Data from a study released this month in Headache: The Journal of Head and Face Pain, confirms once again a major point we've discussed about transformed Migraine. When medications that are being overused and leading to medication overuse headaches are discontinued, there is significant improvement in headache frequency and transformed Migraine reverts back to episodic Migraine without chronic daily headache.
Study objective
To identify the factors contributing to the
reversion of transformed Migraine (TM) into episodic Migraine.
Study method
- 145 of 1,142 consecutive headache patients seen at the Headache Clinic of the Samsung Medical Center met the criteria for diagnosis of transformed Migraine, and their progress was followed for at least one year.
- At initial assessment, data was collected
on
- headache profile based on International Headache Society diagnostic criteria
- medical history including information regarding medication overuse, chronic use of analgesics for other conditions, coexisting chronic illnesses, caffeine consumption in excess of 100mg daily, alcohol consumption, smoking, family medical history
- lifestyle details including exercise
- Management protocol:
- abrupt discontinuation of overused medications
- compliance with preventive regimen
- lifestyle modifications including
regular exercise, elimination of caffeine and alcohol, smoking cessation
Study results
- 136 of the initial 145 patients finished the the study through final follow-up assessment 1 year after the initial evaluation.
- Five patients were lost to follow-up and 4 patients refused the follow-up interview.
- Of the 136 patients:
- 122 were women.
- In 95 (70%) patients, their transformed Migraines converted to episodic Migraine
- 41 (30%) continued to suffer daily headaches without a period of improvement
- 10 did not discontinue overused drugs. None of them improved to episodic Migraine
- The 2 major reasons for poor compliance
with preventive medication regimens were side effects and
low efficacy - Significant positive factors in reversion
of transformed Migraine to episodic:
- good compliance with preventive regimen
- withdrawal from continuous use of analgesics for headache relief (medication overuse)
- regular exercise
Study conclusion
Compliance factors are the most important
factors that determine the reversion of transformed Migraine into episodic
Migraine.
Summary
Transformed Migraine is Migraine disease which
began manifesting in episodic Migraine attacks, increasing in frequency and
changing characteristics, and resulting in almost daily less severe headaches
punctuated by severe and debilitating Migraine attacks. Overuse of pain
relievers has long been noted as a major contributing factor to transformed
Migraine. This study confirms that ending medication overuse is necessary if
transformed Migraine is to lose its characteristics of chronic daily headache
and return to episodic Migraine. Episodic Migraine can then be managed with
effective preventive medications and abortive medications as necessary.
Related information
- What is Transformed Migraine?
- What Is Chronic Daily Headache?
- Medication Overuse Headache: What's a person to do?
- Quiz. Rebound or Medication Overuse Headache
-
Transformed Migraine Related To Sleep Problems
__________
Resources
Seok, Jung Im, Cho, Hyung In & Chung, Chin-Sang
(2006). From Transformed Migraine to Episodic Migraine: Reversion Factors. Headache: The Journal of Head and Face Pain
46 (7), 1186-1190. doi: 10.1111/j.1526-4610.2006.00509.x
