The term migraine stems from hemicrania, describing a periodic disorder consisting of paroxysmal unilateral headache, accompanied by nausea, vomiting, photophobia and/or phonophobia. Hemicrania was later changed to Latin words - hemigranea and migranea; eventually the French cognate, migraine, gained acceptance in the eighteenth century and has prevailed ever since. A working definition of migraine is benign recurring headache and/or neurological dysfunction usually attended by pain-free interludes and often provoked by stereotyped stimuli (1). Migraine may be triggered by certain factors (red wine, menses, hunger, lack of sleep, glare, perfumes, periods of let down) and relieved by others (sleep, pregnancy). Premonitory symptoms occur hours to a day or two before a migraine attack with or without aura. Migraine is more common in females, with a hereditary predisposition towards attacks and the cranial circulatory phenomenon appears to be secondary to a primary central nervous system (CNS) disorder. The Headache Classification Committee of the International Headache Society (IHS) published the classification and diagnostic criteria for headache disorders in 1988 (Table 1.1) (2). The terms “common migraine” and “classical migraine” have been replaced by “migraine without aura” and “migraine with aura”, respectively. These operational criteria have been validated by different approaches and have enabled us to distinguish different headache entities in a reliable manner (3-6). In recent years, the IHS criteria have been used world-wide in several multicentre double-blind drug trials, which have shown a reasonably consistent response rate to triptans (7), reflecting a consensus in the defined migraine group. In a recent MAZE survey, the Migraine Disability Assessment Scale (MIDAS) questionnaire has been used to assess the impact of migraine on work, home and social lives. MIDAS scores confirmed the debilitating effect of migraine; >50% of respondents had a MIDAS grade of III or IV, indicating moderate or severe disability. Less than one-third of patients reported that their current medication was consistently effective and only 36% were 'very satisfied' with their current therapy (8). These results show that migraine patients world-wide are still not receiving adequate treatment and a significant unmet need in migraine care still remains.

antimigraine drugs, migraine, pharmacology
P.R. Saxena (Pramod Ranjan)
Erasmus University Rotterdam
Anglo-Dutch Migraine Association
Erasmus MC: University Medical Center Rotterdam

Kapoor, K. (2003, November 26). Novel Potential Antimigraine Compounds: Carotid and Systemic Haemodynamic Effects in a Porcine Model of Migraine. Erasmus University Rotterdam. Retrieved from