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Migraine: 5 New Things To Know

Migraine: 5 New Things To Know

  • Recently a systematic review examined the available literature on acute care treatments for migraine for effectiveness and tolerability, graded each medication’s level of available evidence, and gave recommendations regarding its use. Five therapies (4 available in the US) with high to low levels of evidence gained a strong recommendation for use. Prochlorperazine (Compazine) carried the highest level of evidence. Ketorolac (IM or IV) was strongly recommended. Meperidine (Demerol) received a weak recommendation. Subcutaneous sumatriptan was the only triptan medication assessed in this review. Details here.
  • Co-author of two phase 2 studies, Peter Goadsby, MD, PhD, notes that "migraine remains poorly treated and there are few effective, well-tolerated, approved treatments that prevent attacks from occurring." Regarding initial results of calcitonin gene-related peptide (CGRP) blockade, he comments: “We are seeing a truly generational change with the first mechanism-based preventive treatment for migraine” that "may potentially represent a new era in disease-specific and mechanism-based preventive therapy for migraine.” Details here.
  • A recent study published in the journal Neurology has found a link between mid-life migraine, especially migraine with aura, and later life Parkinson's disease and parkinsonian symptoms. What's the connection? Details here.
  • Consistent with the clinical impression that migraine worsens during the menopausal transition, these data show that the risk of high-frequency headache is greater during perimenopause and postmenopause as compared with premenopause. Details here.
  • Recently FDA-approved for the prevention of episodic migraine, the Cephaly device can be considered a low risk preventative option that may reduce headache frequency in about half of patients. Details here.

Five recent studies offer new insights on migraine headaches-- its pathophysiologic underpinnings and various modes of therapy.

The five slides that follow summarize the key points of those studies and include links to more details. Among the findings:

. Evidence-based recommendations for treatment for acute migraine relief in the ED have emerged.
. 2 studies report a migraine preventive effect from an entirely novel mechanism--calcitonin gene-related peptide blockade.
. There's a link between mid-life migraine and later life Parkinson Disease and parkinsonian symptoms.
. The menopausal transition is associated with an increased frequency of migraines.
. The newly FDA-approved Cefaly device can be considered a low risk preventative option for patients with episodic migraine



Headaches since childhood. Undiagnosed till my twenties. Hospitalization for migraine and testing for food allergies, no answer. Got worse during pregnancy, but escalated as I grew older. Had so many MR scans, but no one seems to listen. Sure, stress is a main trigger, and all the drugs, ie. Anti convulsive, epileptic etc. caused even more rebound migraines. Then menoupause, got worse, still with the knowlage that I had an accident at 9 years to my neck, I could not get my Neuroligist to take it seriously. Now, at nearly 50, I had a fall, causing a rupture, necessitating an operation and disk replacement. No more migraines. Headaches now and again, but what a relief. It just shows how often health care practitioners do not listen to their patients. Cefaly is a great product, although hard to come by in South Africa, but I can recommend it to any chronic sufferer, migraine or headache. Only problem here is that the drive by pharmaceutical companies to keep Cefaly off the market. A great pity. Triggers are different for all migraine sufferers, but can mask an underlaying problem, like I my case.

Ronel @

Trying to use my "smart" phone, which I don't think is very smart, everything worked fine... A little hard to read small print. I definitely agree with "Amie", where she notes dietary and environmental and STRESS triggers... If there is only one or two triggers present... We get away with it!!! But it is that third or fourth trigger you did not factor in that breaks the dam so to speak. That is why, I guess, we always push the envelope and then that darn migraine hits with a vengeance! I had them before we even one about migraines. Finally realized at my perimenopause what was going on. That was also when Imitrex first came on the market, almost 20 years ago.

Mary @

The show cannot be opened

Stephen @

Not working in Chrome.

Rick @

Removal of mercury fillings works wonders.
Use of facial muscle relaxation techiniques and stimulation of extracranial sites of the cranial nerves with SpineLiner using the Yamasaki technique also 100% relief.

Hasnain @

Show sill does not progress beyond slide 2.

Mark @

Headache often can be very challenging to deal with, esp mixed type of headache. Relaxation technique works great for migraine

Linda @

migraine headaches complicated by chiari type one syndrome

Penelope @


The one thing I have found most effective with my personal migraines is keeping a journal and finding my triggers, or the situation food items that cause them. I found that if I hit three or more at the same time, I am almost 98% likely to suffer from one. change in weather patterns or barometric pressure, too much caffine, hormones(mences), computers for an extended period of time, foods with nitrates( bacon, hot dogs ecta).and of course increase in stress.three at the same ttime I always get one.just that this could help in some ones study for pt care. A FicereRN

Amie @

Slide Show Does not Progress,,, Please fix.

Mark @

Again the presentation does not work. You're wasting my time

James @

Slide show doesn't work

Earl R. @

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