A detail review on migraine

Migraines are neurological disorders causing headaches, nausea, and sensory changes that affect over 12% of the population. They mostly happen on their own, can last for hours to days, disturb daily activities, and most often appear without aura. Certain subtypes include migraine with aura, migraine without aura, chronic migraine, hemiplegic migraine, retinal migraine, menstrual migraine, vestibular migraine, and migraine with brainstem aura. Mast cells, though known for causing allergic reactions, also play a part in immunity and inflammation. The prevalence of migraine is higher among individual with allergies and asthma; thus, mast cells may be involved in both the brain and the meninges. Migraine is diagnosed by history, examination, symptoms, and imaging. The management comprises acute therapies such as NSAIDs, triptans, ergot, antiemetics, ditans, and gepants, while preventive therapy uses beta-blockers, antiepileptics, antidepressants, calcium-channel blockers, and angiotensin-system drugs are used for preventive therapy. Newer treatment inhibits CGRP to reduce attack frequency. Mechanism of action for migraine treatments include the following: NSAIDs reduce prostaglandins by blocking COX enzymes, triptans stimulate serotonin receptors, antiemetics block dopamine pathways, and ditans target 5-HT1F receptors without affecting blood vessels. Preventive options include beta-blockers, antiepileptics, and calcium-channel blockers that stabilize nerve activity. New targets - like PACAP, TRP channels nitric-oxide signaling, and purinergic pathways-guide emerging therapies. Recently approved drugs such as Rimegepant, atogepant, eptinezumab, Zavegepant, and Symbravo brief examples are both acute and preventive migraine care.