Migraine is a chronic, genetically determined, episodic, neurologic disorder that usually presents in early-to-mid life.
Patients complain of intermittent headache and associated symptoms, such as visual disturbance, nausea, vomiting, and sensitivity to light or noise (photophobia and phonophobia).
The diagnosis is based on history and physical exam. No laboratory or imaging tests are essential for diagnosis.
Treatment approaches involve identification and avoidance of trigger factors, and the use of medication to treat the acute attack or prevent future attacks.
There are no clinical trials that identify one migraine therapy (acute therapy or prophylaxis therapy) as superior over others. Triptans in general are preferred over nonspecific treatments. However, there are no trials directly comparing triptans.
Complications include status migrainosus, migrainous infarction, chronic migraine, persistent aura without infarction and seizures, analgesic gastropathy, transformation of episodic to chronic migraine, and medication-overuse headache.