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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache

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One-Year and Five-Year Outcomes in Medication Overuse Headache: A Real-World Study.

Abouch Krymchantowski¹, Carla Jevoux¹, Ana Gabriela Krymchantowski¹

¹Department of Neurology, Headache Center of Rio, Rio de Janeiro, BRA.

|October 28, 2024

Summary

Effective management of medication overuse headache (MOH) involves stopping overused medications and initiating preventive treatments. This study shows a significant reduction in headache days over five years with withdrawal therapy and preventive strategies.

Keywords:

chronic migraine headache days per month medication overuse headache monoclonal antibody preventive treatment

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Last Updated: Jun 9, 2025

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Published on: April 14, 2016

Area of Science:

Neurology
Clinical Pharmacology

Background:

Medication overuse headache (MOH) is a significant global health issue.
Effective MOH management involves medication cessation, transition therapy, and preventive treatment.
Chronic migraine with MOH presents complex treatment challenges.

Purpose of the Study:

To evaluate the one-year and five-year efficacy of managing chronic migraine with MOH.
To assess the impact of withdrawal therapy, conventional preventive medications, and anti-CGRP monoclonal antibodies.

Main Methods:

A prospective, descriptive study conducted at a single tertiary center in Brazil.
Inclusion of consecutive patients diagnosed with chronic migraine and MOH.
Collection of demographic and clinical data at baseline and at one- and five-year follow-ups.

Main Results:

142 patients (116 female, 26 male, mean age 42.1) were followed for five years.
Baseline average headache days per month (HDM) was 25.2.
A ≥75% reduction in HDM was observed in 51.4% at one year and 70.4% at five years.

Conclusions:

Discontinuation of overused medications combined with preventive strategies significantly reduces headache frequency in chronic migraine with MOH.
Long-term follow-up demonstrates sustained benefits of withdrawal therapy and preventive treatments.
Anti-CGRP pathway monoclonal antibodies may offer an additional therapeutic option.