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Inventis - June 2023

What constitutes comprehensive guidance on effective treatment strategies for migraine?

Vishal Pawar

December 21, 2023

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Question

What constitutes comprehensive guidance on effective treatment strategies for migraine?

Answer

Managing migraine effectively involves a multi-pronged approach that addresses both the underlying causes and symptoms[1].

  1. Identification and avoidance of triggers:

This forms the cornerstone of migraine management. Recognizing and avoiding specific triggers can significantly reduce the frequency of migraine episodes[2]

Triggers: Yes / No

  • Emotional stress
  • Excessive thinking
  • Prolonged use of electronic devices
  • Sun exposure
  • Skipping meals
  • Direct airflow from fans or AC
  • Stressful travel conditions
  • Physical exertion
  • Bright lights and loud noises
  • Strong odors and perfumes
  • Altered sleep patterns
  • Dehydration
  • Specific foods
  • Menstrual cycles in females
  1. Preventive medication:

If you experience more than four episodes of headache per month, daily preventive medication may be beneficial[3]. These medications do not function as analgesics but rather address the root causes of migraines, reducing both their frequency and severity when taken consistently.

  1. Acute Treatment of Migraine Episodes:

Individual episodes should be managed with medications such as Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) or Triptans[4]. Over-reliance on these medications without lifestyle modifications and preventive medication, or overuse (more than eight times per month), can exacerbate the underlying condition, leading to medication overuse headaches[5]. Consultation with a specialist is strongly advised for appropriate treatment planning.

    References

    1. Lipton RB, Silberstein SD. "Epidemiology and impact of headache,"Headache, 1994; 34(6): 320–327.

    [PubMed](https://pubmed.ncbi.nlm.nih.gov/7928310/).

    2. Kelman L. "The triggers or precipitants of the acute migraine attack,"Cephalalgia, 2007; 27(5): 394–402.

    [PubMed](https://pubmed.ncbi.nlm.nih.gov/17403039/).

    3. Silberstein SD, Holland S, Freitag F, et al. "Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults,"Neurology , 2012; 78(17): 1337–1345.

    [PubMed](https://pubmed.ncbi.nlm.nih.gov/22529203/)

    4. Goadsby PJ, Raskin NH. "Headache,"Handbook of Clinical Neurology , 2018; 139: 173–190.

    [PubMed](https://pubmed.ncbi.nlm.nih.gov/29307309/)

    5. Diener HC, Dodick DW, Goadsby PJ, et al. "Chronic migraine—classification, characteristics and treatment,"Nat Rev Neurol ,2012; 8(3): 162–171.

    [PubMed](https://pubmed.ncbi.nlm.nih.gov/22330909/).

    Resources for More Information 


    vishal pawar

    Vishal Pawar

    Dr. Vishal Pawar is a highly skilled specialist neurologist with over a decade of experience in neurology and oto-neurology. He completed his MBBS, DNB in Medicine, and DNB in Neurology in India and has been a valuable member of the Aster Gardens specialty clinic in Dubai for seven years. Dr. Pawar's expertise lies in vestibular medicine and headache disorders, and he has actively contributed to patient care, academics, and research in these areas. He has earned recognition as a Fellow of the European Board of Neurology and has established a dedicated vertigo clinic.


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