Transformed migraines are chronic (long-lasting),
daily headaches that originate from episodic migraine headaches. Most patients
who experience transformed migraines have a history of intermittent migraines,
usually beginning in childhood or early adolescence. The onset of daily
transformed migraine headaches generally occurs in people during their 20s and 30s.
Many people with a history of migraine will suddenly
report that the headaches are less severe but are more frequent, until they
begin occurring daily. This change may be caused by the daily use of analgesics
(pain-relieving medications). Some people with transformed migraines report
having some severe episodes accompanied by nausea and vomiting, much like
migraines. Often, it is difficult to differentiate between tension-type
headaches and transformed migraines, since the severity of the daily headache is
milder than the migraines experienced years before.
Because of the difficulty in diagnosis, many people
may be treated inappropriately. Treatment is further complicated because of the
chronic nature of headache. Many people have the tendency to overuse analgesics,
both prescription and over-the-counter. They may use these drugs daily with or
without having a headache. This puts the patient at risk for building up a
tolerance to the drugs. Additionally, patients who use large amounts of
analgesics that contain caffeine will experience withdrawal headaches.
In many cases, patients suffering from transformed
migraines have other health problems, such as hypertension (high blood
pressure), sleep apnea and/or depression or anxiety, which complicate treatment.
Seeking an experienced, multidisciplinary health care team to coordinate
treatment is essential to success. The program with combined physical therapy,
psychological therapy and medical therapy promises greater success in helping
patients with difficult to treat transformed migraines.
References
- National Headache Foundation. Headache Topic Sheets: Transformed Migraines.
www.headaches.org/ Accessed 12/23/2011
- American Headache Society. Chronic Daily Headache: An Overview.
www.achenet.org/ Accessed 12/23/2011