The onset of migraine is usually before age 30 but this disorder can occur at any age. The migraine disorder occurs three times more often in women than men and appear in successive family members. There is also significant relationship between migraine and estrogen secretion. Women may experience attacks during menstruation, headaches diminish during pregnancy, or resolve during menopause. Birth control pills may aggravate migraines.
Many migraine attacks occur spontaneously or sporadically.
For those who experience migraines, stress, anxiety and lack of sleep may also be predisposing factors to an attack. Treatment modalities not only include new medications to treat attacks but also a whole array of medications that have preventive qualities including Beta blockers, calcium channel blockers, tricyclic antidepressants and more recently the anticonvulsant medication Depakote. The future of migraine management appears quite bright with the newer options of both abortive and prophylactic therapy. This allows the physician to more individualize the migraine treatment to result in a more effective, satisfying treatment plan. Stepped care has been advocated specifically starting with a low level abortive treatment and if ineffective, utilizing one of the newer medications.