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Migraine headache in adults

Last reviewed: 10 Jun 2025
Last updated: 07 Mar 2025

Summary

定义

病史和体格检查

关键诊断因素

  • prolonged headache
  • nausea and/or vomiting
  • decreased ability to function
  • headache worse with activity
  • sensitivity to light
  • sensitivity to noise
  • unilateral
  • throbbing sensation
  • aura
完整详情

危险因素

  • family history of migraine
  • female sex
  • obesity
  • stressful life events
  • medication overuse
  • sleep disorders
  • low socioeconomic status
  • allergies or asthma
  • hypothyroidism
完整详情

诊断性检查

首要检查

  • clinical diagnosis
完整详情

需考虑的检查

  • erythrocyte sedimentation rate (ESR)
  • c-reactive protein (CRP)
  • lumbar puncture (LP)
  • cerebrospinal fluid (CSF) culture
  • MRI brain
  • CT head
  • angiography
完整详情

治疗流程

初步治疗

presenting to the emergency department with persistent migraine

急症处理

mild symptoms: nonpregnant

moderate to severe symptoms: nonpregnant

pregnant

持续性治疗

frequent recurring severe/disabling symptoms not linked to menstrual cycle: nonpregnant

frequent recurring severe/disabling symptoms linked to menstrual cycle: nonpregnant

frequent recurring severe/disabling symptoms: pregnant

撰稿人

作者

Timothy A. Collins, MD

Associate Professor of Neurology

Chief

Headache Division

Department of Neurology

Duke University Medical Center

Durham

NC

利益声明

TAC provides expert testimony for legal cases regarding headache disorders and treatment (approximately one or two cases per year). TAC is an author of several references cited in this topic.

鸣谢

Dr Timothy Collins would like to gratefully acknowledge Dr Ann Donnelly, the previous contributor to this topic.

利益声明

AD declares that she has no competing interests.

同行评议者

Anne Walling, MD

Professor

Family and Community Medicine

University of Kansas School of Medicine

Wichita

KS

利益声明

AW declares that she has no competing interests.

Marc S. Husid, MD

Director

Walton Headache Center

Augusta

GA

利益声明

MSH declares that he has no competing interests.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Ailani J, Burch RC, Robbins MS, et al. The American Headache Society consensus statement: update on integrating new migraine treatments into clinical practice. Headache. 2021 Jul;61(7):1021-39.全文  摘要

Eigenbrodt AK, Ashina H, Khan S, et al. Diagnosis and management of migraine in ten steps. Nat Rev Neurol. 2021 Aug;17(8):501-14.全文  摘要

Becker WJ, Findlay T, Moga C, et al. Guideline for primary care management of headache in adults. Can Fam Physician. 2015 Aug;61(8):670-9.全文  摘要

Worthington I, Pringsheim T, Gawel MJ, et al. Canadian Headache Society Guideline: acute drug therapy for migraine headache. Can J Neurol Sci. 2013 Sep;40(5 suppl 3):S1-80.全文  摘要

VanderPluym JH, Halker Singh RB, Urtecho M, et al. Acute treatments for episodic migraine in adults: a systematic review and meta-analysis. JAMA. 2021 Jun 15;325(23):2357-69.全文  摘要

Orr SL, Friedman BW, Christie SC, et al. Management of adults with acute migraine in the emergency department: the American Headache Society evidence assessment of parenteral pharmacotherapies. Headache. 2016 Jun;56(6):911-40.全文  摘要

Silberstein SD, Holland S, Freitag F, et al; Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2012 Apr 24;78(17):1337-45.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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