Abstract

INTRODUCTION

Primary headache disorders are the most frequent reason for referral to neurologists worldwide, and most of these patients have migraine (Menken 1996; Sempere et al. 2002; Rajput et al. 1988). Migraine is a common and frequently incapacitating headache disorder characterized by episodic attacks of moderate-to-severe headache, along with various combinations of neurological, gastrointestinal and autonomic symptoms (Goadsby et al. 2002). The one-year prevalence of migraine is 11% in the United States and Western Europe (6% for males and 15–18% for females) and one quarter of migraine patients experience one or more attacks per week (Goadsby et al. 2002; Hamelsky et al. 2001). A recent report by the World Health Organization ranks migraine as one of the most disabling chronic conditions and equates a day with severe migraine to the disability associated with a day with quadriplegia, psychosis or dementia (Menken et al. 2000).

The aggregate impact of migraine