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What are chronic migraines?

Medically reviewed by Maushmi Sheth
Medically reviewed by Maushmi Sheth

Up to 3-4% of people worldwide suffer from chronic daily or almost daily headaches. The main reason is chronic migraines. However, it can be difficult to diagnose at times. It can be mistaken for a chronic tension headache, and some doctors believe that osteochondrosis or insufficient blood supply to the brain causes such pain. 

Chronic migraine is a condition in which the head hurts 15 days a month or more. At the same time, attacks typical for migraines occur at least eight times a month.

Typically, before a person develops a chronic migraine, they suffer from more rare episodes of episodic migraine. When the disease becomes chronic, the headache may lose its migraine features. It can become bilateral, compressive rather than pulsating. The accompanying symptoms of vomiting, phobia, and sound phobia become weaker. However, although chronic migraines are less similar to the classical ones, they are also sensitive to the specific anti-migraine drugs triptans.

What causes chronic migraines?

Large studies have been carried out that have revealed that the development of chronic migraine is influenced by:

  • excessive use of medication to relieve headaches
  • excess weight
  • depression, stress, or increased anxiety
  • hypothyroidism
  • increased frequency of episodic migraine attacks.

One of the significant factors in the transition of migraine to chronic migraine is considered previous, even for many years, physical or emotional abuse.

However, whether all this is a cause or a consequence of chronic migraines is still under discussion. At the initial stage of developing chronic migraines, when rare seizures become more frequent, certain biochemical changes occur in the brain. If preventive treatment begins at this stage, chronic migraines can be prevented. If more than six months have passed since the onset of chronic migraine, the chances of success decrease. Therefore, it is crucial not to delay treatment.

What triggers the onset of a migraine attack?

migraine attack

The factor can be one or more of the following:

  • Weather changes.
  • Alcohol (particularly red wine).
  • Anxiety, depression, fatigue, severe stress, or relaxation afterward.
  • Prolonged hunger, irregular meals, certain foods (avocados, coffee, chocolate, smoked meats, cheese, citrus fruits, nuts, chicken liver).
  • Insufficient/excessive sleep.
  • Hormonal changes (hormone therapy, contraceptive drugs, ovulation, menstruation).
  • Other factors: too much noise or light, stuffiness, being at a height.

The patient’s complaints are analyzed, the anamnesis is studied, a neurologist examines the patient to diagnose chronic migraine. An important role is played by a headache diary, which allows you to determine its nature, differentiate migraines, and determine whether the patient is abusing pain medications.

Migraine headache treatment

The disease is treated with a set of measures. They are based on drug therapy, triptans, and analgesics. In some cases, ergotamine-containing medications are prescribed.

As a result of therapy, the patient’s general condition is restored, the duration of the attack decreases, and the severity of symptoms decreases. It is possible to prevent the transition of the disease into a chronic form, alleviate symptoms, and improve the patient’s quality of life.

Take triptans:

  • If a migraine without an aura is diagnosed, triptans should be taken in the first half-hour, when the attack has just begun.
  • If a migraine with aura is diagnosed, triptans should be taken when the aura ends and the headache begins. When you take triptans for more than ten days a month for three months or more, you may experience a drug headache

Triptans are contraindicated with:

  • a stroke
  • coronary artery disease
  • coronary artery disease
  • myocardial infarction
  • transient ischemic attack
  • peripheral vascular occlusion.

Prevention of chronic migraine

Prevention of chronic migraine

The doctor recommends preventive measures, so attacks occur less often and are relieved effectively by remedies for headache relief. Prevention is carried out:

  • if a patient has three intense migraine attacks in a month, as well as from eight days a month with a headache;
  • when the patient does not tolerate seizure medication well or is ineffective;
  • when the migraine is chronic (headache is fixed for more than 15 days a month);
  • due to obvious comorbid disorders, depression, anxiety, or drug abuse.

The effect of prevention is positive when in 3 months it is possible to halve the number of days with a headache.

Do not take any medicinal product without consulting your doctor. Only a qualified specialist can prescribe treatment.

Chronic migraine treatment

In the treatment of chronic migraines, the same medications are used for episodic migraines. In addition, there is strong evidence for onabotulinotoxina and, to a lesser extent, topiramate.

Some evidence supports the effective use of neurostimulation for the treatment of chronic migraines. Non-invasive options include supra-orbital stimulation, vagus nerve stimulation, and single-pulse transcranial magnetic stimulation. Invasive treatment options include occipital nerve stimulation, pterygopalatine ganglion stimulation, and ventral tegmental deep brain stimulation.


