Abstract
Migraine and tension-type headache (TTH) are common primary disorders that carry significant
morbidity and socioeconomic effect. In this article, we will review the epidemiology,
presentation, and diagnosis of these disorders. First-line acute treatment for migraine
consists of analgesics, triptans, and antiemetics, while nonsteroidal anti-inflammatory
drugs are the mainstay treatment for TTH. Patients with frequent or chronic headaches
warrant prophylactic therapy. For migraine, various classes of preventives can be
used (β-blockers, tricyclics, antiepileptics, botulinum toxin), with the choice of
therapy tailored to the patient's risk factors and symptoms. For TTH, tricyclics have
the most evidence as prophylactic therapy. A new class of medication, monoclonal antibodies
to calcitonin gene receptor peptide or its receptor, became available in 2018, and
is the first class of medication specifically designed to treat migraine. In addition
to pharmacotherapy, we will also review nonpharmacologic interventions as well as
neuromodulation for migraine.
Keywords
migraine - tension-type headache - chronic migraine - acute treatment - preventive
treatment
