Med. praxi. 2024;21(4):209-214 | DOI: 10.36290/med.2024.026
Joint migraine treatment by GP and neurologist
- Centrum pro diagnostiku a léčbu bolestí hlavy, Neurologická klinika LF UK a FN Plzeň
The paper describes the cooperation of the general practitioner and neurologist in the algorithm of the diagnostics and treatment of migraine. First, the detailed clinical manifestation of migraine is presented and its distinguishing from other most frequent primary headaches such as tension-type headache and cluster headache. In the next part, the algorithm for the treatment of migraine is described. The general practitioner plays a decisive role in treating a few frequent uncomplicated migraine attacks (approximately up to four monthly migraine days). Except for the prescription of acute antimigraine drugs the general practitioner should actively follow the frequency of attacks, their intensity, and the consumption of acute antimigraine drugs in the migraine calendar. In case of an increase in the frequency of attacks and consumption of antimigraine medicines, he should consult the neurologist who initiates the treatment with classical prophylactics of migraine. In case of ineffectiveness and/or intolerance according to the valid criteria, the patient is referred to a headache center. Here the treatment with monoclonal antibodies against calcitonin gene-related peptide (CGRP) or its receptor or the treatment with CGRP antagonists gepants is taken into consideration which is shortly mentioned. An important role of the general practitioner is emphasized who can by early referral to the specialized neurological treatment prevent the development of chronic migraine and medication overuse headache - MOH.
Keywords: migraine, general practitioner, neurologist, headache center, monoclonal antibodies against CGRP or its receptor, gepants.
Received: July 2, 2024; Revised: July 31, 2024; Accepted: July 31, 2024; Published: October 2, 2024 Show citation
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