Migraine is the most common neurological disorder and can be associated with a high degree of disability. In addition to non-pharmacological approaches to reduce migraine frequency, pharmacological migraine preventatives are available. Evidence-based guidelines from the German Migraine and Headache Society (DMKG), and German Society for Neurology (DGN), Austrian Headache Society (ÖKSG), and Swiss Headache Society (SKG) are available for indication and application. For therapy-relevant questions such as the duration of a pharmacological migraine prevention, no conclusions can be drawn from currently available study data. The aim of this review is to present a therapy consensus statement that integrates the current data situation and, where data are lacking, expert opinions. The resulting current recommendations on the duration of therapy for pharmacological migraine prophylaxis are shown here.
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http://dx.doi.org/10.1007/s00115-022-01403-1 | DOI Listing |
Cephalalgia
January 2025
Department of Pharmacology, University of Arizona, Tucson, USA.
Purpose: Photophobia is a common and debilitating symptom associated with migraine. Women are disproportionately affected by migraines, with a higher prevalence and more severe symptoms compared to men. This study investigated the effects of cortical spreading depression on light-aversive and dark-seeking behaviors in a rat model, with an emphasis on sex differences.
View Article and Find Full Text PDFExp Neurol
January 2025
Department of Neurology, University of Virginia, Charlottesville, VA 22908, USA; Department of Neuroscience, University of Virginia, Charlottesville, VA 22908, USA; UVA Brain Institute, University of Virginia, Charlottesville, VA 22908, USA.
Migraine patients often experience sensory symptoms called auras accompanying the headaches. Cortical spreading depression (CSD), a slow-propagating wave of neuroglial depolarization followed by hyperpolarization is proposed to be the neurological mechanism underlying these auras. We have previously found that progesterone regulates susceptibility to migraine through progesterone receptor (PR) activation.
View Article and Find Full Text PDFCurr Pain Headache Rep
January 2025
Department of Neurology - Headache Division, University of Miami Health, University of Miami School of Medicine, 1120 NW 14th Street, 13th Floor, Miami, FL, 33136, USA.
Purpose Of Review: Management of primary headache disorders during pregnancy is limited due to known teratogenicity or unknown safety of many currently available pharmaceutical therapies. Here, we explore the safety and efficacy of non-invasive neuromodulatory devices as another treatment modality for pregnant patients.
Recent Findings: There are six FDA-cleared, non-invasive neuromodulatory devices currently available for the management of headache that include remote electrical neuromodulation (REN), noninvasive vagal nerve stimulation (nVNS), external trigeminal nerve stimulation (eTNS), single-pulse transcranial magnetic stimulation (sTMS), and external concurrent occipital and trigeminal neurostimulation (eCOT-NS).
Curr Pain Headache Rep
January 2025
Advanced Wellness and Pain, Scottsdale, AZ, USA.
Purpose Of Review: Chronic pain affects approximately 1.5 billion people worldwide, representing the leading cause of disability and a significant financial burden on healthcare systems. Conventional treatments, such as opioids and non-steroidal anti-inflammatory drugs, are frequently linked to adverse effects, including dependency and gastrointestinal issues, and often offer limited long-term relief.
View Article and Find Full Text PDFBMC Emerg Med
January 2025
Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, 655 West 8th Street, Jacksonville, FL, 32209, USA.
Background: The ongoing opioid epidemic in the United States has reinforced the need to provide multimodal and non-opioid pain management interventions. The PAMI-ED ALT program employed a multifaceted approach in the Emergency Department (ED) developing electronic health record (EHR) pain management order panels and discharge panels, as well as educating patients, clinicians, and ED staff on opioid alternatives, including non-pharmacologic interventions. The primary objective of this analysis was to compare changes in opioid and non-opioid analgesic administrations and prescribing in ED patients with select pain conditions (renal colic, headache, low back, and non-low back musculoskeletal pain) before and after implementation of PAMI ED-ALT.
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