At no time have the discoveries been as great as in the last 20 years, which leads to the possibility that this pain will pass, yes.
In one of his writings, the Scottish poet William Dunbar (1460-1530), in words that any patient could use today, described the ancient burning agony known to mankind. “The migraine is so unbearable, it goes through my forehead like an arrow, that I can hardly see the light.” Much earlier, around 400 BC. C., Hippocrates spoke of the aversion to light that accompanies the seizures of what is considered the second most common neurodegenerative disease, affecting approximately one billion people (the first is a stroke), and the sixth most common disease . on the World Health Organization scale. From the father of medicine to today, much has been discovered about this disease, but much remains to be understood.
Migraines remain a great mystery, but at no time in history has progress been more remarkable than in the last 20 years, which could make the pain go away, yes. There couldn’t be a more auspicious time for this scenario. The COVID-19 pandemic, as we know, has exacerbated many health conditions, and migraine was one of them. Studies have shown an increase in the number of people who begin to have recurring seizures in those who have already had the disease. The fear caused by the coronavirus infection was crucial for this movement, as evidenced by a study published in the first year of the epidemic, 2020, in the Journal of Headache and Pain. Among patients who did not become infected, 12% reported new events. The percentage rose to 33.2% among those infected. In Brazil, a survey conducted by the University of the State of Bahia indicated an increase in episodes lasting from seven to fourteen days per month. The index went from 7.3% to 24.1% between December 2020 and June 2021. The explanation for this increase is simple. The appearance of symptoms is related to stress and anxiety, two mental states that have increased dramatically in the last two and a half years.
Migraine has specific characteristics, it is not just a pain. It usually appears on one side of the head, palpitations, and can be accompanied by aura (visual disturbances), aversion to light and nausea. Its causes are well defined: in addition to stress and anxiety, there is lack of sleep, prolonged fasting from certain foods, such as chocolate, caffeinated drinks or fatty foods. This information, with primary content, has been published for some time. The great advances against the disease, which have blown up diagnosis and treatment, have recently come about from the combination of information from genetics and a deep understanding of the process that gives rise to the alarm. The knowledge gathered in these areas has made it possible to establish heredity as an important risk factor. If one or both parents have this condition, the probability that the child will have it ranges from 50% to 75%. The identification of a network of genetic variants and the materials from which they are made represents a breakthrough.
Data from this title has led to the creation of one of the greatest advances in pain relief to date, the migraine monoclonal antibody. This class is used against many diseases – there are many that are used in the fight against cancer, for example – because it has the ability to act on molecules specifically related to the disease in question. In the case of the migraine antibody, the concentration is a molecule whose high concentration during attacks is associated with pain. By injection, the drug blocks its action. The alternative available in Brazil is for those who have tried everything and are still struggling. “It is a treatment for patients who do not respond to other treatments,” explains neurologist Alex Baeta, from Beneficência Portugaluesa, in São Paulo. “It works by decreasing the intensity of pain and the spacing of attacks.” The 83-year-old retiree from Sao Paulo, Alvaro Roncolato, has been on the drug for five months, a period in which he feels unmatched. “It changed my life,” he celebrates, “going 27 days without a crisis.”
Antibodies hit the market in 2018. Since then, other good options have emerged, such as nasal sprays approved by the Food and Drug Administration, a U.S. regulatory agency, that contain a substance that relieves pain in some cases fifteen minutes after the application, and intravenous injections of xylocaine, it is capable of terminating around 90% of the crises, as well as their spacing. A final and unusual limitation is the discovery of the effect of medicinal cannabis. The effects are beginning to show: a review of research conducted between 1987 and 2020 found “encouraging” data. Reports of pain reduction were seen in 50% to 86% of cases.
It is no coincidence, given the breadth of good news, that the American Migraine Foundation has stated that we live in “exciting times for the sick.” “There’s nothing magical about wearing sunglasses to turn off the punishing light during a crisis,” says digital influencer Khloe Kardashian, who suffers from pain.
