Carrie Dougherty MD (Dr. Dougherty of the Georgetown Headache Center at MedStar Georgetown University Hospital received consulting fees from Alder, Amgen, Electrocore, and Promius for advisory board membership, and from Amgen for speaking engagements.)
Stephen D Silberstein MD, editor. (

Dr. Silberstein, Director of the Jefferson Headache Center at Thomas Jefferson University, receives honorariums from Allergan, Avanir Pharmaceuticals, Curelator, Depomed, Dr. Reddy's Laboratories, eNeura,  INSYS Therapeutics, Lilly USA, Supernus Pharmacerticals,  Thernica and Trigemina for consulting. He is also the  principal investigator for a clinical trials conducted by Alder Biopharmaceuticals, Amgen, electroCore Medical, Lily USA and Teva.

Originally released January 27, 1994; last updated October 8, 2014; expires October 8, 2017
Notice: This article has expired and is therefore not available for CME credit.

This article includes discussion of migraine, blinding headache, classical migraine, common migraine, migraine with aura, and migraine without aura. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.


Migraine is a common, frequently incapacitating headache disorder characterized by episodic attacks of moderate to severe headaches and various symptoms of neurologic, gastrointestinal, or autonomic nervous systemic dysfunction. Migraine imposes a substantial burden on the individual patient and society. In this article, the author provides updates on new medical devices for migraine treatment.

Historical note and terminology

The earliest systematic description of headache accompanied by visual symptoms and gastrointestinal upset is attributed to Hippocrates (460 to 377 BC). Aretaeus of Cappadocia (30 to 90 AD) distinguished between different headache types, including cephalalgia (a mild, short-lasting headache) and heterocrania (a unilateral episodic headache with vomiting and aversion to light). Thomas Willis (1621 to 1675 AD) wrote the first modern monograph on migraine and called attention to vascular factors in the genesis of the disorder. Edward Liveing (1832 to 1919 AD) proposed that migraines resulted from discharges from the central nervous system; he called these discharges “nerve storms.” Graham and Wolff's classic report on the effect of ergotamine on migraine contained the first comprehensive assumptions about the cause of migraine and its symptoms (Graham and Wolff 1938). In 1988, the International Headache Society created formal diagnostic criteria for migraine that are utilized clinically and in research worldwide (Headache Classification Committee 2004).

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