Migraines are no longer considered a vascular headache and now considered a neurologic disorder of dysfunctional nociceptive processing.  Diagnosis is completed clinically with no lab or imaging usually needed.  Treatment includes - Antidopaminergics (Metoclopramide & Prochlorperazine) - Triptans (Sumatriptan) - Nonsteroidals (Ketorolac).  Consider steroids to lessen the risk of recurrence.  Opioids should be avoided and are last line. Most patients don’t need specialist referral.  

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