Neurology
Migraine — Acute & Preventive
Acute treatment (triptans, NSAIDs, antiemetics), preventive options (propranolol, topiramate, candesartan, CGRP), red flags, MOH.
Source: NICE NG150; BASH
Step 1 of ~5
info
Diagnose Migraine + Exclude Red Flags
Migraine criteria: ≥5 attacks; 4–72h; ≥2 of: unilateral, pulsating, moderate–severe, aggravated by activity; ≥1 of: nausea/vomiting, photophobia/phonophobia. Aura in 25%. Red flags requiring imaging: thunderclap (SAH), focal neurology, papilloedema, age >50 first headache (GCA), worsening with Valsalva (mass), positional, fever + meningism, cancer history, immunocompromised.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Erenumab · CGRP Receptor Monoclonal Antibody — Migraine Prevention
- Propranolol (Migraine Prevention) · Beta-Blocker — Migraine Prophylaxis
- Aspirin with Metoclopramide · Analgesic + Antiemetic (Migraine Treatment)
- Atogepant · CGRP Receptor Antagonist (Gepant — Migraine Prevention)
- Esketamine · NMDA Receptor Antagonist (Treatment-Resistant Depression / Acute Suicidality)
- Candesartan (HFrEF / ACEi Intolerance) · ARB / HFrEF
Pathways
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS
Decision support only. Always apply local guidelines and clinical judgement.