• Lambru Neurology

Chronic Migraine

Chronic migraine is a disabling neurological condition which affects approximately 2% of the world population. To be classed as a chronic migraine, the person must experience at least fifteen days of headaches each month over a three-month period, including at least eight days a month on which the headache and associated symptoms are consistent with fully developed migraine attacks. Typically, most people will first experience episodic migraines which last less than fifteen days each month. Chronic migraines may then develop after a slow increase in headache frequency over months and years, this is named ‘migraine transformation’.

Due to the intensity and increased regularity of chronic migraines they can be extremely disruptive to daily life. People may require time of work or school and they may not be able to take part in social or physical activities. Research has also found that productivity is reduced by more than 50% in chronic migraine sufferers. In fact, The World Health Organisation (WHO) have classified chronic migraine as more disabling than blindness, paraplegia, angina and rheumatoid arthritis.

Symptoms of Chronic Migraine

In addition to lasting more than fifteen days per month over a three-month period, the common symptoms of chronic migraine include:

  • Throbbing pain on one side of the head

  • Nausea and vomiting

  • Light sensitivity (photophobia)

  • Noise sensitivity (phonophobia)

  • Smell sensitivity (osmophobia)

  • Dizziness

  • Tingling in the face, hands or feet

  • Auras (seeing flashing lights, colours, lines or shadows)

Causes of Chronic Migraine

There is no single identifiable cause for chronic migraine. Some people are able to pinpoint specific triggers such as caffeine or bright lights, whilst others cannot. The following factors are associated with increased risk of developing chronic migraines:

  • Obesity

  • Snoring

  • Sleep disorders

  • Excessive caffeine intake

  • Psychiatric disease

  • High baseline headache frequency

  • Major life changes

  • Head or neck injury

  • Female sex

  • Comorbid pain disorders

Medication Overuse

73% of chronic migraine patients overuse headache medications. Overusing headache medications can lead to further complications and worsen the migraine symptoms. If you start to use headache medication daily then you should seek advice from your Doctor or Neurologist.

Diagnosis of Chronic Migraine

There is not a specific test to diagnose chronic migraines. A specialist will assess the symptoms and establish the pattern and nature of the patient’s headaches. It is recommended to keep a diary of the frequency, severity and symptoms of headaches as this can help the consultant determine the diagnosis. Diagnostic tests and scans may be required to aid this process.

Potential Treatment Options

Currently there is no known cure for chronic migraines, although there are methods to manage it. The consultant may recommend lifestyle changes and if these fail to work medications may be prescribed. Painkillers and anti-migraine medications might be prescribed for serious attacks, alternatively there are medications to prevent chronic migraines.

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.

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