine is 7.9% (11.2% for women and 4.0% for men). Whereas that of migrainous disorder (IHS category 1.7) was 9.1%. (22)

 While in Oman the prevalence rate of migraine and tension-type headache was found to be the same (12.2%), with a difference in distribution across sexes: 6.6% of the men and 15.5% of women had migraine, while 13.9% of men and 11.1% of the women suffered from tension-type headache (23)

 

In a study of Egyptian school children in Assiut, the prevalence of migrainous headache was 16.6% with higher rates for females 18.8% than males 14.4 % with female to male ratio 1.33. migraine without aura represented 81.1% of the studied group. There was a significant increase of migraine prevalence with age, and lower social class (24).