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What Exactly Is A Migraine? How Does It Work?

MINNEAPOLIS (WCCO) -- The Food & Drug Administration recently approved a new kind of drug that could reduce migraines and shorten how long symptoms last.

So, how does it work? What exactly is a migraine? Good Question.

When you ask a migraine sufferer what it feels like, their responses vary from "feeling like you're looking through a kaleidoscope" to "extreme sensitivity to light and noise" to "feeling like your eyes are bleeding" to "sometimes feeling kind of nauseous."

"It's basically hypersensitivity to all the sensory inputs," says Dr. Nadeem Iqbal, a neurologist with Neurological Associates of St. Paul, part of Fairview Health Services.

According to the Migraine Research Foundation, 12 percent of people suffer from migraines. So, why do some people get them and others don't?

"Genetics plays a big role and women are more prone to developing this," says Dr. Iqbal. "There are certain triggers also, but other than that, we don't know."

Dr. Iqbal says the process behind a migraine is different from a traditional or sinus and tension headache. Migraines can come with an aura that precedes that headache or without an aura.

With a migraine, something triggers and excites the trigeminal nerve in the brain. That's the nerve that supplies sensation to the face and the lining of the brain, called the meninges. That stimulation of the nerve causes a variety of chemicals to be released and the blood vessels that surround the brain to inflame.

Triggers can range from food, wine, hormones, exhaustion, sleep deprivation and even a change in pressure.

"But, not all these things cause migraines in everyone," says Dr. Iqbal. "Everyone has their own trigger."

Now, the FDA has approved a new class of drugs that claim to prevent migraines or shorten the amount of time symptoms occur. The new drug, Aimovig, is the first of four in the pipeline.

It's given once a month as an injection and works by trying to disrupt the mechanism by which the inflammation occurs. Other migraine medications currently on the market often include pills originally developed for epilepsy and other conditions.

"This newer medication is more preventative," says Dr. Iqbal.

He says he would prescribe it for patients who get four or more migraines a month. Right now, it's priced at $6,900/year. That's before insurance and rebates.

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