Navigating migraine care through the COVID-19 pandemic: an update

• Published in: Journal of Neurology Vol. 268; no. 11; pp. 4388 - 4395
• Main Authors: Angus-Leppan, Heather, Guiloff, Angelica E., Benson, Karen, Guiloff, Roberto J.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Science and Business Media LLC 01.11.2021; Springer Berlin Heidelberg; Springer Nature B.V
• Subjects: Acupuncture; Botulinum toxin; Communicable Disease Control; Coronary artery disease; Coronaviruses; COVID-19; COVID-19 - complications; Diabetes mellitus; Headache; Heart diseases; Humans; Immunosuppression; Long COVID; Medicine; Medicine & Public Health; Migraine; Migraine Disorders; Migraine Disorders - epidemiology; Migraine Disorders - therapy; Neurological Update; Neurology; Neuroradiology; Neurosciences; Pandemics; Post-Acute COVID-19 Syndrome; Quality of Life; Respiratory diseases; Risk factors; Telemedicine; COVID-19; Headache; CGRP antagonists; Telemedicine; Long COVID; Migraine
• ISSN: 0340-5354; 1432-1459; 1432-1459
• DOI: 10.1007/s00415-021-10610-w

The worldwide treatment gap for migraine before COVID-19 inevitably widens as attention focuses on an international emergency. Migraine hits people particularly in their early and middle years, potentially reduces quality of life and productivity, and remains a common emergency presentation. This article examines the impact of COVID-19 on migraine, and changing aspects of migraine care during and after the pandemic. Many risk factors for severe COVID-19—older age, male gender, cardiac and respiratory diseases, diabetes, obesity, and immunosuppression—are less frequent in migraineurs. Telemedicine is effective for migraine follow-up, and needs ongoing evaluation. Most migraine treatments can start or continue in acute COVID-19, with care to avoid drug interactions. Close contact procedures (botulinum toxin, acupuncture and steroid injections) are avoided in lockdown or in the vulnerable. Secondary effects of COVID-19, including long COVID and its economic impact, are probably equal or greater in people with migraine. Migraine and other long-term conditions need adequate resourcing to prevent personal, social and economic suffering. Treating migraine, a sequel of COVID, potentially reduces the impact of long COVID.