Fortnightly Review: Diagnosis and management of migraineBMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7041.1279 (Published 18 May 1996) Cite this as: BMJ 1996;312:1279
- a Institute of Neurology, National Hospital for Neurology and Neurosurgery, London WC1N 3BG
- b Department of Neurology, Glostrup Hospital, Glostrup, Denmark
- Correspondence to: Dr Goadsby.
Before a primary headache such as migraine is diagnosed, secondary headaches should be considered and eliminated on clinical grounds or by appropriate investigations
Migraine is primarily diagnosed by eliciting a history of episodic headache with characteristic associated features. The use of diagnostic headache diaries and simple calendars is strongly encouraged
Optimum treatment of migraine requires explaining the problem to the patient and identifying and avoiding precipitating factors
Treatment may be non-pharmacological or pharmacological. Drugs may be for treating acute attacks, which is required by nearly all patients, or prophylaxis, which is used by patients with frequent severe attacks
Treatment for an acute attack should result in mild or no headache by two hours after drug ingestion, while prophylactic treatment should result in a 50% reduction in the frequency of attacks
Characterisation of the 5-hydroxytryptamine receptor of the 5-HT1 class has provided better treatments for acute attack and impetus for studying mechanism of migraine
Log in using your username and password
Log in through your institution
Register for a free trial to thebmj.com to receive unlimited access to all content on thebmj.com for 14 days.
Sign up for a free trial