Migrene
Sist oppdatert: Sist revidert:
Sist revidert av:Mattias Linde
Definisjon:
En primær, episodisk eller kronisk hodepine ofte kombinert med ulike nevrologiske, gastrointestinale og autonome forandringer. Migrene er en nevrologisk sykdom
Forekomst:
Ettårsprevalens av migrene er ca. 15%, dobbelt så hyppig hos kvinner som hos menn
Symptomer:
Symptomene er oftest intens hodepine med lys- og lydømfintlighet , medtatt/påvirket allmenntilistand og kvalme/oppkast som varer mellom 4 og 72 timer, med eller uten aura
Funn:
Vanligvis er det ingen kliniske funn
Diagnostikk:
KLM-symptomer (kvalme, lysskyhet og medtatthet) gir høy sannsynlighet for at hodepine er migrene. Diagnosen stilles ved oppfyllelse av ICHD-3 diagnosekriterier. Bildediagnostikk er svært sjelden indisert
Behandling:
Behandlingen er enkle analgetika eller triptaner ved anfall. Forebyggende behandling ved hyppige eller intense plager.
- Nasjonal kompetansetjeneste for hodepine - nettside
- Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211. PMID: 29368949 PubMed
- Hagen K, Stovner LJ, Zwart J-A. Time trends of major headache diagnoses and predictive factors. Data from three Nord-Trøndelag health surveys. J Headache Pain 2020; 21: 24. pmid:32160857 PubMed
- Linde M, Stovner LJ, Zwart JA, Hagen K.Time trends in the prevalence of headache disorders. The Nord-Trondelag Health Studies (HUNT 2 and HUNT 3). Cephalalgia. 2011 Apr;31(5):585-96 PubMed
- Stovner LJ, Hagen K, Linde M, Steiner TJ. The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates. J Headache Pain 2022; 23: 34. PMID: 35410119 PubMed
- Hagen K. Genetiske aspekter ved migrene. Tidsskr Nor Lægeforen 2003; 123: 2727-30. PubMed
- Alstadhaug KB, Salvesen R. Migrenesmerte - mekanismer og konsekvenser for behandling. Tidsskr Nor Lægeforen 2007; 127: 3064-8. PubMed
- Romanello S, Spiri D, Marcuzzi E, et al. Association between childhood migraine and history of infantile colic. JAMA 2013; 309: 1607-12. doi:10.1001/jama.2013.747. DOI
- Ljøstad U. Migrene. I NevroNEL. Sist oppdatert 30.10.2019. Siden lest 18.12.2019
- Charles A. Migraine. N Engl J Med 2017; 377: 553-61. pmid:28792865 PubMed
- Vetvik KG, MacGregor EA. Menstrual migraine: a distinct disorder needing greater recognition. Lancet Neurol 2021; 20: 304-315. PMID: 33600767 PubMed
- Rafaelli B, Storch E, Overeem LH, et al. Sex Hormones and Calcitonin Gene–Related Peptide in Women With Migraine: A Cross-sectional, Matched Cohort Study. Neurology 2023. pmid:36813730 PubMed
- Kvisvik EV, Stovner LJ, Helde G, Bovim G, Linde M. Headache and migraine during pregnancy and puerperium: the MIGRA-study. J Headache Pain 2011; 4: 443-51. pmid:21442333 PubMed
- Fasmer OB, Oedegaard KJ. Migrene og psykiske lidelser. Tidsskr Nor Lægeforen 2004; 124: 2350-3. PubMed
- Stensland SØ, Zwart JA, Wentzel-Larsen T, Dyb G. The headache of terror: A matched cohort study of adolescents from the Utøya and the HUNT Study. Neurology 2017 Dec 13; Epub: pii: 10.1212/WNL.0000000000004805. pmid:29237795 PubMed
- Lipton RB, Dodick D, Sadovsky R, et al. A self-administered screener for migraine in primary care: The ID Migraine validation Study. Neurology 2003; 61: 375-382. pmid:12913201 PubMed
- Giffin NJ, Ruggiero L, Lipton RB, et al. A novel approach to the study of premonitory symptoms in migraine using an electronic diary. Neurology 2003; 60: 935-40. Neurology
- Thomsen LL, Eriksen MK, Roemer SF, Anderson I, Olesen J, Russell MB. A population-based study of familial hemiplegic migraine suggests revised diagnostic criteria. Brain 2002; 125: 1379-99. PubMed
- Mayans L, Walling A. Acute migraine headache: treatment strategies. Am Fam Physician 2018; 97: 243-51. PubMed
- Starling AJ, Vargas BB. A Narrative Review of Evidence-Based Preventive Options for Chronic Migraine. Curr Pain Headache Rep. 2015;19:49. pmid:26286071 PubMed
- Legeforeningen. Gjør kloke valg. Fagmedisinske anbefalinger. Norsk nevrologisk foreining. Siden besøkt 09.03.2021 www.legeforeningen.no
