Headache Medicine

Chronic Migraine
Dr. Mit Ankur Raval

Chronic migraine is a high-burden migraine disorder. According to ICHD-3, headache occurs on at least 15 days/month for more than 3 months, with migraine features on at least 8 days/month.

Understanding chronic migraine

The pattern matters.

Headache days

Track total headache days each month.

Migraine days

Note days with migraine features, not just the presence of any headache.

Medication use

Record acute medicines and frequency because medication overuse can coexist.

Disability

Work, family, sleep and daily function help determine the treatment goal.

Treatment

Prevention is usually central.

Preventive therapies

Current migraine prevention includes conventional options and CGRP-targeting therapies; selection is individualised.

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Established preventive therapy for appropriately diagnosed chronic migraine after specialist assessment.

Acute treatment

Acute treatment remains important but frequency should be monitored.

Follow-up

Headache days, disability, acute medicine use and overall function help measure progress.

Patient questions

Patient questions

Does every headache day feel like migraine?
No. In chronic migraine, some headache days may have migraine features and others may not.
Is medication overuse the same as chronic migraine?
No. They can coexist but are distinct clinical concepts.
What should I bring to consultation?
A headache diary, medication list, previous preventive trials and relevant reports are useful.
Reference: ICHD-3 chronic migraine criteria require ≥15 headache days/month for >3 months, with migraine features on ≥8 days/month. ICHD-3
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Important: This website provides general information and is not a substitute for an in-person medical consultation. In an emergency, seek immediate medical care.
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