Last week a lecture at a conference in Vienna, then her consulting hours, and after that promoting a new online course via Instagram: Prof. Dr Dagny Holle-Lee is very active. She is one of Germany’s leading migraine researchers and since 2014 has headed the West German Headache Center in Essen, the largest in Germany, where they treat roughly 4,000 patients a year. ‘Some just need one consultation, others we support for years, because the complaints are very individual’, says Holle-Lee.

Trying to explain migraines is like a giant puzzle, because the triggers, pattern and symptoms can differ so much. Some aspects are now understood, but we still lack understanding of how things interconnect: what is the trigger and what is the consequence of an attack.

All of this makes diagnosis difficult: ‘There are no biomarkers like we have with a heart attack. From both a medical perspective and that of their sufferers, the causes of headaches are often only diagnosed late. Many think they are just a normal part of life and you have to put up with it. We want to change this’, says the 42-year-old, who also works as senior physician in the neurological department.

There are more than 200 types of headache – the two most common are the dull, oppressive tension headache and the throbbing-pulsing migraine. The latter is the most common neurological disease – and the most harmful to quality of life. Current studies by the Robert Koch Institute indicate that over 28 percent of all women and over 18 percent of all men in Germany are affected. Mostly they start in puberty, but for some it is even in childhood. Often the migraines become increasingly frequent over the course of a lifetime, and only start to recede gradually in old age.

In the chronic form, the pains occur on 15 or more days a month, sometimes accompanied by dizziness, nausea or visual disturbances. Yet anyone who takes pain medications or migraine remedies too often risks their pains becoming chronic – a cycle that has to be broken.