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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Tackling chronic migraine: current perspectives
1Neurology Department, Raigmore Hospital, Inverness, UK; Universitat Internacional de Catalunya, Barcelona, Spain.
Abstract:
In the last decade, several diagnostic criteria and definitions have been proposed for chronic migraine (CM). The third edition of the International Classification of Headache Disorders-3 beta, published in 2013, has revised CM diagnostic criteria. CM is defined as "headache occurring on 15 or more days per month for more than 3 months, which has the features of migraine headache on at least 8 days per month." Patients who meet the criteria for CM and for medication-overuse headache should be given both diagnoses. Worldwide, CM prevalence ranges 1%-3%, and its incidence has been estimated to be 2.5% per year. CM is associated with disability and poor quality of life. Modifiable risk factors include (among others): migraine progression (defined as an increase in frequency and severity of migraine attacks); medication and caffeine overuse; obesity; stressful life events; and snoring. CM patients have a significantly higher frequency of some comorbid conditions, including chronic pain, psychiatric disorders, respiratory illness, and some vascular risk factors. Management includes identification and control of comorbidities and risk factors that predispose to CM; treatment and prevention for medication overuse; early treatment for migraine attacks; and an adequate preventive therapy for CM. Several randomized controlled clinical trials have shown the efficacy of topiramate, amitriptyline, onabotulinumtoxinA, and cognitive-behavioral therapy in CM.
Insights
Chronic migraine (CM) affects 1%-3% globally, characterized by headaches on 15+ days/month. Effective management involves addressing risk factors, comorbidities, and utilizing treatments like topiramate and cognitive-behavioral therapy.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Chronic migraine (CM) diagnostic criteria have evolved, with the latest revision in the International Classification of Headache Disorders-3 beta.
- CM is defined by headache frequency (≥15 days/month for >3 months) with migraine features (≥8 days/month).
- Concurrent diagnoses of CM and medication-overuse headache are common and require integrated management.
Purpose of the Study:
- To summarize the current understanding of chronic migraine diagnosis, prevalence, risk factors, comorbidities, and management strategies.
- To highlight the impact of CM on quality of life and associated disabilities.
Main Methods:
- Review of diagnostic criteria and epidemiological data for chronic migraine.
- Identification of modifiable risk factors and common comorbidities associated with CM.
- Summary of evidence-based management and treatment options for CM.
Main Results:
- Global prevalence of CM ranges from 1% to 3%, with an annual incidence of 2.5%.
- Modifiable risk factors include medication overuse, obesity, and stress; comorbidities include chronic pain and psychiatric disorders.
- Effective treatments include topiramate, amitriptyline, onabotulinumtoxinA, and cognitive-behavioral therapy.
Conclusions:
- Effective chronic migraine management requires a multi-faceted approach, including risk factor modification and treatment of comorbidities.
- Evidence-based pharmacologic and non-pharmacologic therapies demonstrate efficacy in managing chronic migraine.
- Improved diagnostic criteria and targeted interventions are crucial for reducing the burden of chronic migraine.
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