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Silberstein SD. Migraine. Lancet. 2004;363:381-391.

Migraine is a very common neurobiological headache disorder that is caused by increased excitability of the CNS. It ranks among the world's most disabling medical illnesses. Diagnosis is based on the headache's characteristics and associated symptoms. The economic and societal effect of migraine is substantial: it affects the patients' quality of life and impairs work, social activities, and family life. There are many acute and preventive migraine treatments. Acute treatment is either specific (triptans and ergots) or non-specific (analgesics). Disabling migraine should be treated with triptans. Increased headache frequency is an indication for preventive treatment. Preventive treatment decreases migraine frequency, and improves the quality of life. More treatments are being developed, which provide hope to the many patients whose migraines remain uncontrolled.

Comment: Laudable aims for the clinician, yet we are more than 10 years post-sumatriptan launch and have still not convinced health care providers that triptans make sound economic sense from both a healthcare provider and societal perspective. We need the AHS and other professional groups to push home the messages developed by the WHO showing migraine headache amongst the top 20 disabling conditions. —David S. Millson

Document Type: Research Article


Publication date: October 1, 2004

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