Pharmacological management of migraine

Kwon, Yesul
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Migraine is one of the most common, disabling neurological disorder characterized by multiple phases: premonitory, aura, and headache. Understanding of the pathophysiology of each phase of migraine has developed over recent years. First, the premonitory phase begins early around 3 days before the headache phase, and involves in the complex interaction between various cortical and subcortical brain regions, including the hypothalamus and brainstem nuclei that regulate nociceptive signaling. The third phase, headache phase involves activation of the trigeminovascular system, the mechanism that is well characterized. In one third of patients, during attacks aura phase may occur and likely correlates with a cortical spreading depression-like events, slowly propagating waves of the neuronal and glial cell depolarization and hyperpolarization. The characteristic at each pathophysiological stage of the migraine is improved, and it will give the identification of new therapeutic targets for the migraine prevention. This review includes the clinical features and neurobiology of migraine and available biological therapies are discussed.
Migraine, CGRP, Triptan, pharmacological treatment, aura