Migraine is one of the most common primary headache disorders, affecting an estimated 24 million people in the United States. An episodic disorder, mi-graine produces a unilateral pain that’s commonly de-scribed as pounding, pulsating, or throbbing. It may be preceded by an aura. Other common symptoms are sensitivity to light or sound, nausea, vomiting, constipation, and diarrhea.
Researchers believe that migraine symptoms are caused by cranial vasodilation or the release of va-soactive and proinflammatory substances from nerves in an activated trigeminal system.
Treatment of migraine aims to alter an attack once it’s under way (abortive or symptomatic treatment) or to prevent an attack. Choice of therapy depends on the severity, duration, and frequen-cy of the headaches; on the degree of disability that the headache creates in the patient; and on patient characteristics.
Abortive treatments may include analgesics (aspirin and aceta-minophen), nonsteroidal anti inflammatory drugs (NSAIDs), ergo-tamine, 5-hydroxytryptaminergic (5-HT1)-receptor agonists, and various miscellaneous drugs (such as isometheptene combina-tions, intranasal butorphanol, metoclopramide, and cortico-steroids). Prophylactic therapy includes beta-adrenergic blockers, tricyclic antidepressants, valproic acid, and NSAIDs, to name a few.