Migraines cost 6,704 euros per patient per year, 90 per cent of which is due to lost productivity

There are several types, although there are two main ones: episodic, i.e. where there are fewer than 15 days of pain per month, or chronic, where there are 15 or more. In Malaga, estimates from experts and medical societies suggest that more than 200,000 people (five million in Spain) are affected, and around 65,000 (one million nationwide) suffer from the chronic form, 80 per cent of whom are women.

Dr Roberto Belvís points out that there are currently treatments capable of radically changing the lives of migraine sufferers, “but the vast majority of those who could benefit from them are not gaining access to these medicines”. “This is due, in part, to the under-diagnosis that continues to plague this condition, but also to the administrative barriers that limit access to the most innovative treatments, even when scientific evidence clearly supports their use,” he adds.

According to the SEN, six anti-CGRP drugs have been available in Spain since 2019, but their prescription is subject to funding criteria that are much stricter than those established by the European Medicines Agency (EMA). Whilst the EMA authorises their use for patients experiencing four days of migraine per month, the National Health Service requires that the patient suffers from at least eight days of migraine per month “and has previously failed to respond to three different preventive treatments”, it adds. These medicines are used to prevent migraine attacks.

A few months ago, the SEN, the Spanish Association for Migraine and Headaches (AEMICE) and the Spanish Headache Foundation (FECEF) sent a joint letter to the Ministry of Health calling for the removal of these restrictions, a request which the Government has rejected.

In any case, there is a significant problem of under-diagnosis: more than 40 per cent of those suffering from this condition remain undiagnosed. Twenty-five per cent of them have never consulted a doctor about their condition. The delay in diagnosis can be as long as six years.

The impact of the condition on the lives of those who suffer from it is significant. Some 48.9 per cent of sufferers have some degree of disability associated with their condition, and one in five suffers from severe disability. “Furthermore, migraine is associated with poorer mental health: almost four in ten patients experience moderate to severe depressive symptoms, and their quality of life – as measured using validated scales – is well below that of the general population,” says Dr Belvís, who is the coordinator of the Headache Study Group at the SEN.

The condition also places a heavy burden on healthcare resources. Over a six-month period, 68.4 per cent of patients have visited their GP, 14.2 per cent have seen a neurologist, 45.6 per cent have attended A&E and 11.8 per cent have been hospitalised.

Dr Ana Jimeno, a neurologist at Vithas Granada and the Vithas Institute of Neurosciences, states that migraine requires a comprehensive medical approach in which healthy lifestyle habits play a key role alongside medical treatment. “Maintaining regular sleep patterns, exercising regularly and following a healthy diet are measures that can help reduce the frequency and intensity of attacks.” A good starting point, according to the doctor, is “a Mediterranean-style diet, rich in plant-based foods, pulses, nuts and oily fish, amongst others.”

It is important to identify and manage individual triggers. Stress is one of the main ones. The condition, however, goes far beyond a simple headache.

José Antonio Reyes, a neurologist at Vithas Xanit Internacional, explains: “It is characterised by episodes of severe pain which may be accompanied by nausea, sensitivity to light and noise, and even significant difficulty in carrying out everyday activities.” Early diagnosis and personalised treatment are essential for managing the condition, reducing attacks and improving quality of life.

The head of the Neurology Department at Vithas Málaga Hospital, Dr Pedro Serrano, points out that, although there is a genetic predisposition, seizures are usually triggered by various factors. “The most common are stress, lack of sleep, dehydration, alcohol or caffeine consumption, and sudden changes to daily routines. Each patient has their own triggers, so identifying them and maintaining a healthy lifestyle, with regular routines and plenty of rest, is essential,” he says.

“Migraine is a highly debilitating neurological condition that has a direct impact on the workplace,” explains the specialist. The neurologist emphasises that “we now have increasingly targeted treatments”. “Early diagnosis, personalised treatment and adapting the workplace where necessary are key measures for preventing the condition from becoming chronic, improving well-being and enhancing professional performance,” he concludes.

Migraines are more common in women and may be particularly influenced by hormonal fluctuations. Menstruation, pregnancy, the postnatal period and the transition to the menopause can alter the frequency or severity of migraine attacks.