A Short Review of Migraine headaches in Nigeria: Epidemiology, Current Challenges, Treatment Approaches, and Future Directions for Improved Management.

Background and objective: Migraine, a leading cause of global disability, disproportionately burdens low-resource countries like Nigeria, where healthcare inequities, cultural stigma, and infrastructural gaps hinder effective management. Despite global advances in migraine therapeutics, Nigeria's burden remains understudied, with fragmented data on epidemiology, treatment access, and outcomes.

Methods: We conducted a narrative review of the literature on migraines in Nigeria using sources such as PubMed, MEDLINE, African Journals Online (AJOL), and Embase. This review synthesizes a broad range of peer-reviewed articles, regional reports, and gray literature to provide an interpretative overview of the topic.

Results: Available evidence suggests that migraine prevalence in Nigeria is estimated at 15-20%, with urban areas reporting rates as high as 26% and a pronounced gender disparity (3:1 female-to-male ratio). Rural regions experience significant underreporting, often attributed to cultural interpretations of migraine symptoms as spiritual phenomena. Most patients rely on over-the-counter analgesics, with 30% developing medication-overuse headaches. Advanced therapies such as triptans and CGRP inhibitors are largely inaccessible due to prohibitive costs.

Conclusion: Nigeria's approach to migraine care lags significantly behind global standards, underscoring the need for context-specific innovations. Priority areas include the expansion of telemedicine to overcome specialist shortages, incentives for local medication production, and the integration of traditional healers into formal referral networks. Policy reforms and collaborative efforts among stakeholders are essential to align Nigeria's migraine management with evidence-based practices, ultimately reducing the burden on individuals and the economy.