Migraine headaches can be frequent and disabling. Effective acute treatment can improve the quality of life for migraineurs. The migraine attack is made up of phases, which include the prodrome, aura and the headache itself. Not every migraineur experiences each phase. Each phase, however, has its own distinct pathogenesis and its own unique acute therapy. This review article will help to define the treatment strategies for the various phases of the migraine attack. It will discuss some general principles of acute migraine treatment, specific acute medications and some unique clinical situations (treatment of the prolonged aura and treating when pain is mild versus moderate/severe). It should be very apparent that a better understating of migraine pathogenesis has led to improved and more effective acute therapies for migraine.
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