24 April 2012

Many Treatments Available To Help Prevent Migraine Unused

A migraine is a common type of headache. With most people, the migraine is felt on only one side of the head.

Symptoms of a migraine attack may include heightened sensitivity to light and sound, nausea, auras (loss of vision in one eye or tunnel vision), difficulty of speech and intense pain predominating on one side of the head. An aura is a group of symptoms that include vision disturbances (spots, tunnel vision, loss of vision) that signals an oncoming migraine attack.

It is caused by abnormal brain activity and can be triggered by a number of factors. The cause of a migraine is still undetermined. It is believed that it involves a Central Nervous System (CNS) disorder. The CNS is made up of the brain and spinal cord. In a migraine, various stimuli or nerve signals may cause a series of neurologic and biochemical events which affect the brain's vascular system. This chain of events starting from the brain, travelling to nerve pathways affect the flow of blood in the brain and its surrounding tissues.

New guidelines: Treatments can help prevent migraine

Research shows that many treatments can help prevent migraine in certain people, yet few people with migraine who are candidates for these preventive treatments actually use them, according to new guidelines issued by the American Academy of Neurology. The guidelines, which were co-developed with the American Headache Society, announced at the American Academy of Neurology's 64th Annual Meeting in New Orleans and published in the print issue of Neurology®, the medical journal of the American Academy of Neurology.

"Studies show that migraine is underrecognized and undertreated," said guideline author Stephen D. Silberstein, MD, FACP, FAHS, of Jefferson Headache Center at Thomas Jefferson University in Philadelphia and a Fellow of the American Academy of Neurology. "About 38 percent of people who suffer from migraine could benefit from preventive treatments, but only less than a third of these people currently use them."

Video: Migraines and Auras

Unlike acute treatments, which are used to relieve the pain and associated symptoms of a migraine attack when it occurs, preventive treatments usually are taken every day to prevent attacks from occurring as often and to lessen their severity and duration when they do occur.

"Some studies show that migraine attacks can be reduced by more than half with preventive treatments," Silberstein said.

The guidelines, which reviewed all available evidence on migraine prevention, found that among prescription drugs, the seizure drugs divalproex sodium, sodium valproate and topiramate, along with the beta-blockers metoprolol, propranolol and timolol, are effective for migraine prevention and should be offered to people with migraine to reduce the frequency and severity of attacks. The seizure drug lamotrigine was found to be ineffective in preventing migraine.

The guidelines also reviewed over-the-counter treatments and complementary treatments. The guideline found that the herbal preparation Petasites, also known as butterbur, is effective in preventing migraine. Other treatments that were found to be probably effective are the nonsteroidal anti-inflammatory drugs fenoprofen, ibuprofen, ketoprofen, naproxen and naproxen sodium, subcutaneous histamine and complementary treatments magnesium, MIG-99 (feverfew) and riboflavin.

Silberstein noted that while people do not need a prescription from a physician for these over-the-counter and complementary treatments, they should still see their doctor regularly for follow-up. "Migraines can get better or worse over time, and people should discuss these changes in the pattern of attacks with their doctors and see whether they need to adjust their dose or even stop their medication or switch to a different medication," said Silberstein. "In addition, people need to keep in mind that all drugs, including over-the-counter drugs and complementary treatments, can have side effects or interact with other medications, which should be monitored."


American Academy of Neurology
American Headache Society
Jefferson Headache Center
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