2 Indications and current treatments
2.1 Migraines are severe headaches that may last for hours, days or longer, often accompanied by nausea, photophobia, phonophobia and the perception of unpleasant odours. In some people migraines may be accompanied by an aura, characterised by the focal neurological symptoms that usually precede or sometimes accompany the headache. The International Headache Society's international classification of headache disorders classifies migraine types.
2.2 The usual treatment option for patients with migraine is medical therapy, either to stop or prevent attacks. Treatments for acute migraine attacks include medications such as analgesics, triptans and anti-emetics (as recommended in NICE's guideline on headaches in over 12s). Treatments to stop or reduce the frequency of migraine attacks include medications such as beta‑blockers, tricyclic antidepressants and antiepileptics.
2.3 Invasive treatments are reserved for patients with distressing symptoms that are refractory to medical treatments. These include treatments such as nerve blocks, botulinum toxin (see NICE's technology appraisal guidance on botulinum toxin type A for the prevention of headaches in adults with chronic migraine), acupuncture or nerve stimulation.