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Current Pain and Headache Reports
Published in: Current Pain and Headache Reports 6/2017

01-06-2017 | Chronic Daily Headache (SJ Wang, Section Editor)

Treatment Update of Chronic Migraine

Authors: Soo-Jin Cho, Tae-Jin Song, Min Kyung Chu

Published in: Current Pain and Headache Reports | Issue 6/2017

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Abstract

Purpose of Review

Although chronic migraine (CM) is a common disorder that severely impacts patient functioning and quality of life, it is usually underdiagnosed, and treatment responses often remain poor even after diagnosis. In addition, effective treatment options are limited due to the rarity of randomized controlled trials (RCTs) involving patients with CM. In the present review, we discuss updated pharmacological, non-pharmacological, and neurostimulation treatment options for CM.

Recent Findings

Pharmacological treatments include both acute and preventive measures. While acute treatment options are similar between CM and episodic migraine (EM), preventive treatment with topiramate and botulinum toxin A exhibited efficacy in more than two RCTs. In addition, several studies have revealed that behavioral interventions such as cognitive behavioral therapy, biofeedback, and relaxation techniques are associated with significant improvements in symptoms. Thus, these treatment options are recommended for patients with CM, especially for refractory cases. Neurostimulation procedures, such as occipital stimulation, supraorbital transcutaneous stimulation, non-invasive vagal nerve stimulation, and transcranial direct current stimulation, have shown promising results in the treatment of CM. However, current studies on neurostimulation suffer from small sample size, no replication, or negative results.

Summary

Although CM is less responsive to treatment compared to EM, recent advance in pharmacological, non-pharmacological, and neurostimulation treatments may provide more chance for successful treatment of CM.
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Metadata
Title
Treatment Update of Chronic Migraine
Authors
Soo-Jin Cho
Tae-Jin Song
Min Kyung Chu
Publication date
01-06-2017
Publisher
Springer US
Published in
Current Pain and Headache Reports / Issue 6/2017
Print ISSN: 1531-3433
Electronic ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-017-0628-6

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