Migraine: A Review on Its History, Symptoms, And Its Treatment

Abstract

Migraine is a prevalent and disabling neurological disorder characterized by recurrent episodes of moderate to severe headache, often accompanied by nausea, vomiting, photophobia, and phonophobia. Historically documented in Egyptian, Greek, and Roman medical texts, the understanding of migraine has evolved from humoral theories to modern neurovascular models. Migraine is classified into several subtypes, with migraine without aura being the most common. Clinical presentation often follows a multi-phase pattern including prodrome, aura, headache, and postdrome. The pathophysiology involves cortical spreading depression, activation of the trigeminovascular system, release of inflammatory neuropeptides like CGRP, serotonin dysregulation, and genetic predisposition. Diagnosis is guided by the ICHD-3 criteria and requires differentiation from other headache types such as tension-type and cluster headaches. Treatment includes both acute therapies (e.g., triptans, NSAIDs, gepants) and preventive approaches (e.g., beta-blockers, CGRP monoclonal antibodies). Non-pharmacological interventions such as cognitive behavioral therapy, neuromodulation devices, and dietary supplements offer additional benefits. Recent advances include CGRP-targeted drugs, wearable technologies, and personalized medicine strategies. This review emphasizes the need for early diagnosis, individualized treatment, and multidisciplinary care to improve outcomes. Continued research on biomarkers and new therapeutic targets holds promise for better prevention and management of migraine.