Adverse Childhood Experiences and Medication Overuse Headache: Burden and Treatment Impact
Claire H Sandoe1, Valerie Lawler1, Suvendrini Lena1
1Centre for Headache, Women's College Hospital, University of Toronto, Toronto, ON, Canada.
Abstract:
Adverse childhood experiences (ACEs) are a risk factor for progression from episodic to chronic migraine. Risk factors for medication overuse headache (MOH) are incompletely understood, but opioid overuse may carry a higher risk than overuse of other medication types. We performed a retrospective chart review investigating the frequency and impact of ACEs in patients with MOH. Of 68 included patients, 37 (54.4%) reported ACEs. There was no significant inter-group difference in baseline migraine disability assessment (MIDAS) or monthly headache days. Patients with ACEs reported more opioid overuse, and worse headache-related disability at follow-up, despite similar monthly headache days. Patients with ACEs require complex, multidisciplinary treatment.
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