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CME: Updates in Migraine Headaches: Best practices and Emerging Therapies in Treatment and Prevention

Activity Description / Statement of Need:

In this online CME self-learning program:

Migraine headache is the leading condition of recurrent cephalalgias of moderate or severe intensity. It is the most common type of headache presented by patients that seek medical treatment, and the World Health Organization (WHO) has ranked migraine in the top fifteen most disabling medical conditions. The condition has been identified as one of the most common neurological disorders, and in the United States, its prevalence in the general population is approximately 12%. In children, the prevalence ranges from 1% to 4% and does not present more commonly in either sex. However, after menarche, its prevalence in females (18%) is approximately three times higher than in males.

While the mechanism behind migraine headaches was long thought to be the result of cerebral arterial vasoconstriction and reactive vasodilation, that theory has since been discredited. More recently, research points in the direction of trigeminovascular activation of pain receptors located throughout the central nervous system. Irrespective of cause however, migraine has long been underdiagnosed in the United States in spite the availability of accepted guidelines for diagnostic criteria and effective agents for prophylaxis and treatment.

There have been a wide array of advances in the realm of migraine management with respect to pharmacotherapeutic options, including both presently approved as well as more novel, potential ones on the horizon. Helping the clinician discern the role of each of agent – present and future – merits continuing healthcare professional education.

Target Audience:

Healthcare professionals who are: primary care physicians, neurologists, headache specialists, nurse practitioners, physician assistants, nurses, OB-GYN specialists, pharmacists, and those who otherwise commonly care for or clinically encounter patients who may experience migraine headache.

This program is supported by an educational grant from Amgen and Promius.

Release Date: July 20, 2016 -- Expiration Date: July 20, 2018

Faculty: Andrew Charles, MD



Introduction, disclosures

Primer and updates on the epidemiology, pathophysiology, clinical presentation, and diagnosis of migraine headaches

  • Statistics, risk factors, social and economic impact
  • Pathophysiology: what is known, what is not
  • Clinical presentation and the barrier of underreporting
  • Clinical practice guideline updates and guidelines’ relative strengths
  • Patient case(s)

Updates in the treatment of patients with migraine headaches

  • Review of present therapies and emerging pharmacotherapy and their respective, anticipated roles 
  • Chronic migraine 
    • Prophylaxis 
      • Calcitonin gene-related peptide ligand and receptor antibodies and antagonists
    • Rescue therapy 
      • Novel routes of administration: triptans
      • Novel serotonergic agents
  • A multipronged attack aimed at managing comorbid psychiatric conditions
  • Special considerations for different patient populations
  • Minimizing barriers to care through a more collaborative care, team-based approach between disciplines 
  • Best practice: putting it all together
  • Patient case(s) 

Summary, conclusions, and best practice recap

Learning Objectives

By the end of the session the participant will be able to:

  • Describe the prevalence of migraine symptoms and the impact that these symptoms have on efficacy of anti-migraine therapy and functional status
  • Describe the sometimes variable manifestations (e.g., incidence and clinical presentation) of migraine headaches, depending on age and sex
  • Recall emerging therapies for the treatment and prevention of chronic migraine headache and anticipate their place in therapy
  • Support team-based learning and communication between all clinicians involved with the care of patients suffering with migraines
  • Given a series of patient cases, diagnosis and treat migraine headaches by employing current treatment guidelines, using evidence-based therapy algorithms, and providing individualized approaches to care



Faculty Disclosure and Resolution of COI

 As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.


Faculty Disclosure: Dr. Andrew Charles, MD, Professor of Neurology, Meyer and Renee, Luskin Chair in Migraine and Headache Studies; Director, UCLA Goldberg Migraine Program, David Geffen School of Medicine at UCLA, Los Angeles, CA discloses that he has received financial compensation as consultant or researcher for Takeda, Amgen, Lilly, Trevana, and eNeura.


Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP is an officer and part owner of ScientiaCME, LLC with no relevent financial disclosures.


Commercial Support Disclosure: This program is supported by an educational grant from AMGEN and Promius.


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural and Linguistic Competence

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.

Additional Courses That Are Related To This Activity

Migraine headaches: Highlights from the American Academy of Neurology 2017 Annual Meeting (AAN 2017)

Migraine Headaches: Highlights from the American Academy of Neurology 2016 Annual Meeting (AAN 2016) : Take-Aways, Emerging Practice Changes, and Barriers to their Implementation

Parkinson's disease: Highlights from the American Academy of Neurology 2017 Annual Meeting (AAN 2017)

Multiple Sclerosis (MS) and Its Complications: Highlights from the American Academy of Neurology 2016 Annual Meeting (AAN 2016) : Take-Aways, Emerging Practice Changes, and Barriers to their Implementation