Chronic migraine

Abstract

Chronic migraine is a disabling neurologic condition that affects 2% of the general population. Patients with chronic migraine have headaches on at least 15 days a month, with at least eight days a month on which their headaches and associated symptoms meet diagnostic criteria for migraine. Chronic migraine places an enormous burden on patients owing to frequent headaches; hypersensitivity to visual, auditory, and olfactory stimuli; nausea; and vomiting. It also affects society through direct and indirect medical costs. Chronic migraine typically develops after a slow increase in headache frequency over months to years. Several factors are associated with an increased risk of transforming to chronic migraine. The diagnosis requires a carefully performed patient interview and neurologic examination, sometimes combined with additional diagnostic tests, to differentiate chronic migraine from secondary headache disorders and other primary chronic headaches of long duration. Treatment takes a multifaceted approach that may include risk factor modification, avoidance of migraine triggers, drug and non-drug based prophylaxis, and abortive migraine treatment, the frequency of which is limited to avoid drug overuse. This article provides an overview of current knowledge regarding chronic migraine, including epidemiology, risk factors for its development, pathophysiology, diagnosis, management, and guidelines. The future of chronic migraine treatment and research is also discussed.

Chronic Migraine

“…17 This translates to about 5 million people in the US living with CM in a given year. CM has a similar female preponderance (3:1, F:M) as seen in EM but, interestingly, the prevalence of CM in women is bimodal, reaching peak prevalence in the late teens and again in the fourth decade of life.…”

Identifying risk factors for rt-pa-related intracerebral hemorrhages in patients with acute stroke

“…CM develops from the episodic form to the chronic form (migraine transformation) over time and usually catches individuals in the most productive period of their lives. While in EM, headache attacks last less than 15 days per month, whereas CM has headache episodes that last for at least 15 days per month, for a total period of over 3 months, with headache attacks of at least 8 days that meet the diagnostic criteria for migraine (2). During CM, the rates of disability, anxiety, and depression associated with headache are high and the treatment is relatively difficult compared with the episodic form (3).…”

Comparative Clinical Electroneurophysiological Characteristics of Chronic Migraine

“…Количество пациентов с ХМ в общей популяции составляет по современным оценкам от 0,4 до 2,4% [5]. При ХМ головные боли (ГБ) становятся прак-тически ежедневными (более 15 дней в месяц, из них не менее 8 приступов мигрени на протяжении более 3 месяцев) [6].…”

“…При ХМ головные боли (ГБ) становятся прак-тически ежедневными (более 15 дней в месяц, из них не менее 8 приступов мигрени на протяжении более 3 месяцев) [6]. Это приводит к тяжелой дезадаптации пациентов и характеризуется высоким риском мигре-нозного статуса и мигренозного инсульта [5,7]. Веро-ятность развития ХМ повышается при наличии у боль-ных актуальной тревоги и депрессии, злоупотребления лекарственными препаратами, сопутствующей патоло-гии нервной системы, внутренних органов и опорно-двигательного аппарата [7,8].…”