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Review
. 2025 Nov;36(4):701-714.
doi: 10.1016/j.pmr.2025.08.002. Epub 2025 Sep 24.

Migraine

Henry H Chen  1 , Kelly M Heath  2 , Palak R Patel  3
Affiliations
Review

Migraine

Henry H Chen et al. Phys Med Rehabil Clin N Am. 2025 Nov.

Abstract

Migraine, a common primary headache disorder, ranks second only to low back pain as a leading cause of disability. Proposed mechanisms include vasodilation, trigeminovascular activation, and neurogenic inflammation. Diagnosis is clinical, as no biomarker exists, and the International Classification of Headache Disorders-3 has clinical criteria for diagnosis. Differentiating migraine from other conditions can be challenging, with "red" and "green flags" guiding assessment. Treatment includes acute and preventive options, with calcitonin gene-related peptide inhibitors and neuromodulation as newer strategies. Complementary therapies and botulinum toxin injections may also benefit those with chronic migraine.

Keywords: Botulinum toxin; Headache; Migraine; Mindfulness; Trigeminovascular; Vasodilation.

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Conflict of interest statement

Disclosures The contents of this work do not represent the views of the Department of the Veterans Affairs or the United States Government. The authors have nothing to disclose.

MeSH terms