Chronic migraine affects 1-2 percent of the general population and about 8 percent of migraine patients.
Migraine is the most common disabling brain disorder. Chronic migraine is a disabling neurological condition that affects 2 percent of the general population. Chronic migraine patients have headache for at least 15 days in a month. Chronic migraine headaches usually increase slowly over months to years. Chronic migraine usually develops from episodic migraine that gradually increases in attack frequency with an annual progression rate of about 3 percent. It also affects society through direct and indirect medical costs.
According to NCBI, migraine affects more than 20 percent of people at some point in their lives; Epidemiological studies have shown that 4.5% of the population of Western Europe has headache at least 15 days a month.
What is the difference between migraine and chronic migraine?
Emerging evidence suggests that episodic migraine and chronic migraine differ not only in degree, but in many ways. Episodic migraine progresses over the course of months or years and can become chronic migraine. It is not clear how episodic migraine progresses and becomes chronic? Some researchers suspect that inflammation causes blood vessels in the brain to swell and compress nearby nerves, causing headaches.
1. First, episodic migraine is characterized by migraine sufferers having headaches 0 to 14 days per month, while chronic migraine is characterized by having headaches 15 or more days per month.
2. Second, people with chronic migraine have more headache days per month than people with episodic migraine. They also experience headaches for longer periods of time on average.
3. Third, to treat episodic migraine and chronic migraine headaches, your doctor may prescribe over-the-counter medications. Depending on the frequency and severity of your symptoms, they may also prescribe prescription medications.
4. Fourth, chronic migraine is associated with greater impairments in cortical processing of sensory stimuli than episodic migraine, perhaps due to more widespread or persistent cortical hyperexcitability.
5. Fifth, compared with episodic migraine patients, chronic migraine patients are more likely to have psychiatric comorbidities such as depression and anxiety, respiratory and cardiovascular diseases.
Migraine: Causes, Treatment, Types and Symptoms
Chronic migraine develops over time due to several factors: – In a person who already has migraine, the number of episodic headaches increases over time, which later takes the form of chronic migraine. Once the headache episodes occur, Medicines used to treat migraines become overused in an attempt to keep the increasing number of headaches under control; Which can further increase the duration of headache. The most common medications responsible for medication overuse are over-the-counter medications, such as Excedrin® and generic equivalents, non-steroidal anti-inflammatory drugs, and acetaminophen.
Stronger medications are those taken at the beginning of a migraine attack. These may be treatments such as Panadol, Panadine or triptans. Overuse of medication means using treatment that is too strong. When people use these treatments more than two or three times a week, over time they may develop a more chronic pattern of headaches and migraines. This means that excessive use of medicines can also cause the problem of chronic migraine. More iron deposits are found in chronic migraine patients than in episodic migraine patients. Which plays a role in chronicizing migraine.
Risk Factors for Chronic Migraine Risk Factors of Chronic Migraine
Other factors associated with chronic migraine include:-
Most people who get chronic migraine are women.
Episodic migraine and chronic migraine have similar symptoms. Only the effect of symptoms becomes more in this, like –
Signs of an episodic migraine turning into a chronic migraine include:-
Diagnosis and test of chronic migraine.
To diagnose chronic migraine, it is important to know the exact number of days per month a person experiences any type of headache.
Your doctor will take a detailed medical history. The doctor will ask about:
your pattern of migraine pain, including when and how the migraine starts; if they are episodic or continuous; How long does a migraine last; If there are any triggers or factors that make a migraine painful. Your description of the pain, including its location, sensation, and severity. Your current and past treatments, including when medications are taken, dosages, results and side effects, and use of alternative or complementary treatments. Your medical history, including other health problems (especially sleep problems, depression, anxiety or fibromyalgia), family history of headaches, current non-headache medications, and lifestyle choices (smoker, alcohol consumption, caffeine intake) . The doctor will ask you about all these things, based on this he will do your imaging tests like CT scan, electroencephalogram (EEG).
Chronic migraine treatment
There are three main categories of migraine treatments:-
Lifestyle treatment?
