Management of migraine

Migraine typically causes an intense, throbbing, unilateral headache. The exact cause is not known, but involves vascular, chemical and neurological factors. Migraine headache may be preceded by an aura of visual disturbance, weakness/numbness or dysphasia. Nausea, vomiting, photo- and phono-sensitivity often accompany the headache. In most cases, people have episodic attacks of migraine, however, a small proportion of sufferers develop chronic migraine with headaches occurring up to daily. This article will focus on the management of migraine in those aged 12 years and over, including management of acute attacks and chronic migraine. The differential diagnosis will be discussed and red flags that point to alternative diagnoses will be highlighted.