- Scottish Intercollegiate Guidelines Network (SIGN).Pharmacological management of migraine. Edinburgh: SIGN; 2023. SIGN publication no. 155. 2023. Available from URL: http://www.sign.ac.uk
- Rabbie R, Derry S, Moore RA. Ibuprofen with or without an antiemetic for acute migraine headaches in adults. Cochrane Database Syst Rev 2013; 4: CD008039. pmid:23633348 PubMed
- Kirthi V, Derry S, Moore RA. Aspirin with or without an antiemetic for acute migraine headaches in adults. Cochrane Database Syst Rev 2013 Apr 30;4:CD008041. Cochrane (DOI)
- Biglione B, Gitin A, Gorelick PB, et al. Aspirin in the Treatment and Prevention of Migraine Headaches: Possible Additional Clinical Options for Primary Healthcare Providers. Am J Med 2019. pmid:31712099 PubMed
- Derry S, Moore RA, McQuay HJ. Paracetamol (acetaminophen) with or without an antiemetic for acute migraine headaches in adults. Cochrane Database Syst Rev 2013. CD008040. doi:10.1002/14651858.CD008040.pub3 DOI
- Lipton RB, Stewart WF, Stone AM, Lainez MJA, Sawyer JPC. Stratified care vs step care strategies for migraine. The disability in strategies of care (DISC) study: a randomized trial. JAMA 2000; 284: 2599-605. Journal of the American Medical Association
- Yang C-P, Liang C-S, Chang C-M, et al. Comparison of New Pharmacologic Agents With Triptans for Treatment of Migraine. A Systematic Review and Meta-analysis. JAMA Netw Open 2021. PMID: 34633423 PubMed
- Cameron C, Kelly S, Hsieh SC et al. Triptans in the Acute Treatment of Migraine: A Systematic Review and Network Meta-Analysis. Headache. 2015;55 Suppl 4:221-35.
- Law S, Derry S, Moore RA. Sumatriptan plus naproxen for acute migraine attacks in adults. Cochrane Database Syst Rev. 2013;10:CD008541. doi: 10.1002/14651858.CD008541.pub2. The Cochrane Library
- Eigenbrodt AK, Ashina H, Khan S, et al. Diagnosis and management of migraine in ten steps. Nat Rev Neurol 2021; 17: 501-514. pmid:34145431 PubMed
- Croop R, Goadsby PJ, Stock DA, et al. Efficacy, safety, and tolerability of rimegepant orally disintegrating tablet for the acute treatment of migraine: a randomised, phase 3, double-blind, placebo-controlled trial. Lancet 2019; 394: 737-745. pmid:31311674 PubMed
- Sommerfelt K, Aune E. Generell veileder i pediatri. Kap. 11.9 Hodepine og migrene. Norsk barnelegeforening. Sist revidert 2017. www.helsebiblioteket.no
- Brandes JL, Kudrow D, Stark SR, et al. Sumatriptan-naproxen for acute treatment of migraine: a randomized trial. JAMA 2007; 297: 1443-54. Journal of the American Medical Association
- Derry CJ, Derry S, Moore RA. Sumatriptan (all routes of administration) for acute migraine attacks in adults - overview of Cochrane reviews. Cochrane Database Syst Rev. 2014 28. DOI: 10.1002/14651858.CD009108.pub2. DOI
- Tfelt-Hansen P, Iversen HK. Triptaner i migrænebehandlingen. Ugeskr Læger 2006; 168: 1850-3. PubMed
- Amundsen S, Nordeng H, Nezvalova-Henriksen K, Stovner LJ, Spigset O. Pharmacological treatment of migraine during pregnancy and breastfeeding. Nat Rev Neurol 2015; 11(4): 209-19. PMID: 25776823 PubMed
- Friedman BW, Irizarry E, Solorzano C, et al. Randomized study of IV prochlorperazine plus diphenhydramine vs IV hydromorphone for migraine. Neurology 2017. pmid:29046364 PubMed
- Colman I, Friedman BW, Brown MD et al. Parenteral dexamethasone for acute severe migraine headache: meta-analysis of randomised controlled trials for preventing recurrence . BMJ 2008; 336: 1359-61. PubMed
- Singh A, Alter HJ, Zaia B. Does the addition of dexamethasone to standard therapy for acute migraine headache decrease the incidence of recurrent headache for patients treated in the emergency department? A meta-analysis and systematic review of the literature. Acad Emerg Med 2008; 15: 1223-33. PubMed
- Hagen K, Stovner LJ. Migrenebehandling ved graviditet og amming. Tidsskr Nor Lægeforen 2006; 126: 3107-9. PubMed
- Mørch-Johnsen G, Myhr K. Behandling av migrene i svangerskapet. RELIS database 2012; : .
