www.AmericanHeadacheSociety.org - American Headache Society (AHS) • www.AmericanMigraineFoundation.org - American Migraine Foundation (AMF)http://ahma.memberclicks.net/ - American Headache and Migraine Association (AHMA) • www.headachejournal.org- Headache: The Journal of Head and Face Pain

MIGRAINE

References1. HeadacheClassificationSubcommitteeoftheInternationalHeadacheSociety.InternationalClassificationofHeadacheDisorders,3rdeditionbeta.Cephalalgia.2013;33:629-808.2. CharlesA.“HeadTalks:Pathophysiology.”ScottsdaleHeadacheSymposium,November21,2014.3. LiptonRB,BigalME,DiamondM,FreitagF,ReedML,StewartWF;AMPPAdvisoryGroup.Migraineprevalence,diseaseburden,andtheneedforpreventivetherapy.Neurology.2007;68:343-9.4. RobbinsMS,LiptonRB.Theepidemiologyofprimaryheadachedisorders.SeminNeurol.2010;30:107-19.5. VosT,FlaxmanAD,NaghaviMetal.Yearslivedwithdisability(YLDs)for1160sequelaeof289diseasesandinjuries1990–2010:asystematicanalysisfortheGlobalBurdenofDiseaseStudy2010.Lancet.2012;380:2163-96.6. Wöber-BingölC.Epidemiologyofmigraineandheadacheinchildrenandadolescents.CurrPainHeadacheRep.2013;17:341.7. StewartWF,StaffaJ,LiptonRB,OttmanR.Familialriskofmigraine:apopulation-basedstudy.AnnNeurol.1997;41:166-72.8. SilbersteinSD,HollandS,FreitagF,DodickDW,ArgoffC,AshmanE;QualityStandardsSubcommitteeoftheAmericanAcademyofNeurologyandtheAmericanHeadacheSociety.Evidence-basedguidelineupdate: pharmacologictreatmentforepisodicmigrainepreventioninadults:reportoftheQualityStandardsSubcommitteeoftheAmericanAcademyofNeurologyandtheAmericanHeadacheSociety.Neurology.2012;78:1337-45.9. HollandS,SilbersteinSD,FreitagF,DodickDW,ArgoffC,AshmanE;QualityStandardsSubcommitteeoftheAmericanAcademyofNeurologyandtheAmericanHeadacheSociety.Evidence-basedguidelineupdate:NSAIDsandother complementarytreatmentsforepisodicmigrainepreventioninadults:reportoftheQualityStandardsSubcommitteeoftheAmericanAcademyofNeurologyandtheAmericanHeadacheSociety.Neurology.2012;78:1346-53.

10.MarmuraMJ,SilbersteinSD,SchwedtTJ.Theacutetreatmentofmigraineinadults:theAmericanHeadacheSocietyevidenceassessmentofmigrainepharmacotherapies.Headache.2015;55:3-20.11.BuseDC.Multidisciplinarymigrainemanagement.PainMedNews.2014;12:14-25.12.CampbellJK,PenzienDB,WallEM;USHeadacheConsortium.Evidence-basedguidelinesformigraineheadache:behavioralandphysicaltreatments.Accessedathttp://tools.aan.com/professionals/practice/pdfs/gl0089.pdf13.BigalME,SerranoD,BuseD,ScherA,StewartWF,LiptonRB.Acutemigrainemedicationsandevolutionfromepisodictochronicmigraine:alongitudinalpopulation-basedstudy.Headache.2008;48:1157-68.14.LiptonRB,SollarsMS,BuseDC.Migraine:Epidemiology,Progression,PrognosisandComorbidity.In:RobbinsMS,GrosbergBM,andLiptonRB(Eds.).NeurologyInPractice:Headache,1sted.London:Wiley-Blackwell;2013:64-87.15.LiptonRB,FanningKM,SerranoD,ReedML,CadyR,BuseDC.Ineffectiveacutetreatmentofepisodicmigraineisassociatedwithnew-onsetchronicmigraine.Neurology.2015;84:688-95.16.ReedML,FanningKM,SerranoD,BuseDC,LiptonRB.Persistentfrequentnauseaisassociatedwithprogressiontochronicmigraine:AMPPStudyResults.Headache.2015;55:76-87.17.AshinaS,SerranoD,LiptonRB,MaizelsM,ManackAN,TurkelCC,ReedML,BuseDC.Depressionandriskoftransformationofepisodictochronicmigraine.JHeadachePain.2012;13:615–624.18.AshinaS,BuseDC,MaizelsM,ManackA,SerranoD,TurkelCC,LiptonRB.Self-reportedanxietyasariskfactorformigrainechronification:resultsfromtheAmericanMigrainePrevalenceandPrevention(AMPP)study.Headache.2010;50(Suppl.1):4.19.MartinVT,FanningKM,SerranoD,BuseDC,ReedML,BernsteinJA,LiptonRB.Chronicrhinitisanditsassociationwithheadachefrequencyanddisabilityinpersonswithmigraine:resultsoftheAmericanMigrainePrevalenceandPrevention(AMPP) Study.Cephalalgia.2014;34:336-48.

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PRODROME

AURA

HEADACHE

POSTDROME

WHAT ARE MIGRAINE SYMPTOMS?1,2

HOW IS MIGRAINE TREATED?8-12

ACUTE MEDICATION TREATMENT OF ATTACKS

Specific medications for migraineNonspecific medications for pain

Anti-nausea medications

MANAGE WHAT MAKES MIGRAINE WORSE

LIFESTYLE AND NON-MEDICATION TREATMENTSKeeping a diary

Avoiding triggersCognitive behavioral therapy

Biofeedback, Relaxation training, Stress management

PREVENTATIVE TREATMENTS

Prescription medicationsSupplements

InjectionsDevices

• A common and disabling neurological condition• Attacks of headache and other symptoms because of an abnormally sensitive brain

HOW COMMON IS MIGRAINE?3-6

1 billion worldwide

1 in 5 women

1 in 4 homes

1 in 11 children

1 in 16 men

WHAT IS AURA?1

• One-third of people with migraine• Reversible attacks of neurological symptoms• Usually last from a few minutes up to an hour

Light sensitivity, sound sensitivity, nausea, fatigue, yawning, increased urination, cravings, mood change,

neck pain

Change in vision such as seeing spots, stars, lines, flashing lights, zigzag lines, or waves

Numbness and tingling

Difficulty speaking or understanding others

Throbbing pain on one or both sides of the head

Worse with movementNausea, vomiting, sensitivity to light, sound

and odors

WHAT IS MIGRAINE?1

IS MIGRAINE INHERITED?6,7

If 1 parent has migraine: 50% chance of a child having it too

If both parents have migraine: 75% chance of a child having it too

CAN MIGRAINE GET WORSE OVER TIME?13-19

• 2-3% of people with episodic migraine every year develop chronic migraine • Chronic migraine indicates headache happening on half of all days for 3 or more months • Risk factors for chronic migraine

Stressful life eventsHead injuryExcessive caffeine useOveruse of opioids and barbituratesNot having an optimized acute treatment planMore headache days per monthPersistent frequent nausea with migraineSnoring and sleep apneaOther pain conditionsDepressionAnxietyAllodynia (skin and scalp sensitivity to touch)Allergic rhinitis

Fatigue, difficulty concentrating, weakness, dizziness,

lightheadedness, decreased energy