Changes in lifestyle can bring about a major change in the migraine pattern of the patient. These are based on the fact that migraine patients are sensitive to changes in their body and environment.
Lifestyle treatment includes:-
Sleep –
Regular sleep also makes a big difference. Many people believe that too little or no sleep can trigger frequent attacks. Too much sleep can also be a trigger for some people. Doctors recommend that people try to go to sleep and wake up at roughly the same time throughout the week, and all other advice for sleep hygiene applies here as well. Avoid using devices or spending too much screen time such as television or mobile before sleeping. Try to maintain a regular routine so that your sleep quality can be optimized.
Hydration –
Hydration is a very basic advice that often gets sidelined in our busy lives. Dehydration can trigger a migraine. Practical tips like staying hydrated and keeping a water bottle nearby can help.
course meal –
Regular meals can also make a big difference, especially for people for whom hunger is a trigger. Food generally low in carbohydrates and high in protein is better because fluctuations in blood sugar can also be a trigger for migraine. The protein portion does not need to be a huge portion, it can be a handful for breakfast or fish or beans or something similar. Eating some protein with each meal can help keep your blood sugar stable and potentially prevent another heart attack.
caffeine –
Caffeine can be harmful, especially in cities where coffee is a big part of the social culture. For most people, one coffee a day is fine, but when you’re drinking more than that on a regular basis, it’s too much.
Caffeine may actually be associated with frequent headaches in the same way that drug overuse may. If you are drinking more and more caffeine, you may have more and more attacks. When consumed in moderation, caffeine can also be used as an acute treatment. Many of you may have found that coffee or Coke really helps if you have migraines and this is probably related to the effect of caffeine on the blood vessels. Caffeine may also help the absorption of some migraine treatments that may be used for acute treatment. This is an important reason to limit your caffeine intake.
Diet Triggers –
We can try to avoid foods that contain a lot of additives and preservatives as some of those things can trigger migraines. Alcohol is a well-known trigger for migraines, as are some other things like MSG or nitrates that are associated with cured meats or deli meats. Artificial sweeteners can also be a trigger. It cannot be said with certainty which fertilizer or food item can trigger a migraine. It varies from person to person. Recognizing what your triggers are can be helpful in helping manage migraines.
Preventive treatment –
Preventive treatment aims to reduce the number and severity of headaches. Preventive treatment may also be considered if a patient is not amenable to acute treatment, or their current treatment is associated with side effects, or if they are not ready for the usual acute treatment. This is a list of traditional preventive medicines that will help in preventive treatment –
Many of these treatments have been used for a long time and many of them work well for some patients. Ilzo has a good track record of effectiveness against beta blockers, tricyclic antidepressants and some anti-epileptics, particularly topiramate and sodium valproate.
Onabotulinum Toxin A (Botox) Injection
Botox is generally well tolerated. Patients often prefer Botox because it does not involve daily medications and has no cognitive side effects. In Australia, Botox is commonly used as a migraine medication.
CGRP (calcitonin gene-related peptide) is a neuropeptide that is released during a migraine attack.
There are three anti-CGRP antibodies that are involved at various stages –
But remember, do not take any medicine without doctor’s and expert’s opinion, the doctor will tell you the medicine according to your condition and symptoms.
Behavioral Treatment –
Cognitive Behavioral Therapy (CBT)
These behavioral treatments help patients better understand migraines and their response to stress. It allows people to have more control over their migraine condition by increasing self-awareness and taking control of the mind-body connection. Biofeedback is a process by which people can assess their stress response and then learn ways to control it. You can also take classes for behavioral treatment in which mindfulness meditation and other related things are taught and you get more help.
Result
Migraines are considered chronic when people have 15 or more headache days per month, at least 8 of which meet criteria for migraine. Chronic migraine can be a very disabling condition. The development of chronic migraine is associated with several potentially treatable risk factors. Chronic migraine treatment should mainly focus on the use of medication and non-pharmacological preventive treatment, in this you can also adopt behavioral treatment.