In colloquial language, migraine is considered synonymous with headache due to its wide distribution among population. But neurologically it is more than just a headache because it involves neural pathways, neurotransmitters and hormones. It is characterized by constant and frequent, mild to disabling throbbing or pulsating headache associated with a wide variety of symptoms.
In neurosciences, according to ad hoc committee definition Migraine is defined as “recurrent attacks of headache widely varied in intensity, frequency and duration. The attacks are commonly unilateral at onset; are usually associated with anorexia, and sometimes, with nausea and vomiting; in some, are preceded or associated with conspicuous sensory, motor and mood disturbances (aura), and are often familial.”
In general population, migraine is notorious to affect a fair number of people. Mostly women are affected more than men. Its incidence is 15 – 18 % in females, about 6% in males and 4 – 6 % in children. Incidence varies with age, gender and presence of aura. Migraine with aura has an earlier onset of age. During and after puberty, migraine is more common in women than men. Overall, migraine is a chronic debilitating disease making day to day activities difficult for the patient.
Medical management is the mainstay of treatment of migraine, but a large number of patients are refractory to medical management. There is worsening of migraine in spite of treatment. Occipital nerve stimulation is an invasive procedure is highly effective procedure when other conservative treatment fails to relieve the intractable pain of chronic posterior headache.