Current Practice Migraine

This article deals primarily with migraine, but since the treatment of migraine can usefully be divided into specific and non-specific components it is hoped that the principles will be found of use in the treatment of headaches in general. The term psychosomatic is, fortunately, dying on its feet. If it were not, it would perhaps be necessary to explain why migraine should not be considered as a psychosomatic illness. Migraine has been a specific syndrome for as long as neurologists have been writing textbooks. Nevertheless, though migraine has a respectable but complex anatomical and biochemical background-which research is just beginning to unravel-it is primarily a genetically determined disability, recurrent in nature, which shows both partial penetrance and non-specific trigger sensitivity. That is to say, not all those individuals who are genetically predisposed to migraine necessarily have any attacks at all. In those who do have attacks