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Chapter 12 - Migraines

from Part III - Chronic Pain Conditions Head and Neck

Published online by Cambridge University Press:  01 December 2023

Omar Viswanath
Affiliation:
Creighton University, Omaha
Ivan Urits
Affiliation:
Southcoast Brain & Spine Center, Wareham
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Summary

Migraine headache is a highly prevalent and disabling neurological primary headache disorder. It is characterized by disabling, throbbing, episodic, unilateral headaches associated with neurologic features such as photophobia, phonophobia, or autonomic symptoms like nausea and vomiting lasting 4 to 72 hours at a time. Patients will often avoid bright lights or loud noises. About 30% of migraine patients experience auras which are unilateral focal neurological disturbances prior the headache onset, often manifested as visual, sensory, or motor symptoms. Pathophysiology of migraine headache is still unclear and is being studied; however, calcitonin gene-related peptide (CGRP) is believed to play a major and important role, and therefore has become a primary therapeutic target. This was supported by the finding of CGRP release during acute migraine attacks and then subsequent normalization of CGRP levels after efficacious sumatriptan treatment. These findings have been a focal point in recent pharmacological developments in managing migraine headaches.

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Publisher: Cambridge University Press
Print publication year: 2023

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