Abstract

MIGRAINE: A COMPREHENSIVE REVIEW OF PATHOPHYSIOLOGY, MANAGEMENT, AND FUTURE DIRECTIONS:

Thiyagarajan S., T. Lokeswari, V. Chandru, Dr. P. Pravallika*

Abstract

Background: Migraine is a severely disabling neurological disorder driven by deep brain mechanisms. The four-phase attack, marked by unilateral, throbbing pain, is fundamentally linked to the hypothalamus and activation of the trigeminovascular system, where the peptide CGRP acts as the primary pain signal. It's a huge global health burden, yet widely mistreated. Scope: This review explores migraine's biological basis and assesses current treatments, from simple analgesics to specialized Triptans. We aim to highlight major gaps in care— such as poor diagnosis, limited provider knowledge, and unequal access to the best medicines—to define a realistic path toward future personalized treatment. Key Findings: Migraine is consistently underdiagnosed and undertreated because many healthcare workers aren't fully familiar with diagnostic rules or first-line drugs. This forces patients onto over-the-counter painkillers, increasing the risk of chronic migraine. Effective treatments, especially newer CGRP-targeted drugs, are oftenout of reach due to cost. Research bias toward women also means the significant suffering of men is frequently overlooked. Conclusion: Better outcomes depend on adopting a personalized medicine model. This requires substantial healthcare reforms, including mandated medical education and efforts to ensure all patients have equitable access to the full spectrum of modern, evidence-based therapies.

Keywords: Migraine Pathophysiology, Triptans, CGRP Inhibitors, Treatment Gaps, Personalized Medicine.