Migraine treatment improved considerably with the advent of the 'triptans' in the 1990s. While the drugs used previously for headache treatment had efficacy, some compounds had bothersome side effects and their overuse could lead to severe complications. In the early days of the triptans, it was widely presumed that migraine was no longer a treatment problem. However, it has gradually been recognized that a significant proportion of patients are not responsive to triptans or do not tolerate them. It is now clear that, even with effective treatment, patients with frequent migraine attacks are not treated well exclusively with acute medications. This is partly because patients are still bothered by the attacks and partly because frequent intake of acute medication may result in medication-overuse headache. These problems have led to a renewed interest in preventive migraine drugs.
Part of the Frontiers in Headache Research series, this book summarizes the several promising new avenues for the development of future drugs for the treatment of migraine, including cortical-spreading depression inhibition, nitric oxide synthase inhibition and calcitonin gene-related peptide (CGRP) receptor antagonism, as well as other potential targets. The book presents frontline knowledge of these evolving modalities as far as it is available in the public domain. It is hoped that readers and their patients will find it exciting to learn about all the novel possibilities, and also that the impressive research advances in migraine will lead to increased funding, not only of migraine but also of other types of headache.

Headache medicine research is a rapidly expanding discipline and many important advances in headache management have developed over the last 20 years. However, the revolution and evolution in headache medicine has remained limited largely to the developed countries. Indeed, there is an enormous need for further quality and capacity of headache care in most parts of the world. Thankfully, efforts to bridge this gap have begun. To date, training of practitioners in headache medicine is improving in the developing countries, country-specific epidemiological research is increasing, and new therapies are trickling slowly to the developing world.
Part of the Frontiers in Headache Research series, this book brings the theme of a global campaign to the forefront. Researchers, scientists, and respected clinicians from around the world discuss aspects of access to care, individual and societal burden, and public health authorities address the problems of headache medicine as public health issues to hundreds of millions of headache sufferers worldwide.

Headache is a huge public health problem and migraine alone cost 27 billion Euros per year in Europe. It is therefore important how the health care service for headache patients is organised throughout the world. Patients seen at headache clinics are more severely affected than those seen in general practice, and headache clinics need to be familiar with a long list of relatively rare headache disorders.
Part of the Frontiers in Headache Research series, this volume is the first book to focus specifically on headache clinics, their classification and organization, their methods of diagnosis, and their approaches to multi-disciplinary management. The clinical features of patients seen in headache clinics are thoroughly discussed. The value of a number of diagnostic laboratory techniques including when and how to use neuro-imaging is discussed. Also a number of more specialised methods employed only in referral headache centres are covered, such as nitro-glycerine challenge, indomethacin test, and oxygen breathing. The treatment options for severely affected patients are discussed including the possibilities of combining two or more prophylactic medications, the use of epidural blood patch and the different methods for discontinuation of medication overuse.
This volume will be an invaluable resource for neurologists, physicians in headache/pain clinics and interested general practitioners.

A new era in the treatment of migraine headache arrived with development of a revolutionary class of drugs known as the triptans.

The book describes the development of this class of drugs, starting with the discovery of sumatriptin, covers the pharmacology and the mechanisms of action of the full range of triptans, before comparing their clinical efficacy and tolerability. Each drug is described by the company who produces it and then reviewed, based on experimental and clinical evidence, by independent scientists.

This comprehensive review will provide clinicians with guidance on which triptan to select for which patient.

The editors have gathered together the leading international experts to produce a book that will appeal to all neurologists and general physicians caring for headache patients as well as those with research interests in the field.

Cluster headache affects 0.1 per cent of the population and is a severe form of primary headache. This volume of Frontiers in Headache Research is an up-to-date and comprehensive review of the condition and its related disorders. The book begins with a discussion of the basic circadian biology of the condition followed by an overview of relevant epidemiological studies. Cluster headache is then described in comparison with related disorders, including paroxysmal hemicrania, SUNCT, hemicrania continua and hypnic headache, and the system of classification discussed. The volume then moves on to look at the wealth of basic research into cluster headache, including, animal studies, work on the autonomic nervous system in man, neuropeptide research, studies of biological rhythms, the associated endocrinology, information derived from neuroimaging and the influence of genetic factors. The final sections of the book examine acute treatment, prophylaxis, the potential for surgical treatment and the opportunities for further innovative therapies. The contributing authors are all international specialists in this field.

Though the topics of 'pain' and 'headache' are obviously linked, these two research fields have in recent years developed at their own pace, often with scant attention paid to the other. By forging closer links between these fields, it should be possible to develop a deeper understanding of both the pain mechanisms associated with headache and a deeper understanding of pain itself. This book brings together researchers and clinicians from the forefront of these two disciplines to explore how the basic pain mechanisms relate to migraine and other forms of headache. With cutting-edge research from the frontiers of headache and pain research, the book will be essential for clinicians treating headache sufferers, providing answers to many of the commonly asked questions about the mechanisms of their headache. It will also be of interest to those pain researchers dealing with mechanisms related to headache and migraine.

The new international classification of headache disorders (IHCD-2) contains precise diagnositic criteria for headache disorders, but it is very difficult to read. The book, edited by the chairman of the classification committee, provides an invaluable insight for all those who diagnose headache in their daily practice. This book follows the International Headache Classification, but expands on it by discussing the background of the various diagnoses, the pitfalls and the practical problems in interpretation, and thus provides a more comprehensive source for those diagnosising headache disorders. It discusses diagnostic instruments such as headache diaries, headache calendars, and structured interviews. It also focuses on weak points in the headache classification where solid data is missing, and personal experience plays a greater role. Finally, it provides an insight for future descriptive research. A whole catalogue of research ideas are presented which can be realized in any clinical setting where a large number of headache patients are being treated.

Most of the familiar headache drugs are used to stop a headache attack that is already in progress, or about to begin. However, there is now a growing body of research aimed at developing medications that can be taken on a regular basis to prevent headaches from starting. These drugs will be targetted at patients whose headaches are frequent or who get their headaches at predictable times. This book reviews the potential for prophylactic treatment of headache. It provides most of the existing evidence in the field of pharmaco-prophylaxis of migraine and other chronic headaches and may thus, serve as a platform for new initiatives in the field. The book reviews the research into the pharmacological mechanisms involved, the classes of drugs in development and the clinical trials methodology.
The editors have gathered together the leading international experts to produce a book that will appeal to neurologists caring for headache patients, researchers in the field and those based in the pharmaceutical industry.

This is the first book devoted to the study of the social and economic consequences of headache. Reducing the Burden of Headache analyses the financial cost of headache diseases, the disability and suffering they cause and the impact they have on the quality of life of the sufferers and their families.

These are issues of major importance; migraine appears in the top 20 list of diseases ranked according to years lived with disability. Headache, in general, is thought to account for approximately 20% of all days lost from work. Of even greater importance is the impact on everyday life, studies have shown that migraine has a greater impact on the quality of life of sufferers than many other diseases generally considered to be more serious.

This book describes and analyses the epidemiological data accumulated in the field and suggests guidelines and interventions aimed at improving healthcare for headache. Adoption of these suggestions combined with judicious use of existing resources and modern treatment options can lead to great improvements in the lives of headache sufferers world-wide.

This book will be of interest to neurologists, general practitioners, epidemiologists, public health specialists, health service managers and all those interested in improving services and outcomes for sufferers of headache.