Summary
Clear symptoms and signs are found in patients during severe migraine attacks. Diagnostic difficulties are encountered in eliciting this episodic clinical picture. A label of migraine, however, is only the beginning: factors that precipitate attacks, fears aroused in the migraineur and the failure, or partial efficacy, of acute and prophylactic therapy need also to be determined. If migraine is complicated by an additional headache, the analysis becomes more difficult, but the diagnosis still has to be accurate. This, however, is not always possible at the initial interview. A successful consultation should be more than just diagnostic; it is the beginning of treatment.
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References
Asher R (1958) The sedation and stimulation of man. Lancet I:954–956
Blau JN (1980) Migraine prodromes separated from the aura: complete migraine. Br Med J 281:658–660
Blau JN (1982) Resolution of migraine attacks: sleep and the recovery phase. J Neurol Neurosurg Psychiatry 45:223–226
Blau JN (1982) How to take a history of head or facial pain. Br Med J 285:1249–1251
Blau JN (1984) Towards a definition of migraine headache. Lancet I:444–445
Blau JN (1984) Fears aroused in patients by migraine. Br Med J 288:1126
Blau JN (1985) Pathogenesis of migraine: initiation. J R Coll Phys Lond 19:166–168
Blau JN (1986) Clinical characteristics of premonitory symptoms in migraine. In: Amery WK, Wauquier A (eds) The prelude to the migraine attack. Baillière Tindall, London, pp 39–45
Blau JN (1989) Time to listen to the patient. Br Med J 298:39
Blau JN, Thavapalan M (1988) Preventing migraine: a study of precipitating factors. Headache 28:481–483
Couch JR, Diamond S (1983) Status migrainosus: causative and therapeutic aspects. Headache 23:94–101
Critchley M (1979) The divine banquet of the brain. Raven Press, New York, p 231
Headache Classification Committee, the International Headache Society (1988) Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia 8 (suppl 7):10–11
Olesen J (1978) Some clinical features of the acute migraine attack. An analysis of 750 patients. Headache 18:268–271
Rowsell AR, Neylan C, Wilkinson M (1973) Ergotamine induced headache in migraine patients. Headache 13:65–67
Wilkinson M, Williams K, Leyton M (1978) Observations on the treatment of an acute attack of migraine. In: Friedman A, Critchley M (eds) Research and clinical studies in headache, vol 6. Karger, Basel, pp 141–146