What causes chronic migraines?
If you suffer from chronic migraine headaches, you know how debilitating they can be. Chronic migraines affect approximately 1 in 6 households in the United States, and for those who struggle with the condition, it can be difficult and sometimes nearly impossible to work or enjoy day-to-day activities.
Neurologist and pain medicine specialist Sankeerth Challagundla, MD, explained how chronic migraines are triggered and how it can be treated.
What is a chronic migraine headache?
“Migraine is not just a bad headache,” Dr. Challagundla said. “Migraine is a neurological disease.”
Symptoms vary from person to person, but the most common symptoms include head pain, sensitivity to light and sound, nausea, vomiting, brain fog, dizziness, fatigue, and trouble with concentration. Other symptoms can include vision changes, tingling, numbness and weakness.
How often do chronic migraine attacks occur?
The number of migraine attacks vary from person to person. They can happen once a month, a few times a year or very rarely.
“Some patients get some kind of headache almost every day with severe ones intermittently,” Dr. Challagundla said. “When the headaches happen more than 15 days per month, that is when we call it chronic migraine.”
What causes chronic migraines?
“We don’t have a clear answer to what causes chronic migraine, but it is likely genetic,” Dr. Challagundla said. “There are more than 100 genes that may be associated with migraine risk, which is why migraine differ from one person to another.”
Triggers for migraine can include:
- Stress
- Hormone changes
- Foods such as aged cheese, red wine, chocolate and preserved meats
- MSG
- Caffeine
- Poor sleep
- Dehydration
- Skipping meals
- Weather changes
- Strong odors
The most common reasons for transitioning from episodic to chronic migraines include obesity, concussions, untreated depression or anxiety, untreated sleep disorders and medication overuse headache.
How do I know if I’m having chronic migraine headaches?
“There is no specific test to diagnose migraine like a brain scan or a blood test,” Dr. Challagundla said. “It is a clinical diagnosis.”
Physicians diagnose chronic migraine by examining and talking with a patient, getting their history regarding the description of the headache, and finding out what triggers the headaches.
“Sometimes there are other neurological issues that can seem like migraine, but they have something else going on,” Dr. Challagundla said. “In those cases, we like to get brain imaging and do other tests to make sure that we rule out other causes.”
How are chronic migraines treated?
There are many treatment options for chronic migraine, but care plans usually involve a mix of treatments.
The most common treatments include lifestyle changes, medications, procedures like nerve blocks, Botox, and the use of devices like CEFALY and GammaCore. It’s also important to treat underlying conditions that can worsen chronic migraine such as neck pain, depression, insomnia, sleep apnea, TMJ disorders and fibromyalgia.
Is there any hope for a cure for chronic migraine headaches?
“There is a lot of research going on to understand how migraine occurs and what genes are causing migraine,” Dr. Challagundla said. “Many newer medications have been coming out for prevention as well as treatment of migraine. There has been a significant change in the last few years with newer medications which act on the CGRP molecules that have been a game changer in the field of migraine. And there are newer medications under research and clinical trials right now.”
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