Migraine affects approximately 1 billion people worldwide, with up to 15% of adults in the United States having migraine attacks in any given year. More than 90% of patients with recurrent headache presenting to primary care offices and emergency departments have migraine. Migraine is associated with high socioeconomic and personal impact; it is the second leading cause of years lived with disability worldwide for all ages and the leading cause in women aged 15 to 49 years. Diagnostic uncertainty increases the likelihood of unnecessary investigations and suboptimal management. This In the Clinic article advises clinicians about diagnosing migraine; ruling out secondary headache disorders; developing treatment plans that may include self-management, nonmedication treatments, acute medications, and preventive medications; and deciding when to refer a patient to a specialist.
Use this article to:
- Consult a neurologist to review how to diagnose migraine and the various treatment options.
- What is the appropriate follow-up of patients with migraine? How often should they be seen? Should any tests be done routinely?
- Test your knowledge by completing the quiz that accompanies the article and then review the correct answers.
Annals of Internal Medicine is the premier internal medicine academic journal published by the American College of Physicians (ACP). It is one of the most widely cited and influential specialty medical journals in the world.