John Gormley (Dublin South East, Green Party)
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Question 192: To ask the Tánaiste and Minister for Health and Children her views on whether migraine is a disabling illness. [10137/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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Migraine is a debilitating condition characterised by severe headache and a range of other physical symptoms. It is estimated that 10% of the UK population suffer from migraine, according to Bal and Hollingsworth in 2005. Migraine is three times more common in women than in men and is most commonly experienced between the ages of 15 to 55 years.

There are two types of migraine: migraine without an aura, common migraine, and migraine with aura, classical migraine. Common migraine consists of a severe throbbing headache usually located on one side with abdominal symptoms, including loss of appetite, nausea, vomiting, dislike of food, constipation or diarrhoea. This affects about 80% of sufferers. Sufferers may also experience sensitivity to smell, light and noise which leads them to rest in a quiet, darkened room.

In classical migraine, the headache is preceded by visual disturbances such as flashing lights, zigzag lines and blind spots or tingling limbs. The average length of a migraine attack is 22 hours and sufferers generally feel washed out for another one or two days afterwards. The average number of attacks suffered is 13 per year.

The exact reason migraine occurs is unknown. However, research suggests that attacks are linked to chemical changes in the body, serotonin release, and that blood vessels and certain nerve endings within the brain are involved. Many factors can trigger migraine attacks such as stress; physical fatigue or lack of sleep; too much sleep; certain foods such as cheese or alcohol; extreme emotions; missed meals and hormonal factors. Avoidance of identifiable trigger factors reduce the number of headaches a patient may experience. Healthy lifestyles including regular exercise and avoidance of nicotine may also enhance migraine management. Non-pharmacological type interventions for control of migraine are helpful to some patients. These include biofeedback and counselling. These, as with most elements of migraine, need to be individualised to the patient.

Pharmacological control of migraine includes the use of analgesics, anti-inflammatory agents, ergotamine preparations and 5HT drugs such as sumatriptan. Due to the severity of the headache, some patients may also require a narcotic analgesic but if the patient is experiencing frequent migraine attacks, habituating analgesics should be avoided. If patients have frequent migraine attacks and if the attacks do not respond consistently to migraine specific acute treatments, or if the migraine specific medications are ineffective or contraindicated because of other medical problems, then preventive medication should be given to reduce the migraine frequency and improve the response to the acute migraine medicines. In summary, migraine is a common condition which in most cases can effectively be treated by conventional medication. However, in a small percentage of patients, migraine is a debilitating condition whose symptoms are very difficult to control.