We last discussed the treatment of migraine in 1964.1 Classical migraine consists of an initial aura, often visual, followed by unilateral headache (hemicrania), associated with nausea, vomiting or photophobia. Attacks may last for an hour or up to two days. There may be no aura, particularly if the patient awakens with a headache. The headache may be bilateral and is usually aggravated by coughing or movement. Depression, hypertension, raised intracranial pressure, meningism and other causes of headache must be excluded before treatment is begun.
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