Migraine is a chronic disease that occurs due to the hypersensitivity of the nucleus in the brain stem of the trigeminal nerve that receives the sensation of the face and head. Migraine can be triggered by external stimuli such as cold, light, and smell, as well as mood disorders such as sleep, hunger, depression and anxiety due to the connections of this nerve with many systems in the brain.
The main exacerbation of the pain in migraine is the enlargement of the head and brain vessels with the effect of the trigeminovascular system on the vessels. Migraine headaches can be seen in childhood or even infancy. However, after the effects of hormones in adolescence and stress factors come into play, the frequency and severity of pain between the ages of 35-45 affect daily life. Patients are born predisposed to hypersensitivity of the nerve.
Until 10 years ago, migraine treatment consisted of only pain relievers and drugs used in different diseases. Botulinum toxin is a drug that has found its place as the gold standard treatment in many different fields since 1989, and was approved by the FDA in 2009, specifically for the mechanism of chronic migraine. The effectiveness and safety of the drug has been documented by thousands of studies and patients. There is very clear scientific evidence for its use in migraine. Botulinum toxin significantly increases the number of pain-free days in chronic migraine patients and enables patients to return to daily life with an increase in their quality of life.
VACCINE METHOD IN MIGRAINE TREATMENT
Drugs used during attacks, ie migraine attacks, are not suitable for long-term use. The first of these is the triptan group drugs that we know to be effective. Since these drugs cannot be used more than 6-8 tablets per month, botulinum toxin is the only approved treatment option in chronic migraine as an effective and safe treatment in patients with frequent attacks of 15 days or more.
With the advancement of drug technology, the interest in migraine treatment is increasing. We know that many diseases that could not be cured in the past can now be treated with the biological medicine revolution. However, these drugs are prioritized for the use of life-threatening diseases due to research and development processes and production costs. The drug defined as migraine vaccine (erenumab) is in the biological drug group and is basically not a vaccine. There is no such thing as completely treating and ending migraine. Because it is an injectable product, it has taken this name among the people. This drug blocks the receptors on the vessel to which cgrp substance, which is released from the trigeminal nerve endings and causes the vessels to dilate, is attached.
