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A 44 year old woman with longstanding migraine presents for follow-up. She has an average of 12 headache days each month, and about half of these are severe enough to affect her ability to work. Trials of amitriptyline and propranolol for prevention, and three triptans and two non-steroidal anti-inflammatories for acute treatment, have not been effective. She has heard that there are new migraine treatments available and wonders if any of them would be right for her. She notes that she sometimes has trouble remembering to take medications every day.