Content:
Overview
Content on this page:
Overview
Content on this page:
Overview
Overview
Migraine headache without aura has at least five attacks of any two symptoms of unilateral headache that is throbbing or pulsating in nature, moderate to severe pain and activity-aggravated pain. It is accompanied by nausea and/or vomiting, photophobia and phonophobia. The symptoms last for 4-72 hours without signs of secondary headache.
Migraine headache with aura has at least two attacks with any of the fully reversible symptoms of flickering lights, spots or lines and/or vision loss, sensory symptoms of pins and needles and/or numbness and dysphasic speech disturbance but without motor weakness. Accompanied by at least two of the following symptoms of homonymous visual symptoms and/or unilateral sensory symptoms or at least one aura symptom develops gradually over ≥5 minutes and/or different aura symptoms that occur in succession over ≥5 minutes.
Therapy should be guided according to frequency, duration and severity of attacks, associated symptoms, degree of disability, history of treatment, evidence-based efficacy and patient’s preference. Coexisting medical conditions should also be considered in migraine therapy. Effective therapy should be established and promptly used to decrease pain and disability.
The use of drugs is based on a progressive predetermined way. Safe, effective and inexpensive medications are used as first-line agents. If initial agent fails, migraine-specific medication is then used.
Prophylactic treatment should be considered in patients whose attacks significantly interfere with daily activities despite acute therapy, with frequent attacks, with contraindication/unresponsive to ≥10 days/month treatment with ergot derivatives, triptans, opioids, or combination drugs, or ≥15 days/month treatment with non-opioid analgesics, Acetaminophen, or NSAIDs, with adverse events from acute therapy, or upon patient’s request. The agent used should be started at a low dose and slowly titrated to higher doses. Increase dose until benefit is seen or until limited by adverse events.
For further information regarding the management of Migraine Headache, please refer to Disease Algorithm for the Treatment Guideline.
Migraine headache with aura has at least two attacks with any of the fully reversible symptoms of flickering lights, spots or lines and/or vision loss, sensory symptoms of pins and needles and/or numbness and dysphasic speech disturbance but without motor weakness. Accompanied by at least two of the following symptoms of homonymous visual symptoms and/or unilateral sensory symptoms or at least one aura symptom develops gradually over ≥5 minutes and/or different aura symptoms that occur in succession over ≥5 minutes.
Therapy should be guided according to frequency, duration and severity of attacks, associated symptoms, degree of disability, history of treatment, evidence-based efficacy and patient’s preference. Coexisting medical conditions should also be considered in migraine therapy. Effective therapy should be established and promptly used to decrease pain and disability.
The use of drugs is based on a progressive predetermined way. Safe, effective and inexpensive medications are used as first-line agents. If initial agent fails, migraine-specific medication is then used.
Prophylactic treatment should be considered in patients whose attacks significantly interfere with daily activities despite acute therapy, with frequent attacks, with contraindication/unresponsive to ≥10 days/month treatment with ergot derivatives, triptans, opioids, or combination drugs, or ≥15 days/month treatment with non-opioid analgesics, Acetaminophen, or NSAIDs, with adverse events from acute therapy, or upon patient’s request. The agent used should be started at a low dose and slowly titrated to higher doses. Increase dose until benefit is seen or until limited by adverse events.
For further information regarding the management of Migraine Headache, please refer to Disease Algorithm for the Treatment Guideline.
