Episodic and chronic migraine headache: Breaking down barriers to optimal treatment and prevention

Richard B. Lipton, Stephen D. Silberstein

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

Migraine is a common disabling primary headache disorder that affects an estimated 36 million Americans. Migraine headaches often occur over many years or over an individual's lifetime. By definition, episodic migraine is characterized by headaches that occur on fewer than 15 days per month. According to the recent International Classification of Headache Disorders (third revision) beta diagnostic criteria, chronic migraine is defined as "headaches on at least 15 days per month for at least 3 months, with the features of migraine on at least 8 days per month." However, diagnostic criteria distinguishing episodic from chronic migraine continue to evolve. Persons with episodic migraine can remit, not change, or progress to high-frequency episodic or chronic migraine over time. Chronic migraine is associated with a substantially greater personal and societal burden, more frequent comorbidities, and possibly with persistent and progressive brain abnormalities. Many patients are poorly responsive to, or noncompliant with, conventional preventive therapies. The primary goals of migraine treatment include relieving pain, restoring function, and reducing headache frequency; an additional goal may be preventing progression to chronic migraine. Although all migraineurs require abortive treatment, and all patients with chronic migraine require preventive treatment, there are no definitive guidelines delineating which persons with episodic migraine would benefit from preventive therapy. Five US Food and Drug Association strategies are approved for preventing episodic migraine, but only injections with onabotulinumtoxinA are approved for preventing chronic migraine. Identifying persons who require migraine prophylaxis and selecting and initiating the most appropriate treatment strategy may prevent progression from episodic to chronic migraine and alleviate the pain and suffering associated with frequent migraine.

Original languageEnglish (US)
Pages (from-to)103-122
Number of pages20
JournalHeadache
Volume55
Issue numberS2
DOIs
StatePublished - Mar 1 2015

Fingerprint

Headache Disorders
Migraine Disorders
Therapeutics
Headache
Primary Headache Disorders
Pain

Keywords

  • chronic migraine
  • diagnosis
  • Episodic migraine
  • iontophoretic transdermal system
  • onabotulinumtoxinA injection
  • treatment

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Episodic and chronic migraine headache : Breaking down barriers to optimal treatment and prevention. / Lipton, Richard B.; Silberstein, Stephen D.

In: Headache, Vol. 55, No. S2, 01.03.2015, p. 103-122.

Research output: Contribution to journalArticle

@article{87f851a1b398460d9c72c272cfdc0d8a,
title = "Episodic and chronic migraine headache: Breaking down barriers to optimal treatment and prevention",
abstract = "Migraine is a common disabling primary headache disorder that affects an estimated 36 million Americans. Migraine headaches often occur over many years or over an individual's lifetime. By definition, episodic migraine is characterized by headaches that occur on fewer than 15 days per month. According to the recent International Classification of Headache Disorders (third revision) beta diagnostic criteria, chronic migraine is defined as {"}headaches on at least 15 days per month for at least 3 months, with the features of migraine on at least 8 days per month.{"} However, diagnostic criteria distinguishing episodic from chronic migraine continue to evolve. Persons with episodic migraine can remit, not change, or progress to high-frequency episodic or chronic migraine over time. Chronic migraine is associated with a substantially greater personal and societal burden, more frequent comorbidities, and possibly with persistent and progressive brain abnormalities. Many patients are poorly responsive to, or noncompliant with, conventional preventive therapies. The primary goals of migraine treatment include relieving pain, restoring function, and reducing headache frequency; an additional goal may be preventing progression to chronic migraine. Although all migraineurs require abortive treatment, and all patients with chronic migraine require preventive treatment, there are no definitive guidelines delineating which persons with episodic migraine would benefit from preventive therapy. Five US Food and Drug Association strategies are approved for preventing episodic migraine, but only injections with onabotulinumtoxinA are approved for preventing chronic migraine. Identifying persons who require migraine prophylaxis and selecting and initiating the most appropriate treatment strategy may prevent progression from episodic to chronic migraine and alleviate the pain and suffering associated with frequent migraine.",
keywords = "chronic migraine, diagnosis, Episodic migraine, iontophoretic transdermal system, onabotulinumtoxinA injection, treatment",
author = "Lipton, {Richard B.} and Silberstein, {Stephen D.}",
year = "2015",
month = "3",
day = "1",
doi = "10.1111/head.12505-2",
language = "English (US)",
volume = "55",
pages = "103--122",
journal = "Headache",
issn = "0017-8748",
publisher = "Wiley-Blackwell",
number = "S2",

}

TY - JOUR

T1 - Episodic and chronic migraine headache

T2 - Breaking down barriers to optimal treatment and prevention

AU - Lipton, Richard B.

