Migraine — Current Understanding and Treatment

• Published in: The New England journal of medicine Vol. 346; no. 4; pp. 257 - 270
• Main Authors: Goadsby, Peter J, Lipton, Richard B, Ferrari, Michel D
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 24.01.2002
• Subjects: Analgesics - therapeutic use; Biological and medical sciences; Ergotamines - therapeutic use; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Headaches; Humans; Medical research; Medical sciences; Migraine; Migraine Disorders - diagnosis; Migraine Disorders - drug therapy; Migraine Disorders - physiopathology; Migraine Disorders - prevention & control; Nervous system (semeiology, syndromes); Neurology; Pain - etiology; Receptors, Serotonin; Serotonin Receptor Agonists - pharmacology; Serotonin Receptor Agonists - therapeutic use; Human; Nervous system diseases; Pathogenesis; Treatment efficiency; Migraine; Cardiovascular disease; Ergot derivatives; Epidemiology; Cerebral disorder; Vascular disease; Non steroidal antiinflammatory agent; Symptomatology; Chemotherapy; Analgesic; Pain; Treatment; Central nervous system disease; Triptan derivatives; Cerebrovascular disease
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMra010917

Migraine is a common and sometimes debilitating disorder. This review describes the epidemiology, pathophysiology, and preventive and symptomatic treatment of migraine, with special attention to drug therapy with the triptans. Migraine is a common, chronic, incapacitating neurovascular disorder, characterized by attacks of severe headache, autonomic nervous system dysfunction, and in some patients, an aura involving neurologic symptoms. 1 , 2 Recent advances in basic and applied clinical neuroscience 3 have led to the development of a new class of selective serotonin (5-hydroxytryptamine [5-HT]) receptor agonists that activate 5-HT 1B and 5-HT 1D (5-HT 1B/1D ) receptors and are known as the triptans; these agents have changed the lives of countless patients with migraine. Despite such progress, migraine remains underdiagnosed and the available therapies underused. 4 In this article, we review the current understanding of . . .