If you are diagnosed with chronic migraines, you need to see a doctor for 4-12 months. The duration depends on how severe the disease is. In the future, you need to visit a doctor every 2-3 months so that they can correct the treatment and assess its effectiveness.

The patient must improve their condition by:

  • adhering to a healthy lifestyle
  • regularly carrying out the prevention of the disease
  • avoiding provoking factors
  • monitoring the intake of pain medications.

If these measures are followed, it will be possible to improve the quality of life significantly. If you have a headache and suspect a chronic migraine, do not self-medicate. Be sure to see your doctor and get all the tests you need to have the correct treatment for your type of headache.

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Lone Star Neurology
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Edward Medina
Edward Medina
15:34 30 Jun 22
Just such an amazing staff that makes you feel like part of their family. I’ve been going there for over 5 years now... and each visit I get the very best care and treatments that I have ever received in the 20+ years that I’ve been dealing with severe debilitating migraines. Since i started seeing them the number of my migraines has dropped from 15-20 a month to 2-3 every 3 month. I highly recommend them …they will change your life!read more
Daneisha Johnson
Daneisha Johnson
22:20 19 May 22
Dr. Askari was very kind and explained everything so I could understand. The other staff were nice as well. I would... have gave 5 stars but I was a little taken aback when I checked in and had to pay 600.00 upfront. I think that should have been discussed in a appointment confirmation call or email just so I could have been more
Jean Cooper
Jean Cooper
16:54 29 Apr 22
I love the office staff they are friendly and very helpful. Dr. JODIE is very caring and understanding to your needs... and wants to help you. I will go back. would recommend Dr. Dr. Jodie to other Patients in a heart beat. The team works well more
Linda M
Linda M
19:40 02 Apr 22
I was obviously stressed, needing to see a neurologist. The staff was so patient and Dr. Ansari was so kind. At one... point he told me to relax, we have time, when I was relaying my history of my condition. That helped ease my stress. I have seen 3 other neurologists and he was the only one who performed any assessment tests on my cognitive and physical skills. At one point I couldn't complete two assessments and got upset and cried. I was told, it's OK. That's why you're here. I was truly impressed, and super pleased with the whole experience!read more
Leslie Durham
Leslie Durham
15:05 01 Apr 22
I've been coming here for about 5 years. The staff are ALWAYS friendly and knowledgeable. The Doctors are the absolute... best!! Jodie Moore is always in such a great mood which is a plus when you are already stressed. Highly recommendedread more
Monica Del Bosque
Monica Del Bosque
14:13 25 Mar 22
Since my first post my thoughts have changed here. It's unfortunate. My doctor and PA were great, but the office staff... is horrible. They never call you back when they say they will, they misinform you, they cause you too much stress wondering what's going on, they don't keep you posted. They never answer the phone. At this point I've left four messages in the last week, and I have sent three messages. Twice from their portal and one direct email. No response. My appointment is on Monday morning at 8:30am, no confirmation on my insurance and what's going on. What the heck is going on, this is ridiculous!I've given up... the stress her office staff has put me through is just not worth it. You can do so much better, please clean house, either change out your office staff, or find a way for them to be more efficient please. You have to do something. This is not how you want to run your practice. It leaves a very bad impression on your more
Ron Buckholz
Ron Buckholz
23:32 23 Mar 22
I was actually pleasantly surprised with this visit! It took me a long time to get the appointment scheduled because no... one answers your phones EVER! After a month, I finally got in, and your staff was warm, friendly, and I was totally impressed! I feel like you will take care of my needs!read more
Steve Nabavi
Steve Nabavi
16:28 16 Mar 22
It was a nice visit. Happy staff doing all they can do to comfort the patients in a very calming environment. You ask... me they are earned a big gold star on the fridge. My only complaint they didn't give me any more
Katie Lewis
Katie Lewis
16:10 10 Feb 22
Had very positive appointments with Jodie and Dr. Sheth for my migraine care. Jodie was so fast with the injections and... has so much valuable info. I started to feel light headed during checkout and the staff was SO helpful—giving me a chair, water, and taking me into a private room until I felt better. Highly recommend this practice for migraine patients, they know what they’re doing!!read more
Joshua Martinez
Joshua Martinez
16:02 10 Dec 21
I was scheduled to be checked and just want to say that the staff was fantastic. They were kind and helpful. I was... asked many questions related to what was going on and not once did I feel as though I was being brushed off. The front desk staff was especially great in assisting me. I'm scheduled to go back for a mri and am glad that I'll be going more
Isabel Ivy
Isabel Ivy
21:42 03 Nov 21
