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Chronic migraine--classification, characteristics and treatment
Hans-Christoph Diener1, David W Dodick, Peter J Goadsby
1Department of Neurology and Headache Center, University Hospital Essen, Hufelandstrasse 55, Essen, Germany. h.diener@uni-essen.de
Nature Reviews. Neurology
|February 15, 2012
Summary
Chronic migraine, defined by frequent headaches, is disabling and hard to treat. Research is limited, but some treatments like topiramate and botulinum toxin type A show promise for managing this condition.
Area of Science:
- Neurology
- Headache Medicine
- Clinical Research
Background:
- Chronic migraine (CM) is a severe neurological disorder characterized by frequent headaches.
- Current understanding of CM epidemiology is limited by inconsistent diagnostic criteria.
- CM significantly impacts quality of life, often co-occurring with other pain and mood disorders.
Purpose of the Study:
- To review the evolving understanding of chronic migraine.
- To discuss the epidemiology, pathophysiology, clinical features, and treatment of CM.
- To highlight the challenges in CM research and management.
Main Methods:
- Literature review of studies on chronic migraine.
- Analysis of diagnostic criteria from the International Classification of Headache Disorders.
- Synthesis of available treatment data and expert opinions.
Main Results:
- Prevalence and incidence of CM remain uncertain due to varied study definitions.
- CM patients experience more frequent headaches and comorbidities than episodic migraine sufferers.
- Limited clinical trial data exists for CM, with few trials including patients with frequent headaches.
Conclusions:
- Effective management of CM is challenging due to its disabling nature and limited evidence-based treatments.
- Topiramate and botulinum toxin type A have trial data supporting their use in CM.
- Conventional episodic migraine preventive therapies may also benefit CM patients, guided by expert opinion.
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