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Chronic daily headache: diagnosis and management
Joseph R Yancey1, Richard Sheridan2, Kelly G Koren1
1Fort Belvoir Community Hospital, Fort Belvoir, VA, USA.
American Family Physician
|May 3, 2014
Summary
Chronic daily headache, often chronic migraine or tension-type, requires careful diagnosis. Treatment involves stopping medication overuse and considering prophylactic therapies to reduce frequency and improve quality of life.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Chronic daily headache affects 15+ days/month for 3+ months.
- Common types include chronic migraine and chronic tension-type headache.
- Secondary causes must be ruled out, potentially requiring MRI.
Purpose of the Study:
- To define chronic daily headache.
- To outline diagnostic considerations, including red flags and medication overuse.
- To review effective treatment strategies, both pharmacologic and non-pharmacologic.
Main Methods:
- Diagnosis based on headache frequency and duration criteria.
- Assessment for secondary headache causes using red flags and imaging (MRI).
- Evaluation for medication overuse, a common exacerbating factor.
Main Results:
- Medication overuse can significantly increase headache frequency.
- Prophylactic treatments demonstrably reduce headache frequency and severity.
- Non-pharmacologic and pharmacologic options exist for management.
Conclusions:
- Accurate diagnosis of chronic daily headache is crucial.
- Addressing medication overuse is a key treatment component.
- A multimodal approach combining prophylactic treatments improves patient outcomes and quality of life.
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