- Evans EW, Lorber KC. Use of 5-HT1 agonists in pregnancy. Ann Pharmacother 2008; 42: 543-9. PubMed
- Contag SA, Bushnell C. Contemporary management of migrainous disorders in pregnancy. Curr Opin Obstet Gynecol 2010; 22: 437-45. PubMed
- Cassina M, De Gianantonio E et al. Migraine therapy during pregnancy and lactation. Expert Opin Drug Saf 2010; 9: 937-48. PubMed
- Källén K, Winbladh B. Läkemedel och fosterskador. Propranolol. http://www.janusinfo.se/gravreg/ (Sist endret: juni 2010).
- Lee MJ, Guinn D et al. Headache in pregnancy. UpToDate, last updated Mars 19. 2010. UpToDate
- Varkey E, Cider A, Carlsson J, Linde M. Exercise as migraine prophylaxis: a randomized study using relaxation and topiramate as controls. Cephalalgia 2011; 31: 1428-38. pmid:21890526 PubMed
- Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of episodic migraine. Cochrane Database of Systematic Reviews 2016, Issue 6. Art. No.: CD001218. DOI: 10.1002/14651858.CD001218.pub3. DOI
- Ni X, Dong L, Tian T, et al. Acupuncture versus Various Control Treatments in the Treatment of Migraine: A Review of Randomized Controlled Trials from the Past 10 Years. J Pain Res. 2020 Aug 12;13:2033-2064. PMID: 32884332 PubMed
- Long C, Ye Y, Chen M, et al. Effectiveness of yoga therapy for migraine treatment: A meta-analysis of randomized controlled studies. Am J Emerg Med 2022; 58: 95-99. pmid:35660369 PubMed
- Silberstein SD, Holland S, Freitag F,et al.; Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2012 Apr 24;78(17):1337-45. doi: 10.1212/WNL.0b013e3182535d20. Erratum in: Neurology. 2013 Feb 26;80(9):871. PMID: 22529202 PubMed
- Holland S, Silberstein SD, Freitag F, et al.; Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2012 Apr 24;78(17):1346-53. doi: 10.1212/WNL.0b013e3182535d0c. PMID: 22529203 PubMed
- Lipton RB, Cohen JM, Gandhi SK, et al. Effect of fremanezumab on quality of life and productivity in patients with chronic migraine. Neurology. 2020 Aug 18;95(7):e878-e888. PMID: 32747522 PubMed
- Goadsby PJ, Reuter U, Lanteri-Minet M, et al. Long-Term Efficacy and Safety of Erenumab: Results From 64 Weeks of the LIBERTY Study. Neurology. 2021. PMID: 33910942 PubMed
- Lipton RB, pozo-Rosich P, Blumenfeld AM, et al. Rates of Response to Atogepant for Migraine Prophylaxis Among Adults A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open 2022; 5: e2215499. pmid:35675076 PubMed
- Ashina M, Lanteri-Minet M, Pozo-Rosich P, et al. Safety and efficacy of eptinezumab for migraine prevention in patients with two-to-four previous preventive treatment failures (DELIVER): a multi-arm, randomised, double-blind, placebo-controlled, phase 3b trial. Lancet Neurology 2022. pmid:35716692 PubMed
- Powers SW, Coffey CS, Chamberlin LA, et al. Trial of Amitriptyline, Topiramate, and Placebo for Pediatric Migraine. N Engl J Med 2016; Oct 27: Epub. pmid:27788026 PubMed
- Tronvik E, Stovner LJ, Helde G, Sand T, Bovim G. Prophylactic treatment of migraine with an angiotensin II receptor blocker: a randomized controlled trial. JAMA 2003; 289: 65-9. PubMed
- Stovner LJ, Linde M, Gravdahl GB, et al. A comparative study of candesartan versus propranolol for migraine prophylaxis: A randomised, triple-blind, placebo-controlled, double cross-over study. Cephalalgia 2014; 34: 523-32. pmid:24335848 PubMed
