BAB I

PENDAHULUAN

Migraine is a common disorder in women, more common than diabetes mellitus,

osteoarthritis, or asthma. Most of the 28 million Americans who have migraine are

female, with a 1-year migraine prevalence of 18% in females compared with 6% in males

older than 12 years. In the United States alone, an estimated 112 million bedridden days

per year are attributed to this disorder. Annual direct and indirect costs of migraine are

estimated at $13 billion. An estimated 15% to 18% of the U.S. female population has

either diagnosed or undiagnosed migraine, with the highest prevalence occurring in

women aged 25 to 55 years . Several observations support a relationship between female

sex hormones and migraines. The prevalence of migraine in women is roughly two to

threetimes higher than that in men. (3116)

BAB II
TINJAUAN PUSTAKA

A. Migran

MIGRAINE is a common, chronic, incapacitating neurovascular disorder,

characterized by attacks of severe headache, autonomic nervous system dysfunction,

and in some patients, an aura involving neurologic symptoms.(257) Migraine is a

common neurologic disorder characterized by episodic attacks of moderate to severe

throbbing headache, which may be disabling and accompanied by nausea, vomiting,

photophobia, and/or phonophobia. (3116) Some people who get migraines have warning

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symptoms, called an aura, before the actual headache begins. Most people, however, do

not have such warning symptoms.

B. Klasifikasi

International Headache Society classification of migraine without aura and

migraine with aura (s11)

A. Migraine without aura

Recurrent headache disorder manifesting in attacks lasting 4–72 hours. Typical

characteristics of the headache are unilateral location, pulsating quality, moderate or

severe intensity, aggravation by routine physical activity and association with nausea

and/or photophobia and phonophobia.

Diagnostic criteria:

a. At least five attacks1 fulfilling criteria B–D

b. Headache attacks lasting 4–72 hours (untreated or unsuccessfully treated)

c. Headache has at least two of the following characteristics:

1. Unilateral location

2. Pulsating quality

3. Moderate or severe pain intensity

4. Aggravation by or causing avoidance of routine physical activity (e.g. walking

or climbing stairs)

d. During headache at least one of the following:

1. Nausea and/or vomiting

2. Photophobia and phonophobia

e. Not attributed to another disorder in the Appendix because of uncertainty over

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 whether they should be regarded as separate entities

B. Typical aura with migraine headache

Typical aura consisting of visual and/or sensory and/or speech symptoms.

Gradual development, duration no longer than 1 hour, a mix of positive and negative

features and complete reversibility characterise the aura, which is associated with a

headache fulfilling criteria for ‘1.1 Migraine without aura’.

Diagnostic criteria:

a. At least two attacks fulfilling criteria B–D

b. Aura consisting of at least one of the following, but no motor weakness:

1. Fully reversible visual symptoms including positive features (e.g.

flickering lights, spots or lines) and/or negative features (i.e. loss of vision)

2. Fully reversible sensory symptoms including positive features (i.e. pins and

needles) and/or negative features (i.e. numbness)

3. Fully reversible dysphasic speech disturbance

c. At least two of the following:

1. Homonymous visual symptoms1 and/or unilateral sensory symptoms

2. At least one aura symptom develops gradually over ≥5 minutes and/or

different aura symptoms occur in succession over ≥5 minutes

3. Each symptom lasts ≥5 and <60 minutes

d. Headache fulfilling criteria B–D for ‘1.1 Migraine without aura’ begins during the

aura or follows aura within 60 minutes

e. Not attributed to another disorder

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C. Tanda dan Gejala

Migraine is characterized by episodes of head pain that is often throbbing and

frequently unilateral and may be severe. In migraine without aura (previously known as

common migraine), attacks are usually associated with nausea, vomiting, or sensitivity to

light, sound, or movement.5 When untreated, these attacks typically last 4 to 72

hours.6 A combination of features is required for the diagnosis, but not all features are

present in every attack or in every patient (Table 1).

These symptoms distinguish migraine from tension-type headache, the most common

form of primary headache, which is characterized by the lack of associated features. Any

severe and recurrent headache is most likely to be a form of migraine and to be

responsive to antimigraine therapy. In 15 percent of patients, migraine attacks are

usually preceded or accompanied by transient focal neurologic symptoms, which are

usually visual; such patients have migraine with aura (previously known as classic

migraine).

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In a recent large, population-based study, 64 percent of patients with migraine had only

migraine without aura, 18 percent had only migraine with aura, and 13 percent had

both types of migraine (the remaining 5 percent had aura without headache). Thus, up

to 31 percent of patients with migraine have aura on some occasions,10 but clinicians

who rely on the presence of aura for the diagnosis of migraine will miss many cases. We

find it useful to assess the severity and effects of migraine by asking about time lost

because of migraine at work or school, in performing household work or chores, or in

family, social, and leisure activities. One can ask patients directly about temporary

disability, have them keep a diary, or get a quick but accurate estimate with the use of the

Migraine Disability Assessment Scale (MIDAS) (Table 2), a wellvalidated five-item

questionnaire that is easy to use in practice.

D. Patofisiologi

E. Terapi

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F. Pencegahan

BAB III
PENUTUP

DAFTAR PUSTAKA