The evolution of medication overuse headache: history, pathophysiology and clinical update. Chronic migraine–classification, characteristics and treatment. Pearls and pitfalls in human pharmacological models of migraine: 30 years’ experience. The global burden of headache: a documentation of headache prevalence and disability worldwide. Contributions of epidemiology to our understanding of migraine. The epidemiology, burden, and comorbidities of migraine. Cumulative lifetime migraine incidence in women and men. Female sex hormones in men with migraine. Migraine pathophysiology: lessons from mouse models and human genetics. Biological insights from the premonitory symptoms of migraine. The prevalence of premonitory symptoms in migraine: a questionnaire study in 461 patients. Premonitory symptoms in migraine: an electronic diary study. Variability of clinical features in attacks of migraine with aura. Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010. The prevalence and characteristics of migraine in a population-based cohort: the GEM study. Migraine remains second among the world’s causes of disability, and first among young women: findings from GBD2019. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd Edition. Global, regional, and national burden of migraine and tension-type headache, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Epidemiology and comorbidity of headache. The impact of migraine on quality of life in the general population: the GEM study. Migraine–current understanding and treatment. The emergence of new treatment targets and therapies illustrates the bright future for migraine management. Several neuromodulation modalities have been approved for acute and/or preventive migraine treatment. Intramuscular onabotulinumtoxinA may be helpful in chronic migraine (migraine on ≥15 days per month) and monoclonal antibodies targeting CGRP or its receptor, as well as two gepants, have proven effective and well tolerated for the preventive treatment of migraine. CGRP receptor antagonists (gepants) and lasmiditan, a selective 5HT1 F receptor agonist, have emerged as effective acute treatments. Because of cardiovascular safety concerns, unreliable efficacy and tolerability issues, use of ergots to abort attacks has nearly vanished in most countries. Management includes analgesics or NSAIDs for mild attacks, and, for moderate or severe attacks, triptans or 5HT 1B/1D receptor agonists. Despite earlier beliefs, vasodilation is only a secondary phenomenon and vasoconstriction is not essential for antimigraine efficacy. Spreading depolarization probably causes aura and possibly also triggers trigeminal sensory activation, the underlying mechanism for the headache. Depression, epilepsy, stroke and myocardial infarction are comorbid diseases. The aetiology is multifactorial with rare monogenic variants. Migraine is a common, chronic, disorder that is typically characterized by recurrent disabling attacks of headache and accompanying symptoms, including aura.
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