Migraine in Adults
Migraine is a common primary headache disorder. It is characterized by attacks of moderate or severe headache and associated symptoms such as photophobia, phonophobia, nausea, and vomiting.
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- Headache is typically unilateral, pulsating or throbbing and lasts 4–72 hours.
- Migraine symptoms are often aggravated by, or cause avoidance of, routine activities of daily life (such as walking).
- Migraine can occur with or without aura.
- Aura is characterized by transient focal neurological symptoms (for example visual symptoms such as fortification spectra and/or scotoma, speech disturbance, or sensory symptoms such as paraesthesiae) which usually precede, or in some people, accompany the headache.
- Depending on the frequency of attacks migraine can be classified as episodic or chronic.
- Episodic migraine occurs on fewer than 15 days per month.
- Chronic migraine is headache occurring on at least 15 days per month
- A headache diary may be useful to identify potential triggers (such as stress, specific foods, dehydration, missed meals, or disturbed sleep) and monitor effectiveness of treatment.
- Depending on the specific clinical situation, management of acute migraine includes:
- Trigger avoidance (where possible) and lifestyle changes.
- Drug treatment with simple analgesia (such as paracetamol, ibuprofen, or aspirin), or a triptan, or combination therapy with a triptan and paracetamol or a nonsteroidal anti-inflammatory drug.
- An anti-emetic (prochlorperazine or metoclopramide) may be added even in the absence of nausea or vomiting.
Please see pathways attached for more information.
For treatment of migraine in adults in primary care please see additional document attached.
