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Dr Nissan is a staff physician at the Diamond Headache Clinic, and Dr Diamond is associate director of the Diamond Headache Clinic in Chicago, Ill. Dr Diamond is also a clinical assistant professor in the Department of Medicine at The Chicago Medical School at Rosalind Franklin University of Medicine and Science, in North Chicago, Ill.

Address correspondence to George R. Nissan, DO, Diamond Headache Clinic, 467 W Deming Pl, Suite 500, Chicago, IL 60614-2970.E-mail: gnissan{at}diamondheadache.com

Migraine is a common, incapacitating disorder that is underdiagnosed in clinical practice. Early and correct diagnosis of migraine is essential and can lead to significant improvements in a patient's quality of life. In the clinical practice setting, a screening tool can be used that can help differentiate migraine from other headache disorders. New research into the development of central sensitization and cutaneous allodynia in chronic migraine sufferers has led to an early treatment approach with triptans and other agents for acute migraine episodes. This approach results in greater 2-hour headache pain-free results. The use of botulinum toxin type A in the prophylaxis of migraine and mixed-headache types offers an alternative treatment in patients who may not have responded to other currently available migraine prophylactic agents.