- Chronicle EP, Mulleners WM. Anticonvulsant drugs for migraine prophylaxis. Cochrane Database of Systematic Reviews 2016, Issue 5. Art. No.: CD003226. DOI: 10.1002/14651858.CD003226.pub3. DOI
- Marmura MJ. Safety of topiramate for treating migraines. Expert Opin Drug Saf. 2014;13(9):1241-7. doi: 10.1517/14740338.2014.934669 DOI
- Schrader H, Stovner LJ, Helde G, Sand T, Bovim G. Prophylactic treatment of migraine with angiotensin-converting enzyme inhibitor (lisinopril): randomised, placebo controlled, crossover study. BMJ 2001; 322: 19-22. PubMed
- Reuter U. A Review of Monoclonal Antibody Therapies and Other Preventative Treatments in Migraine. Headache 2018. pmid:29697156 PubMed
- Hwang TJ, Vokunger KN, Kesselheim AS. New Treatments for Migraine—Therapeutic Ratings and Comparative Coverage in the US, Canada, and Europe. JAMA Intern Med 2021. pmid:34901995 PubMed
- Tepper S, Ashina M, Reuter U, et al. Safety and efficacy of erenumab for preventive treatment of chronic migraine: a randomised, double-blind, placebo-controlled phase 2 trial. Lancet Neurol 2017; 16: 425-34. pmid:28460892 PubMed
- Tepper SJ, Diener H-C, Ashina M, et al. Erenumab in chronic migraine with medication overuse Subgroup analysis of a randomized trial. Neurology 2019. pmid:30996056 PubMed
- Ashina M, Goadsby PJ, Dodick DW, et al. Assessment of Erenumab Safety and Efficacy in Patients With Migraine With and Without Aura A Secondary Analysis of Randomized Clinical Trials. JAMA Neurol 2021. pmid:34928306 PubMed
- Dodick DW, Silberstein SD, Bigal ME, et al. Effect of Fremanezumab Compared With Placebo for Prevention of Episodic Migraine. JAMA 2018; 319: 1999-2008. doi:10.1001/jama.2018.4853 DOI
- Ferrari MD, Diener HC, Ning X, et al. Fremanezumab versus placebo for migraine prevention in patients with documented failure to up to four migraine preventive medication classes (FOCUS): a randomised, double-blind, placebo-controlled, phase 3b trial. Lancet. 2019 Sep 21;394(10203):1030-1040. PMID: 31427046 PubMed
- Stauffer VL, Dodick DW, Zhang Q et al. Evaluation of Galcanezumab for the Prevention of Episodic Migraine. The EVOLVE-1 Randomized Clinical Trial. JAMA Neurol. 2018;75(9):1080–1088. PMID: 29813147 PubMed
- Detke HC, Goadsby PJ, Wang S et al. Galcanezumab in chronic migraine The randomized, double-blind, placebo-controlled REGAIN study. Neurology 2018. pmid:30446596 PubMed
- Pozo-Rosich P, Ailani J, Ashina M, et al. Atogepant for the preventive treatment of chronic migraine (PROGRESS): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 2023. pmid:37516125 PubMed
- Simpson DM, Hallett M, AshmanEJ, et al. Practice guideline update summary: Botulinum neurotoxin for the treatment of plepharospasm, cervical dystonia, adult spasticity, and headache. Neurology 2016. doi:10.1212/WNL.0000000000002560 DOI
- Diener HC, Dodick DW, Aurora SK, et al. OnabotulinumtoxinA for treatment of chronic migraine: results from the double-blind, randomized, placebo-controlled phase of the PREEMPT 2 trial. Cephalalgia 2010; 30: 804-14. PubMed
- Aurora SK, Dodick DW, Diener HC, et al. OnabotulinumtoxinA for chronic migraine: efficacy, safety, and tolerability in patients who received all five treatment cycles in the PREEMPT clinical program. Acta Neurol Scand. 2014; 129: 61-70. pmid:24107267 PubMed
- Herd CP, Tomlinson CL, Rick C, et al. Botulinum toxins for the prevention of migraine in adults. Cochrane Database Syst Rev 2018. doi:10.1002/14651858.CD011616.pub2. Pmid: 29939406. The Cochrane Library
