Andrew Charles, MD, Professor, Director of Headache Research and Treatment Program, UCLA David Geffen School of Medicine, discusses migraine as a problem of brain excitability and chemistry rather than a problem of vascular phenomena. New treatments are now focusing on modulating brain chemistry. What doctors once thought were sinus or tension headaches are now being attributed to migraine and this should be the default diagnosis for any headache presentation.

Reading:
Goadsby PJ.”Increasing our understanding of migraine to enhance treatment outcomes”–symposium. Foreword.
Cephalalgia. 2009 Dec;29 Suppl 3:v-vi.
Samaan Z, Macgregor EA, Dowson A, McGuffin P, Farmer A. Diagnosing migraine in research and clinical settings: The validation of the Structured Migraine Interview (SMI).BMC Neurol. 2010 Jan 14;10(1):7.
Firnhaber JM, Rickett K. Clinical inquiries. What are the best prophylactic drugs for migraine?J Fam Pract. 2009 Nov;58(11):608-10. Review.

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