偏头痛,一种普遍的神经系统疾病,影响了约14.1%的全球人口,对女性的影响不成比例。这种使人衰弱的状况极大地损害了生活质量,生产力,并导致高昂的医疗费用,不仅对个人,而且对整个社会结构都提出了挑战。尽管我们对偏头痛病理生理学的理解有所进步,治疗选择仍然有限,需要对有效疗法进行持续研究。这篇综述深入研究了偏头痛管理的复杂性,检查遗传易感性的作用,环境影响,个性化治疗方法,合并症,现有急性和预防性治疗的疗效和安全性。它进一步探讨了偏头痛和紧张型头痛之间的连续性,并讨论了治疗各种偏头痛亚型的复杂性,包括有和没有光环的人。我们强调最近向三叉神经血管激活和血管活性物质释放的范式转变,如降钙素基因相关肽(CGRP),提供了新的治疗靶点。我们评估开创性的临床试验,药代动力学和药效学观点,安全,耐受性,以及CGRP单克隆抗体和gepant的实际应用。面对误诊等持续存在的治疗障碍,药物过度使用头痛,获得专科护理的机会有限,我们讨论了创新的CGRP针对性策略,长期疗效数据的高成本和稀缺,并建议为土耳其和发展中国家量身定制的全面解决方案。审查提供了战略建议,包括制定初级保健准则,建立专门的门诊诊所,向医生介绍新的治疗方法,提高全球对先进疗法的可及性,培养病人的教育。强调改变生活方式和整体方法的重要性,该综述强调了大众媒体和患者群体在传播关键健康信息和塑造偏头痛管理未来方面的潜力.
Migraine, a prevalent neurological disorder, affects approximately 14.1% of the global population and disproportionately impacts females. This debilitating condition significantly compromises quality of life, productivity, and incurs high healthcare costs, presenting a challenge not only to individuals but to societal structures as a whole. Despite advances in our understanding of migraine pathophysiology, treatment options remain limited, necessitating ongoing research into effective therapies. This review delves into the complexity of migraine management, examining the roles of genetic predisposition, environmental influences, personalized treatment approaches, comorbidities, efficacy and safety of existing acute and preventive treatments. It further explores the continuum between migraine and tension-type headaches and discusses the intricacies of treating various migraine subtypes, including those with and without aura. We emphasize the recent paradigm shift toward trigeminovascular activation and the release of vasoactive substances, such as calcitonin gene-related peptide (CGRP), which offer novel therapeutic targets. We assess groundbreaking clinical trials, pharmacokinetic and pharmacodynamic perspectives, safety, tolerability, and the real-world application of CGRP monoclonal antibodies and gepants. In the face of persisting treatment barriers such as misdiagnosis, medication overuse headaches, and limited access to specialist care, we discuss innovative CGRP-targeted strategies, the high cost and scarcity of long-term efficacy data, and suggest comprehensive solutions tailored to Turkiye and developing countries. The review offers strategic recommendations including the formulation of primary care guidelines, establishment of specialized outpatient clinics, updating physicians on novel treatments, enhancing global accessibility to advanced therapies, and fostering patient education. Emphasizing the importance of lifestyle modifications and holistic approaches, the review underscores the potential of mass media and patient groups in disseminating critical health information and shaping the future of migraine management.