- Jackson JL, Kuriyama A, Hayashino Y. Botulinum toxin A for prophylactic treatment of migraine and tension headaches in adults: a meta‐analysis. JAMA.2012;307:1737‐1745
- Banzi R, Cusi C, Randazzo C, et al. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) for the prevention of migraine in adults. Cochrane Database Syst Rev. 2015 Apr 1;4:CD002919. Cochrane (DOI)
- Linde M, Mulleners WM, Chronicle EP, et al. Gabapentin or pregabalin for the prophylaxis of episodic migraine in adults. Cochrane Database Syst Rev 2013; 6: CD010609. doi:10.1002/14651858.CD010609 DOI
- Xu S, Yu L, Luo X, et al. Manual acupuncture versus sham acupuncture and usual care for prophylaxis of episodic migraine without aura: multicentre, randomised clinical trial. BMJ. 2020; 368: m697. PMID: 32213509 PubMed
- Andrasik F. What does the evidence show? Efficacy of behavioural treatments for recurrent headaches in adults. Neurol Sci 2007; 28(suppl 2): 70-7.
- Campbell JK, Penzien DB, Wall EM, for the U.S. Headache Consortium. Evidence-based guidelines for migraine headache: behavioral and physical treatments. Accessed May 18, 2007, at: http://www.aan.com/professionals/practice/pdfs/gl0089.pdf.
- Wells RE, O`Connell N, Pierce CR, et al. Effectiveness of Mindfulness Meditation vs Headache Education for Adults With Migraine: A Randomized Clinical Trial. JAMA Intern Med. 2020. PMID: 33315046 PubMed
- Sharpe L, Dudeney J, Williams ACC, et al. Psychological therapies for the prevention of migraine in adults. Cochrane Database Syst Rev. 2019 Jul 2;7:CD012295. doi: 10.1002/14651858.CD012295.pub2. DOI
- Allais G, Chiarle G, Bergandi F, et al. Migraine in perimenopausal women. Neurol Sci 2015;36 suppl 1:79-83. pmid:26017518 PubMed
- Schwedt TJ. Chronic migraine. BMJ. 2014 ;348:g1416. doi: 10.1136/bmj.g1416. DOI
- Adelborg K, Szépligeti SK, Holland-Bill L, et al. Migraine and risk of cardiovascular diseases: Danish population based matched cohort study. BMJ 2018 Jan 31; 360:k96. PMID: 29386181 PubMed
- Martinez-Majander N, Artto V, Ylikotila P, et al. Association between migraine and cryptogenic ischemic stroke in young adults. Ann Neurol 2020. PMID: 33078475 PubMed
- Øie LR, Kurth T, Gulati S, Dodick DW. Migraine and risk of stroke. J Neurol Neurosurg Psychiatry 2020; 91: 593-604. pmid:32217787 PubMed
- Kurth T, Winter AC, Eliassen AH, et al. Migraine and risk of cardiovascular disease in women: prospective cohort study. BMJ 2016; 353: i2610. doi:10.1136/bmj.i2610 DOI
- Gudmundsson LS, Scher AI, Aspelund T, et al. Migraine with aura and risk of cardiovascular and all cause mortality in men and women: prospective cohort study. BMJ 2010; 341: c3966. BMJ (DOI)
- Kurth T, Rist PM, Ridker PM, et al. Association of Migraine With Aura and Other Risk Factors With Incident Cardiovascular Disease in Women. JAMA 2020; 323: 2281-9. pmid:32515815 PubMed
- Mattias Linde, professor, overlege nevrologi, Norsk Senter for Hodepineforskning (NorHEAD), Institutt for nevromedisin, NTNU
- Ingard Løge, spesialist allmennmedisin, redaktør NEL
Tidligere fagmedarbeidere
- Espen Dietrichs, professor og avdelingsoverlege, Universitetet i Oslo og Nevrologisk avdeling, Rikshospitalet, Oslo
- John-Anker Zwart, overlege - stipendiat, Det medisinske fakultet, Norges teknisk-naturvitenskapelige universitet, Trondheim