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One of these statements about migraine is false – which is it?
- Prevalence peaks after age 50
- It affects 1 in 5 women
- It affects 1 in 13 men
- It is ranked by WHO as 19th among all disease worldwide causing disability
Regarding the IHS classification of headache, which one of these statements is false?
- Cluster headache typically lasts 15 - 180 minutes
- Migraine is not typically associated with red or watery eyes
- The pain of medication-overuse headache may be mild, moderate or severe
- The pain of migraine is eased by movement
Which one of these statements about migraine is false?
- Aura affects about 6 per cent of migraine sufferers
- An aura lasts for 5 to 60 minutes
- Aura is always followed by headache
- Aura tends to occur in more mature patients, such as peri- or postmenopausal women
Thinking about the pathophysiology of migraine, which one of these statements is false?
- Modern imaging techniques have failed to demonstrate changes in cerebral blood volume and blood flow during an attack
- Activation of the trigeminovascular system leads to dilatation of cranial blood vessels and the throbbing headache
- Release of vasoactive neurotransmitter peptides is thought to lead to a sterile neurogenic inflammation
- Migraine is an inflammatory process associated with gastric stasis
One of these statements about patients’ expectations of treatment of migraine is false – which one?
- 86 per cent of patients rate complete relief of head pain with no recurrence as important or very important
- Migraine is so troublesome that only 5 per cent of patients lapse from care
- Rapid onset of relief is important to 83 per cent of patients
- Flexibility and individualised care should be offered to each patient
Which one of these statements about nondrug strategies to treat migraine is false?
- They involve avoiding events and situations that lower an individual’s threshold for developing headache
- Exercise should be avoided
- Patients should try not to fast for more than 12 hours overnight
- Caffeine intake should be minimised
Thinking about using simple or combination analgesics to treat migraine, which one of these statements is false?
- Simple analgesics should be taken as soon as the aura, premonitory phase or headache starts
- The mean pain-free rate (reduction of pain from moderate or severe to no pain 2 hours after treatment) is the preferred end-point and averages 24 per cent
- Headache response, defined as pain going from moderate or severe to mild or none after 2 hours, averages 60 per cent
- Soluble or dispersible formulations of analgesics offer no advantage over plain tablets
Which one of these statements about the actions and use of triptans is false?
- They have selective agonist activity at serotonin receptor sites but serotonin 1B receptors are not exclusively located on cranial vessels
- Stratified care is more effective and less costly than stepped care
- They should be taken as the premonitory symptoms or aura start, not when the headache starts
- Compared with sumatriptan 100mg tablets, almotriptan 12.5mg shows similar efficacy at two hours but better sustained pain-free response, consistency and tolerability
In the prevention of migraine, which one of these statements is false?
- Very frequent headache is defined as at least 5 episodes per week
- Preventive treatment does not stop all attacks and acute treatment will still be needed
- A time frame for stopping treatment should be agreed with the patient at the outset
- Preventive medication may be indicated if a patient prefers it despite taking effective acute medication
Which one of these statements about drugs for preventive treatment of migraine is false?
- In clinical trials of topiramate, difficulty with memory and concentration, and mood and language problems, each affected about 6 per cent of patients
- No patient will obtain benefit from topiramate at doses below 50mg twice daily
- Butterbur reduces migraine frequency in adults and children
- Botulinum toxin type A has been shown to improve quality of life in patients with migraine

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