Loder, E

Tfelt-Hansen, P

The Journal of Headache and Pain

P Tfelt-Hansen

E Loder

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EHMTI-0368. Treatment of migraine attacks as suggested by Dr. John R. Graham in 1955. A historical analysis with current implications

Harvard University - DASH 

 EHMTI-0368. Treatment of migraine attacks as suggested by Dr.John R. Graham in 1955. A historical analysis with currentimplications  (Article begins on next page)The Harvard community has made this article openly available.Please share how this access benefits you. Your story matters.Citation Tfelt-Hansen, P., and E Loder. 2014. “EHMTI-0368. Treatmentof migraine attacks as suggested by Dr. John R. Graham in 1955.A historical analysis with current implications.” The Journal ofHeadache and Pain 15 (Suppl 1): M11. doi:10.1186/1129-2377-15-S1-M11. http://dx.doi.org/10.1186/1129-2377-15-S1-M11.Published Version doi:10.1186/1129-2377-15-S1-M11Accessed February 17, 2015 3:19:32 AM ESTCitable Link http://nrs.harvard.edu/urn-3:HUL.InstRepos:13347503Terms of Use This article was downloaded from Harvard University's DASHrepository, and is made available under the terms and conditionsapplicable to Other Posted Material, as set forth athttp://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAAMEETING ABSTRACT Open AccessEHMTI-0368. Treatment of migraine attacks assuggested by Dr. John R. Graham in 1955. Ahistorical analysis with current implicationsP Tfelt-Hansen1*, E Loder2From 4th European Headache and Migraine Trust International Congress: EHMTIC 2014Copenhagen, Denmark. 18-21 September 2014IntroductionIn 1955 Dr. John R. Graham, an astute clinician, pub-lished 3 influential papers on migraine theories andmainly on treatment of migraine in the New EnglandJournal of Medicine [1,2,3]. Many of Dr. Graham’sc l i n i -cal observations remain relevant to current methods oftreating migraine attacks and some of his examples ofsuggestions are shown below.Examples of suggestions on ergot therapy:1. The patient should be checked regarding to diagno-sis of migraine and possible contraindications to ergottherapy.2. The ergot dose should be carefully selected as theminimally effective dose.3. The patient should be instructed to use ergot asearly in the attack as he can make the diagnosis of “oneof his migraine.”4. He should be urged to use the selected amount ofergot at the start rather than to distribute it over severalhours.5. Ergot derivatives should not be considered a failureuntil ergotamine tartrate has been given, early in anattack, by the parenteral route.ConclusionIf the word “ergot” is replaced with” triptans” Dr. Gra-ham thus seemingly anticipated in 1955 optimal modernacute treatment of migraine.No conflict of interest.Authors’ details1Neurology Danish Headache Center, Glostrup Hospital, Glostrup, Denmark.2J.R.Graham Headache Center, Harvard Medical School, Boston, USA.Published: 18 September 2014References1. NEJM: 1955, 253:726-30.2. NEJM: 1955, 253:770-6.3. NEJM: 1955, 253:814-21.doi:10.1186/1129-2377-15-S1-M11Cite this article as: Tfelt-Hansen and Loder: EHMTI-0368. Treatment ofmigraine attacks as suggested by Dr. John R. Graham in 1955. Ahistorical analysis with current implications. The Journal of Headache andPain 2014 15(Suppl 1):M11.Submit your manuscript to a journal and beneﬁ  t from:7 Convenient online submission7 Rigorous peer review7 Immediate publication on acceptance7 Open access: articles freely available online7 High visibility within the ﬁ  eld7 Retaining the copyright to your article    Submit your next manuscript at 7 springeropen.com1Neurology Danish Headache Center, Glostrup Hospital, Glostrup, DenmarkFull list of author information is available at the end of the articleTfelt-Hansen and Loder The Journal of Headacheand Pain 2014, 15(Suppl 1):M11http://www.thejournalofheadacheandpain.com/content/15/S1/M11© 2014 Tfelt-Hansen and Loder; licensee Springer. This is an Open Access article distributed under the terms of the Creative CommonsAttribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction inany medium, provided the original work is properly cited.

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EHMTI-0368. Treatment of migraine attacks as suggested by Dr. John R. Graham in 1955. A historical analysis with current implications

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