PAINWeek Journal Premier Issue | Page 38

EXPERT OPINION ePiDeMiOLOGY Table Migraine Classification t is estimated that more than 30 million people in the United States have one or more migraine headaches a year. Furthermore, migraine is found in 18% of females and 6% of males.1 Migraine accounts for 64% of severe headaches in women and 43% in men. About 75% of all people who experience migraine are women. One in 6 American women has migraine headaches.2 It was long ago that it was believed that there was no difference between migraine incidence and prevalence in young boys and girls before puberty. In fact, the incidence of migraine with aura peaks in boys at about age 5 and in girls at about age 12 to 13. The incidence of migraine without aura peaks in boys at age 10 to 11 and in girls at age 14 to 17.3 Before puberty, both the prevalence and incidence of migraine are higher in boys than in girls. After age 12, the prevalence increases in both males and females, peaking at 30 to 40 years. The female-to-male ratio increases from 2.5:1 at puberty to 3.5:1 at age 40.4 The incidence of migraine changes over time, with decreased attack severity and frequency after menopause in about two-thirds of women. For most women with migraine, the attacks stop during pregnancy, as might be expected, because during pregnancy there are no significant peaks and troughs of estrogen. On the other hand, some women may manifest migraine at this time. While the onset of migraine after age 50 is rare, it can also begin even after age 60. e e MiGRAiN DiAGNOS S: nosology Migraine without aura (common migraine) Probably migraine without aura Migraine with aura (classic migraine) Probably migraine with aura Chronic migraine Chronic migraine associated with analge ͥ