I had such a good experience with Lone Star Neurology, Brent my MRI Tech was so awesome and made sure I was very... comfortable during the appointment. He gave me ear plugs, a pillow, leg support and blanket, easiest MRI ever lol 🤣 My 72 hour EEG nurse Amanda was also so awesome. She made sure I was take care of over the 3 days and took her time with the electrodes to make sure it was comfortable for me! Paige was also a huge help in answering all my questions when it came to my test results, and letting me know her honest opinions about how I should go forth with my more
Leslie Luce
Leslie Luce
17:37 20 Oct 21
The professionalism and want to help attitude of this office was present from the moment I contacted them. The follow... up and follow through as well as their willingness to find a way to schedule my dad was above and beyond. We visited two offices in the same day with the same experience. I am appreciative of this—we spend a lot of time with doctors and this was top notch start to more
robert Parker
robert Parker
16:38 16 Apr 21
I love going to this office. The staff is friendly and helpful. The doctor is great. I am getting the best... neurological tests and treatment I have ever had. The only reason I did not give them a 5 star rating is because it is impossible to reach a live person at the office to reschedule appointments. Every time I have tried to get through to the office it says all people are busy and I am sent to a voicemail. If they could get their phone answering fixed, I would give them a strong 5 more
MaryAnn Hornbaker
MaryAnn Hornbaker
00:26 25 Feb 21
Dr. Harney is an excellent Dr. I found him friendly , personable and thorough. I evidently am an unusual case. ... Therefore he spent a Hugh amount of time educating me. He even gave me literature to further explain my condition and how to follow up. This is something you rarely get from your doctors. So I am more than please with my doctor and his more
Roger Arguello
Roger Arguello
03:05 29 Jan 21
Always courteous, professional. The staff is very friendly and always work with you to find the best appointment time.... The care team has been great. Always taking the time to listen to your concerns and to find the best more
Margaret Rowland
Margaret Rowland
01:12 27 Jan 21
I have been a patient at Lone Star Neurology for several years. Now both my adult daughters also are patients there. I... love Jodie. She is always so prompt whether it is a teleamed call are a visit in the office. She takes the time to explain everything to me and answers all my questions. I am so blessed to have Jodie as my more
Susan Miller
Susan Miller
03:01 13 Jan 21
My husband had an accident 5 years ago and Lone Star Neurology has been such a blessing to us with my husbands care.... Jodie Moore is his provider and she is amazing! Jodie is very knowledgeable, caring, and thorough. She takes her time with you, making sure your needs are met and she is happy to answer any questions you may have. Lone Star Neurology’s patients are very lucky to have Jodie providing their care. Thank you Lone Star Neurology and especially Jodie for everything you have done for us. Jodie, you are the best!read more
Windalyn C
Windalyn C
01:32 09 Jan 21
Jodie is wonderful. She is very caring and knowledgeable. I have been to over a dozen neurologists, and none were able... to help me as much as they have here. Thanks!read more
Katie Kordel
Katie Kordel
00:40 09 Jan 21
Jodi Moore, nurse practitioner, is amazing. I have suffered from frequent, debilitating headaches for almost 20 years.... She has provided the best proactive and responsive care I have ever received. My quality of life has been greatly improved by her caring approach and tenacity in finding more
Ellie Natsis
Ellie Natsis
15:41 07 Jan 21
I have had the best experience at this neurologist's office! For over a year I have been receiving iv treatments here... each month and my nurse, Bobbie is beyond wonderful!! She's so attentive, knowledgeable, caring, and detail oriented. She makes an otherwise uncomfortable experience much more pleasant and definitely puts me at ease! She also helps me with my insurance,ordering this specialty medication and dealing with the ordering process which is no easy feat.Needless to say, she goes above a beyond in every way and I'm so grateful to this office and to Bobbie for all they do for me!read more
Matt Morris
Matt Morris
15:39 07 Jan 21
Let me start by saying that I have been coming here for years. Due to my autoimmune disease, I am in this office... once every three weeks for multiple hours at a time. The office is very clean and the staff very friendly. My only complaint would be there communication via phone. They aren't the best at responding if you leave a voicemail and expect a call back. I understand that this is prob just due to the sheer number of alls they receive daily. What I can say I like the best about the office are the people. Bobby who handles my infusions is great. I never have any issues with her setting up my infusions. She is very quick to reply to messages sent via text and if she were to leave then my whole opinion of the office may change. I also enjoy people like Matt, Lauren, and Jodi. I appreciate all that they do for me and without this team I'm not sure I would be as happy as I am to visit the office as frequently as I have to. Please ensure that these folks are recognized as they are what makes my visit to this office so tolerable :).read more
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