BMJ  2006;332:25-29 (7 January), doi:10.1136/bmj.332.7532.25

Clinical review

Recent advances in the diagnosis and management of migraine

¹ Headache Group, Institute of Neurology, National Hospital for Neurology and Neurosurgery, London WC1N 3BG peterg@ion.ucl.ac.uk

The first 150 words of the full text of this article appear below.

Introduction

The World Health Organization considers that severe migraine can be as disabling as quadriplegia.¹ The disorder affects as many of 15% of adults in North America and Western Europe and is probably one of the commonest reasons for patients to see their doctors. Traditionally, headache is given little time in medical teaching, but headache science is advancing rapidly, fuelled by developments in treatment and neuroscience, and there is a sense of excitement perhaps unrivalled in neurology. Many recent advances have particular relevance to clinical practice in terms of both diagnosis and management; I will highlight these. Interested readers should see recent monographs listed in the Further reading box for more detailed accounts of the management of headache disorders.

Methods

I based my selection of topics for this review on clinical themes that arise from referrals to the Headache Group at the National Hospital for Neurology and Neurosurgery. Thus the primary driver . . . [Full text of this article]

Headache classification—improving and simplifying the diagnosis of migraine

Childhood migraine
Chronic daily headache

Core issues for general practitioners

Secondary headache
Differentiating migraine and tension-type headache

Genetics of migraine—explaining to patients why they have the problem

Pathophysiology of headache—where is the lesion?

Functional brain imaging in migraine

Migraine—what new treatments can we expect?

New treatments and unmet needs

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