Research: SUPIOT F,

Listed in Issue 179

Abstract

SUPIOT F, Service de Neurologie, Hopital Erasme, Bruxelles. Frederic.Supiot@ulb.ac.be describes the clinical symptoms and treatments for migraine, the most frequent neurological illness in Europe and North America.

Background

Migraine is Europe and North America's most frequent neurological illness. Its prevalence is about 12%, affecting women twice more than men.

Methodology

Migraine illness is defined by the occurrence of several episodes of pulsatile headaches, uni- or bilateral, accompanied or preceded by signs of central and autonomic nervous system dysfunction. Considered benign, it can lead to non-negligible social and professional handicap. Its social and economic repercussions are serious, due to consequences in terms of work incapacity.

Results

Essentially relying on drugs, therapeutic divides itself into migraine attack treatment and migraine prophylaxis. Migraine attack treatment relies essentially on acetaminophen and non-steroidal antiinflammatory agents, associated or not with antiemetics like domperidone and metoclopramide, accessorily on ergot derivatives and triptans.

Conclusion

Migraine prophylaxis is best provided by propranolol, valproic acid and amitryptiline, anti-serotoninergic agents, topiramate, flunarizine and other agents should be reserved to particular cases. In some cases, children in particular, non-drug approaches such as relaxation, biofeedback or behavioral therapy can be privileged although relying on weak scientific evidences.

References

Supiot F. [Migraine in 2009: from attack to treatment]. [French] Revue Medicale de Bruxelles. 30(4): 399-403. Sep 2009.

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