[Migraine in 2009: from attack to treatment]

Rev Med Brux. 2009 Sep;30(4):399-403.
[Article in French]

Abstract

Migraine is Europe and North America's most frequent neurological illness. Its prevalence is about 12%, affecting women twice more than men. Migraine illness is defined by the occurrence of several episodes of pulsatile headaches, uni- or bilateral, accompanied or preceded by signs of central and autonomic nervous system dysfunction. Considered benign, it can lead to non negligible social and professional handicap. Its social and economic repercussions are serious, due to consequences in terms of work incapacity. Essentially relying on drugs, therapeutic divides itself into migraine attack treatment and migraine prophylaxis. Migraine attack treatment relies essentially on acetaminophen and non-steroidal antiinflammatory agents, associated or not with antiemetics like domperidone and metoclopramide, accessorily on ergot derivatives and triptans. Migraine prophylaxis is best provided by propranolol, valproic acid and amitryptiline, anti-serotoninergic agents, topiramate, flunarizine and other agents should be reserved to particular cases. In some cases, children in particular, non-drug approaches such as relaxation, biofeedback or behavioral therapy can be privileged although relying on weak scientific evidences.

Publication types

  • English Abstract

MeSH terms

  • Adrenergic Uptake Inhibitors / therapeutic use
  • Amitriptyline / therapeutic use
  • Behavior Therapy
  • Biofeedback, Psychology
  • Child
  • Europe / epidemiology
  • Female
  • Humans
  • Male
  • Migraine Disorders / economics
  • Migraine Disorders / epidemiology
  • Migraine Disorders / psychology
  • Migraine Disorders / therapy*
  • North America / epidemiology
  • Relaxation Therapy
  • Serotonin Antagonists / therapeutic use

Substances

  • Adrenergic Uptake Inhibitors
  • Serotonin Antagonists
  • Amitriptyline