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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Optimizing migraine therapy: evidence-based and patient-centered care
Merle L Diamond1, Richard G Wenzel, George R Nissan
1Diamond Headache Clinic, Inpatient Unit, 2900 North Lake Shore Drive Chicago, IL 60657, USA. clinic@diamondheadache.com
Expert Review of Neurotherapeutics
|June 21, 2006
Summary
Effective migraine management requires a patient-physician partnership, combining lifestyle changes and acute medications. Stratified care, tailored to migraine severity, improves outcomes over general approaches.
Area of Science:
- Neuroscience
- Clinical Neurology
- Public Health
Background:
- Migraine is a chronic neurovascular disorder impacting quality of life.
- Primary care providers frequently manage migraine, necessitating optimal therapeutic strategies.
- Comprehensive migraine management involves patient-physician collaboration and personalized care plans.
Purpose of the Study:
- To outline optimal therapeutic approaches for managing chronic migraine in primary care.
- To emphasize the benefits of stratified care over step care for migraine treatment.
- To highlight the role of patient diaries and validated assessment tools in therapy adjustment.
Main Methods:
- Review of clinical evidence supporting various migraine treatments.
- Comparison of stratified care versus step care models.
- Emphasis on patient-reported outcomes and validated disability assessment tools (e.g., MIDAS, HIT).
Main Results:
- Nondrug approaches (education, lifestyle) and acute medications are key components of therapy.
- Triptans and dihydroergotamine are effective for moderate-to-severe migraine.
- NSAIDs (with antiemetics/caffeine) are suitable for mild-to-moderate migraine.
- Stratified care, based on disease severity, is superior to step care.
- Preventive medications are indicated for high-frequency or debilitating migraines.
Conclusions:
- Optimal migraine therapy integrates non-drug strategies, acute treatments, and patient-physician goal setting.
- Stratified care, utilizing migraine-specific agents early for severe cases, improves patient outcomes.
- Routine monitoring via patient diaries and validated tools ensures effective, adjusted migraine management.
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