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Blackburn with Darwen Primary Care Trust - About Us

Appendix 1 : Guidelines on the Management of Migraine

There are four elements to good migraine management:


  • correct and timely diagnosis

  • reassurance

  • predisposition / trigger identification and avoidance

  • intervention (drug or non-drug)


Confirm that the diagnosis is correct! Migraine with aura is readily diagnosed - the headache is preceded by transient hemianopic disturbance, a spreading scintillating scotoma, or transient sensory or dysphasia symptoms usually involving the  face or arm, (but rarely the leg).


Migraine without aura may be more difficult to diagnose: the International Headache Society criteria include the following:


Headaches having at least two of the following characteristics


  • unilateral location

  • pulsating quality

  • moderate or severe intensity

  • aggravation by routine physical activity


and during headache at least one of the following:


  • nausea and/or vomiting or diarrhoea

  • photophobia and phonophobia


Every day headache is not a simple migraine.  Some patients may develop chronic daily headaches in association with pre-existing migraine as a result of excessive analgesic usage (medication overuse headache), and it is important to identify this group.


Management Of Migraine

Photo migraine management



All material in this section is aimed at health professionals, but is information currently held within the public domain.   Members of the public seeking advice on medicine-related matters are encouraged to speak with their GP, pharmacist or nurse, or contact NHS Direct on 0845 46 47. 

Richard Lee, East Lancashire Health Economy New Drugs Pharmacist.


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