Shortening Attacks With Early Migraine Intervention

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Key Questions
  • How effective is early intervention in trying to stop or mitigate a migraine attack while it is still in the mild stage?
  • How can we identify the best time to treat an attack in the early stages?
  • How do we know if some of the symptoms we’re having can be considered premonitory symptoms?
  • Do premonitory symptoms vary from person to person, or even attack to attack?
  • What is the migraine aura, and how can we recognize when it’s happening?
  • Can migraine aura change over the course of someone’s lifetime?
  • Does aura need to be present in order for a diagnosis of migraine?
  • What is the earliest point in a migraine attack when an acute medication should be used?
  • How do you decide whether to use abortive medications to treat an attack early, especially when you’re prescribed a limited amount of medication, and when some of your attacks can be milder than others?
  • Is it still possible to intervene early in an attack when you wake with morning migraine?
  • Can nonmedicinal approaches to treating migraine — such as meditation, breathwork, exercise, hydration, or using ice packs — be effective treatments early in an attack?
Interview Notes
Andrew Charles, MD

Andrew Charles, MD

Director
UCLA Goldberg Migraine Program

Dr. Andrew Charles is director of Headache Research and Treatment, and professor of neurology at the David Geffen School of Medicine at UCLA. He leads the Goldberg Migraine Program, established in December 2015 with the largest single private grant ever for migraine research, in order to develop new treatments and research a potential cure. He has served on the board of directors for the American Headache Society since 2010, and the board of trustees for the International Headache Society since 2011. Dr. Charles educates neurologists, headache specialists and primary care physicians around the world on headache research and treatment. He’s also been published in numerous medical journals such as Neurology and Headache, and serves as an associate editor of Cephalalgia.

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