Clinical features of patients with chronic migraine

Abstract:

Chronic migraine is caused by chronification of episodic migraine, i.e. by increasing the frequency of headache days to 15 and more per month. In clinical presentation, in addition to migraine headaches that must occur in more than a half of the headache days, other types of headaches might be also present (most commonly the tension-like type). The following risk factors are predictors for the progression of an episodic migraine to a chronic form: increased frequency of headaches, excessive use of analgesics, cutaneous allodynia and obesity, as well as some comorbidities, including chronic pain syndromes outside the cephalic area, anxiety and depression. Chronification is reversible - in about one quarter of the patients the chronic migraine turns back to the episodic one after therapeutic intervention (replacing analgesics with the new ones and after prophylaxis). However, in some patients, standard therapy is not effective and the headache in the chronic migraines becomes refractory.

Key words:
chronic migraine; clinical features; refractory headache; risk factors