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Migraine is more than a headache – a rethink offers hope


Drugs that can prevent or relieve migraine attacks are only effective for some people. Research is starting to untangle the reasons why.

Medical advances in the past few decades — including the approval of gepants and related treatment s — have redefined migraine as “a treatable and manageable condition”, says Diana Krause, a neuropharmacologist at the University of California, Irvine. May and others think that the hypothalamus loses control over the limbic system about two days before the attack begins, and it results in changes to conscious experiences that might explain symptoms such as light- and sound-sensitivity, or cognitive impairments. At the same time, the breakdown of hypothalamic control puts the body’s homeostatic balance out of kilter, which explains why symptoms such as fatigue, nausea, yawning and food cravings are common when a migraine is building up, says Krause.

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