Migraine: Manifestations, Pathogenesis, and Management

Migraine: Manifestations, Pathophysiology, and Management, Second Edition, is a much expanded, updated monograph that focuses in detail on migraine's diverse variations, its pathophysiology, and its treatment. Authored by a clinician/scientist who himself suffers from migraine, the book's premise is that the clinical significance of migraine and its treatment are intelligible only if the physician understands the anatomical, physiological, and pharmacological factors underlying both head pain and the other manifestations of migraine. The book provides clear clinical descriptions of the myriad of specific migraine syndromes, and discusses the rationale for, and elements of, a sensitive, inclusive patient history. Also covered are important but sometimes ignored topics such as environmental triggering of migraine and myofascial syndromes. The Second Edition also bridges the gap between basic science and clinical practice by explaining those substantive advances made in understanding fundamental mechanisms of head pain and aura. Recent knowledge about genetics, hormonal changes, cerebral circulation, nitric oxide, peptides, central sensitization of trigeminal neurons, and the role of periaqueductal gray matter buttress the discussion of basic mechanisms. On the treatment side, the Second Edition reflects the impressive advances in pharmacological approaches to migraine. There is a greatly expanded section on the triptans and their mechanisms of action, and rationales and practical information about the use of all other viable anti-migraine and prophylactic drugs. Psychobiological aspects of stress and stress management, elimination of environmental stimuli, the educational facets of management, and aspects of the patient/physician interaction so crucial in the treatment of migraine are all discussed. Special problems associated with the care of women, children, the elderly, patients with intractable headaches, and emergency department patients are thoroughly reviewed. In sum, this scholarly, well-referenced book offers in one volume a comprehensive scientific and clinical discussion of migraine headache.