What predicts the change from episodic to chronic migraine?

Marcelo E. Bigal, Richard B. Lipton

Research output: Contribution to journalReview article

89 Scopus citations

Abstract

While we wait for evidence regarding the benefits of risk factor modifications in the prevention of chronic migraine, several interventions are justifiable based on their other established benefits. For example, decreasing headache frequency with behavioral and pharmacological interventions will decrease current disability even if it does not modify clinical course. Monitoring the body mass index and encouraging maintenance of normal body weight is good practice in patients with and without migraine. Avoiding overuse of caffeine is desirable apart from its potential benefit in preventing progression. Sleep problems should be investigated and treated. Psychiatric comorbidities should be identified and addressed. Medications containing opioids and barbiturates should be reserved for a few selected cases of migraine, and their use should be monitored. For these interventions, the possibility of preventing progression may motivate clinicians to offer good care and patients to engage in the treatment plan.

Original languageEnglish (US)
Pages (from-to)269-276
Number of pages8
JournalCurrent Opinion in Neurology
Volume22
Issue number3
DOIs
StatePublished - Jun 1 2009

Keywords

  • Chronic migraine
  • Risk factors
  • Transformed migraine

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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