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PreCourse 8: Real-World Pharmacologic Management in Headache Disorders: Navigating Clinical Grey Zones

Session: PreCourse 8: Real-World Pharmacologic Management in Headache Disorders: Navigating Clinical Grey Zones - Presented by the CSF Pressure and Volume Disorders SIG & Pharmacology and Therapeutics SIG

Managing Nausea & GI Issues in Migraine

Thursday, December 4, 2025

3:20 PM - 3:45 PM MST

Location: Rainmakers Ballroom

Faculty(s)

Jeffrey Royce, MD, FAHS

Headache Medicine Fellowship Director
University of Illinois College of Medicine at Rockford
Rockford, Illinois, United States

Illustrative cases will be used to elucidate the management of the most bothersome symptom nausea and vomiting in migraine. The pathophysiology of nausea will be discussed as well as the pharmacology of antiemetic drugs and their side effects. Non-pharmacologic and complimentary approaches and the use of cannaboids will be included. A brief discussion of complicating GI conditions such as gastroparesis and functional GI disorders will be entertained. The concept of the gut-brain conection will be delineated.

Learning Objectives:

Understand the management strategies for nausea and vomiting as a debilitating symptom of migraine, improving patient care and outcome and list the pharmacologic and non pharmacologic treatments as well as their side effects and contraindications
Describe the pathophysiology of nausea in migraine including neurovacular and gastrointestinal mechanisms
Be aware of the comorbid conditions of the GI tract which cause or contribute to nausea and vomiting in migraine