Diagnosis and management of migraine in ten steps

Anna K. Eigenbrodt, Håkan Ashina, Sabrina Khan, Hans Christoph Diener, Dimos D. Mitsikostas, Alexandra J. Sinclair, Patricia Pozo-Rosich, Paolo Martelletti, Anne Ducros, Michel Lantéri-Minet, Mark Braschinsky, Margarita Sanchez del Rio, Oved Daniel, Aynur Özge, Ayten Mammadbayli, Mihails Arons, Kirill Skorobogatykh, Vladimir Romanenko, Gisela M. Terwindt, Koen PaemeleireSimona Sacco, Uwe Reuter, Christian Lampl, Henrik W. Schytz, Zaza Katsarava, Timothy J. Steiner, Messoud Ashina (Coresponding Author)

Research output: Contribution to journalReview articlepeer-review

87 Citations (Scopus)


Migraine is a disabling primary headache disorder that directly affects more than one billion people worldwide. Despite its widespread prevalence, migraine remains under-diagnosed and under-treated. To support clinical decision-making, we convened a European panel of experts to develop a ten-step approach to the diagnosis and management of migraine. Each step was established by expert consensus and supported by a review of current literature, and the Consensus Statement is endorsed by the European Headache Federation and the European Academy of Neurology. In this Consensus Statement, we introduce typical clinical features, diagnostic criteria and differential diagnoses of migraine. We then emphasize the value of patient centricity and patient education to ensure treatment adherence and satisfaction with care provision. Further, we outline best practices for acute and preventive treatment of migraine in various patient populations, including adults, children and adolescents, pregnant and breastfeeding women, and older people. In addition, we provide recommendations for evaluating treatment response and managing treatment failure. Lastly, we discuss the management of complications and comorbidities as well as the importance of planning long-term follow-up.

Original languageEnglish
Pages (from-to)501-514
Number of pages14
JournalNature Reviews Neurology
Issue number8
Publication statusPublished - Aug 2021

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database


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