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MIGRAINE CLINICS

The realization that migraine is a disorder causing a vast amount of unnecessary suffering has led to an increased interest in the subject. Specialist centers have been set up with the support of the Migraine Trust for treatment and research of acute migraine attacks in London (the two clinics serving this purpose are the Princess Margaret Clinic and the Charring Cross Hospital Migraine Clinic). In addition to offering treatment of the acute attack, these and other clinics provide consultation facilities for general practitioner referrals, so that all sorts of treatment methods are tried and many trials undertaken.
Perhaps the most important function of the migraine clinic is to deal with and study the acute attack which, surprisingly, is rarely seen by most hospital doctors. In the clinic, tests can be performed on those with an acute attack which, it is hoped, when pieced together will give a better idea of what happens during the acute attack. This insight should help in the development of more appropriate treatment.
These studies are also important in the assessment of treatment. For instance, the recognition that tablets taken during an attack do not always help led to the measurement of levels in the blood of aspirin taken during an attack; these were shown to be lower than when taken at any other time. It was this finding that confirmed the slowness of emptying of the stomach and the consequent recommendation to use Maxolon to stimulate the gut and aid absorption, so making the levels of ingested drugs higher.
The advantage of grouping patients with the same disorder together is that it allows the clinic staff to concentrate on specialized areas and makes research easier. The facility for treatment of acute attacks helps not only patients but research workers. However, in countries where patients visit a specialist, a neurologist, directly rather than being referred on from their general practitioner, there is not such a demand for such clinics. This means that research workers do not have the opportunity of studying patients during an acute attack.
A town (or catchment area of population) has to be of a particular size in order for such facilities to be viable, e.g. about a quarter of a million people is probably the smallest size for this purpose. Alternatively, there needs to be a large concentration of commuter workers in the area (as there is in the City of London where the Princess Margaret Clinic is situated).
In the United States there are several organizations operating such clinics which, although privately run, are fully used.

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