AU - Silberstein, Stephen D.

PY - 2015/3/1

Y1 - 2015/3/1

N2 - Migraine is a common disabling primary headache disorder that affects an estimated 36 million Americans. Migraine headaches often occur over many years or over an individual's lifetime. By definition, episodic migraine is characterized by headaches that occur on fewer than 15 days per month. According to the recent International Classification of Headache Disorders (third revision) beta diagnostic criteria, chronic migraine is defined as "headaches on at least 15 days per month for at least 3 months, with the features of migraine on at least 8 days per month." However, diagnostic criteria distinguishing episodic from chronic migraine continue to evolve. Persons with episodic migraine can remit, not change, or progress to high-frequency episodic or chronic migraine over time. Chronic migraine is associated with a substantially greater personal and societal burden, more frequent comorbidities, and possibly with persistent and progressive brain abnormalities. Many patients are poorly responsive to, or noncompliant with, conventional preventive therapies. The primary goals of migraine treatment include relieving pain, restoring function, and reducing headache frequency; an additional goal may be preventing progression to chronic migraine. Although all migraineurs require abortive treatment, and all patients with chronic migraine require preventive treatment, there are no definitive guidelines delineating which persons with episodic migraine would benefit from preventive therapy. Five US Food and Drug Association strategies are approved for preventing episodic migraine, but only injections with onabotulinumtoxinA are approved for preventing chronic migraine. Identifying persons who require migraine prophylaxis and selecting and initiating the most appropriate treatment strategy may prevent progression from episodic to chronic migraine and alleviate the pain and suffering associated with frequent migraine.

AB - Migraine is a common disabling primary headache disorder that affects an estimated 36 million Americans. Migraine headaches often occur over many years or over an individual's lifetime. By definition, episodic migraine is characterized by headaches that occur on fewer than 15 days per month. According to the recent International Classification of Headache Disorders (third revision) beta diagnostic criteria, chronic migraine is defined as "headaches on at least 15 days per month for at least 3 months, with the features of migraine on at least 8 days per month." However, diagnostic criteria distinguishing episodic from chronic migraine continue to evolve. Persons with episodic migraine can remit, not change, or progress to high-frequency episodic or chronic migraine over time. Chronic migraine is associated with a substantially greater personal and societal burden, more frequent comorbidities, and possibly with persistent and progressive brain abnormalities. Many patients are poorly responsive to, or noncompliant with, conventional preventive therapies. The primary goals of migraine treatment include relieving pain, restoring function, and reducing headache frequency; an additional goal may be preventing progression to chronic migraine. Although all migraineurs require abortive treatment, and all patients with chronic migraine require preventive treatment, there are no definitive guidelines delineating which persons with episodic migraine would benefit from preventive therapy. Five US Food and Drug Association strategies are approved for preventing episodic migraine, but only injections with onabotulinumtoxinA are approved for preventing chronic migraine. Identifying persons who require migraine prophylaxis and selecting and initiating the most appropriate treatment strategy may prevent progression from episodic to chronic migraine and alleviate the pain and suffering associated with frequent migraine.

KW - chronic migraine

KW - diagnosis

KW - Episodic migraine

KW - iontophoretic transdermal system

KW - onabotulinumtoxinA injection

KW - treatment

UR - http://www.scopus.com/inward/record.url?scp=84922576114&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84922576114&partnerID=8YFLogxK

U2 - 10.1111/head.12505-2

DO - 10.1111/head.12505-2

M3 - Article

C2 - 25662743

AN - SCOPUS:84922576114

VL - 55

SP - 103

EP - 122

JO - Headache

JF - Headache

SN - 0017-8748

IS - S2

ER -