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Updated: Aug 6, 2025
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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
18.3K
Expert consensus established around flexible, individualized migraine treatment utilizing a modified Delphi panel.
Marlon Graf1, Edward Kim2, Iris Brewer1
1PRECISIONheor, Bethesda, Maryland, USA.
Headache
|March 15, 2023
Summary
Headache specialists recommend customizing migraine treatment, moving beyond acute vs. preventive. Novel therapies support a new "situational prevention" approach for predictable triggers.
Area of Science:
- Neurology
- Clinical Practice
- Migraine Management
Background:
- Traditional migraine treatment classification (acute vs. preventive) is limited by available drugs.
- Emerging flexible therapies necessitate rethinking treatment paradigms.
- Understanding clinical practice and expert consensus is crucial for integrating novel migraine treatments.
Purpose of the Study:
- To characterize treatment decision-making processes for migraine.
- To formalize consensus on key factors headache specialists consider.
- To evaluate the role of novel migraine therapies in clinical practice.
Main Methods:
- A three-round modified Delphi process involving 19 migraine clinical experts.
- Utilized online questionnaires, aggregated results discussions, and response revisions.
- Elicited likelihood ratings, rankings, and estimates on treatment decision-making factors.
Main Results:
- Experts reached strong consensus on definitions for acute and preventive migraine treatments.
- Identified a need for customized patient treatment plans (median=100).
- Agreed on a new category: "situational prevention" for predictable triggers or time-limited needs (median=100).
Conclusions:
- Migraine treatment customization is vital.
- Novel therapies enable a "situational prevention" approach.
- Experts identified the value of situational prevention for specific patient needs and time periods.
