Management of migraine in the Caribbean: A descriptive study

Background Migraine headaches in the Caribbean region, despite being a debilitating illness impacting quality of life and inherently disability adjusted life years has not been given the emphasis it deserves. Migraine has a significant and rising neurologic burden internationally. Yet as advancements are being made, the Caribbean region is falling behind. This paper attempts to bridge that gap by gathering statistical evidence, not just of the prevalence of migraine headaches, but also of the scope of practice surrounding migraine headaches within the English speaking Caribbean. The primary objective is to assess existing healthcare infrastructure, aiming to identify critical gaps, subsequently proposing areas for improvement, to ultimately enhance care for individuals across the diverse Caribbean diaspora. Methods A descriptive, cross sectional survey was conducted over the period July to August 2025 among Neurologists across seven English speaking Caribbean territories. The questionnaire assessed specialist availability, diagnostic tools, access to therapies, non-pharmacologic interventions, barriers to care, and educational initiatives. Ethical approval was not required due to the design of the study, and the CARE guidelines were adhered to throughout. Responses reflected perceived availability rather than audited formularies. Data were analysed descriptively. No patient data were collected, ethical approval was not required, and participation was voluntary and uncompensated. Results Caribbean territories, including Trinidad, Barbados, and Jamaica, demonstrated comparatively broader therapeutic availability, while smaller nations such as Antigua, St Vincent, Guyana, and St Lucia reported markedly restricted options. Acute management remains largely reliant on older, non-specific agents, with limited access to triptans and an almost complete absence of neuromodulation or novel migraine specific therapies. This heterogeneity in therapeutic access reflects systemic disparities in headache care across the region. Conclusion The Caribbean diaspora is a multi-cultural and highly diverse group, which unfortunately has previously been under-represented in worldwide studies on migraine treatment and management, meaning that the care afforded to patients has often been limited. This paper has identified several key gaps, that once addressed, should significantly improve the standard of care for migraine headaches in the region, thereby improving the quality of life of patients, and by extension, mitigating it's downstream socio-economic consequences.