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Migrän

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Definition:
Episodisk huvudvärk som karaktäriseras av olika kombinationer av neurologiska, gastrointestinala och autonoma förändringar.
Förekomst:
Ettårsprevalensen är 16 % bland kvinnor och 8 % bland män.
Symtom:
Anfall av huvudvärk, oftast halvsidig, som varar mellan 4 och 72 timmar med eller utan aura.
Kliniska fynd:
Mellan anfallen finns det vanligtvis inga kliniska fynd.
Diagnostik:
Typisk anamnes. Inga specifika undersökningar eller prover är av diagnostisk betydelse.
Behandling:
Anfallskupering – i första hand prövas enkla analgetika (paracetamol eller NSAID), i andra hand triptaner, eventuellt i kombination med NSAID. Förebyggande behandling – undvika utlösande faktorer, eventuellt beteendeterapi och/eller läkemedelsprofylax med i första hand betablockerare.
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  • Anna Nager, docent och specialist i allmänmedicin, Karolinska institutet