Chronic Migraine: Everything You Need to Know

People with chronic migraine experience it for at least 15 days a month. It's a disorder that requires treatment and medical monitoring.
Chronic Migraine: Everything You Need to Know

Last update: 16 December, 2022

When a person experiences migraine for 15 days or more per month, of which 8 include all the characteristic symptoms of this disorder, they may be suffering from chronic migraine. According to studies carried out by experts in neurology, 2% of the population is affected by this type of headache.

What else do we need to know about chronic migraine? Can it pose a health risk? Does it require any type of special treatment or monitoring? We’ll tell you everything below.

Symptoms of chronic migraine

When we use the term chronic migraine, we’re not referring to the fact that it’s a lifelong condition as such, but rather to the frequency with which it occurs on a monthly basis. As we already mentioned, it must occur at least 15 days a month.

According to an update on the topic published by the Colombian Neurology Association, (most of the article is in Spanish) chronic migraine is a complication of the disease. On the same level as status migrainosus, persistent aura without infarction, and migraine infarction.

The MSD Manual tells us that chronic migraine used to be called a combined or mixed headache, because it had characteristics of both a tension headache and a migraine. Also, it tends to be more common in people who overuse drugs to relieve acute headaches.

As in other types, the most characteristic symptom of chronic migraine is a throbbing headache, which can range from moderate to severe. It’s usually accompanied by photophobia, phonophobia, osmophobia, nausea, and vomiting. In addition, it’s common for it to include an aura.

Chronic migraine in a woman.
The persistence of symptoms for more than 15 days is what determines the diagnosis of the chronic form.

Causes and associated risk factors

The causes of migraine are unknown. However, reference is made to the combination of various factors, both internal and external.

In the case of chronic migraine, the main risk factors would be the following:

  • Suffering from anxiety or depression
  • A family history of migraine (people who have a family history are more likely to have some type of migraine).
  • Consuming pain relievers regularly (even though their use can relieve headaches, when ingested in excess they can actually exacerbate the discomfort).
  • Being a woman of childbearing age (women tend to be more likely to suffer from various types of migraine, according to the Office on Women’s Health ).

In addition to all this, not maintaining good lifestyle habits can also influence the development of chronic migraine. When we talk about good habits, we’re not only talking about healthy eating and regular exercise, but also regular sleep and meal times.

Avoiding certain triggers, as well as excesses of any kind, is beneficial. The consumption of alcohol and caffeine should be limited.

Diagnosis of chronic migraine

To receive the diagnosis of chronic migraine, it isn’t usually necessary to resort to imaging tests (such as an MRI or CT scans). It’s usually established by the doctor by conducting an interview with the person and the corresponding physical examination.

The doctor may refer the patient to a psychiatrist for an evaluation. This would be to find out if there’s any depression or anxiety involved.

Treatment

Botox for chronic migraine.
Botulinum toxin treatment is authorized in cases of chronic migraine.

When it comes to treating chronic migraine, pharmacological treatment is combined with non-pharmacological. The only medication approved and specially designed for chronic migraine is botulinum toxin, as it has been shown to be effective in reducing the duration of pain and the severity of symptoms. This is confirmed by the American Headache Society. This medicine is given via injection into areas of the head and neck every 12 weeks.

In the acute phase of migraine, the same drugs are generally used as in episodic migraine, including monoclonal antibodies. The latter block the calcitonin gene-related peptide (CGRP).

The most prescribed medications are the following:

  • Pain relievers, such as acetaminophen.
  • Nonsteroidal anti-inflammatory drugs, such as ibuprofen.
  • Triptans.
  • Ergotamine derivatives.

Changing your habits when faced with chronic migraine

It’s important that the patient adapt or improve their habits, in order to maintain a good quality of life and reduce the impact of migraines. It’s the combination of proper treatment with a healthy lifestyle that has been shown to provide the greatest number of benefits.

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