Department of Neurology, University of California, San Francisco, 94115, USA.
Lancet Neurol. 2010 Mar;9(3):285-98. doi: 10.1016/S1474-4422(10)70005-3.
Migraine is a common and disabling brain disorder with a strong inherited component. Because patients with migraine have severe and disabling attacks usually of headache with other symptoms of sensory disturbance (eg, light and sound sensitivity), medical treatment is often required. Patients can be managed by use of acute attack therapies (eg, simple analgesics or non-steroidal anti-inflammatory drugs) or specific agents with vasoconstrictor properties (ie, triptans or ergot derivatives). Future non-vasoconstrictor approaches include calcitonin gene-related peptide receptor antagonists. Preventive therapy is probably indicated in about a third of patients with migraine, and a broad range of pharmaceutical and non-pharmaceutical options exist. Medication overuse is an important concern in migraine therapeutics and needs to be identified and managed. In most patients, migraine can be improved with careful attention to the details of therapy, and in those for whom it cannot, neuromodulation approaches, such as occipital nerve stimulation, are currently being actively studied and offer much promise.
偏头痛是一种常见的致残性脑部疾病，具有很强的遗传因素。由于偏头痛患者会出现严重且致残的头痛发作，通常伴有其他感觉障碍症状（如对光和声敏感），因此通常需要进行医学治疗。患者可通过使用急性发作治疗药物（如简单的镇痛药或非甾体类抗炎药）或具有血管收缩特性的特定药物（即曲普坦类或麦角类衍生物）进行治疗。未来的非血管收缩方法包括降钙素基因相关肽受体拮抗剂。约三分之一的偏头痛患者可能需要预防性治疗，并且存在广泛的药物和非药物选择。药物滥用是偏头痛治疗中的一个重要问题，需要加以识别和管理。对于大多数患者，通过仔细关注治疗细节，可以改善偏头痛症状，而对于那些不能改善的患者，目前正在积极研究神经调节方法，如枕神经刺激，这些方法具有很大的应用前景。
