RIYADH: Dr. Walid Alesefir, consultant neurologist and headache specialist at Al-Habib Hospital in Riyadh talks us through migraine care and rates in the Gulf — as well as the surprising fact that in the Gulf, women are twice as likely to suffer from migraines.
The World Health Organization recognizes migraines as the world’s second leading cause of disability. Despite affecting more than one billion people globally and up to one-third of the population in Arab countries, there is a persistent stigma around this serious and often debilitating condition. The severity of symptoms is often dismissed with the perception that it’s “just a headache,” leading to its underdiagnosis and undertreatment and both health and economic impact.
Migraine attacks can last for hours to days, and the pain can be so severe that it interferes with your daily activities. Some common triggers include stress, lack of sleep, menstruation, caffeine and alcohol consumption. With the rapid urbanization of the Middle East and Africa region, these stressors are increasingly present in many people’s lives. Once triggered, symptoms could range from pulsating headaches, nausea, and vomiting to sound and photosensitivity. Migraine attacks can also affect the brain, spinal cord, and nerves throughout the body, potentially causing intense pain and nausea. These symptoms can range anywhere from 4 to 72 hours.The unpredictability means that migraine can strike at any time, causing significant disruptions to people’s lives.
Despite its crippling effects, migraine remain overlooked, underdiagnosed, and undertreated. In fact, only 40% of those with migraine or tension-type headaches are professionally diagnosed. Misconceptions around migraine being “just” a headache often lead to patients invalidating their own symptoms. Poor treatment outcomes also contribute to this; more than two-thirds of people living with migraine have either never consulted a physician or have stopped doing so due to low expectations of treatment. Many people living with migraines are unsatisfied with the current standard of care.
Untreated migraine impact mental health and the economy
Beyond the pain, living with migraines has repercussions on mental health. People who get migraine are two to four times more likely to suffer from depression, experience feelings of isolation and helplessness against the pain. The underdiagnosis of migraine may result in misunderstandings, stigmatization, and a lack of support from family, friends, and the broader society. The unpredictable nature of migraine and the lack of understanding or validation from others can further contribute to emotional burden and feelings of isolation.
Likewise, people who live with migraines have to carry the burden of direct costs of doctor visits, hospitalizations, and medical treatments. These costs may have a disproportionate effect to underprivileged communities in the Middle East and Africa region who have to balance other everyday priorities on top of their migraine attacks. To contextualize, these patients also miss an average of 4.5 working days a month – adding to the economic costs of living with migraine.
Migraine attacks don’t just impact the sufferer, however. The loss of work productivity and absenteeism among patients with undiagnosed migraine can have a significant economic impact on both employers and society as a whole. Migraine account for a greater global economic burden than all other neurological conditions combined. Globally, migraines impact women three to four times more than men, and attacks are often more severe for women. In the Gulf, women are twice as likely to suffer from migraines.
Underdiagnosis can strain healthcare resources, as these patients may visit multiple healthcare providers seeking relief and answers. This can lead to increased healthcare utilization, longer wait times, and decreased accessibility for those in need of care.
Awareness is key to proper migraine care
Addressing the underdiagnosis of migraine is crucial to minimize these individual and societal impacts. Education and awareness campaigns, improved access to healthcare services, and better training for healthcare professionals can contribute to early detection, appropriate treatment, and improved management of migraine.
There have been efforts to raise awareness about migraine in the region. For instance, in the UAE where the migraine is the second-highest cause of disability, RAK hospital hosted migraine patient panels in order to destigmatize and share resources about migraine pain management and treatment.
However, there remains a significant amount of work ahead. By enhancing public awareness and bolstering the capabilities of our healthcare system, we have the potential to enhance the detection rates of migraine and alleviate the associated effects on individuals and society. It is crucial for individuals, healthcare providers, policymakers, and society as a whole to join forces in a unified endeavor to minimize the underdiagnosis of migraine and enhance the overall well-being of those afflicted by this incapacitating condition.