Transformed Migraine: Near-Daily, Less Severe Migraine Attacks

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Transformed migraine is a type of migraine that starts out with episodic migraine attacks. The attacks then increase in frequency but transform or change in their characteristics, until they become almost daily — but less severe — headaches sometimes punctuated by severe and debilitating migraine attacks.

When you reach this point, you have transformed migraine, which also can be called chronic migraine.

This type of headache disorder may appear to be a cross between tension-type headache and migraine, although experts consider it a form of migraine disorder.

People who have transformed migraine often have a history of episodic migraine attacks (in other words, migraine attacks for less than half of each month) that began in their teens or 20s. Most people with transformed migraine are women, and more than 90% have a history of migraine with aura.

If you have more than one migraine attack per week, are obese, and are experiencing a lot of stress, you're at higher risk for developing transformed migraine.

What Happens When Migraine "Transforms?"

As your less-frequent episodic migraine disorder transforms to transformed, or chronic, migraine, you'll find that your migraine attacks become more frequent. This can occur over a period of months or over years, depending on a variety of factors that include genetics, lifestyle, life events, and your overall health.

Initially, you'll also have sensitivity to light and sound during your migraine attacks, as well as nausea, but these symptoms will become less severe and less frequent, and may even dissipate over time as your migraine disorder transforms.

Ultimately, you'll be left with a pattern of daily or almost daily headaches that seem to be a mixture of tension-type headaches and migraine attacks.

Your pain should drop in severity from mild to moderate, and may not always be accompanied by nausea, plus light and sound sensitivity.

However, your other migraine symptoms — including unilateral pain, gastrointestinal symptoms and aggravation by other triggers — may persist once your condition becomes transformed or chronic migraine.

Chronic Migraine and Medication Overuse

Nearly 80% of those with transformed or chronic migraine overuse medications, medical studies have shown. This medication overuse may actually increase the frequency of migraine attacks, and it also can lead to rebound headaches, also known as Medication Overuse Headache, or MOH.

Treating chronic migraine normally is a job for a headache specialist. If you have chronic migraine that's complicated by frequent rebound headaches, your doctor may recommend stopping all medications for some period of time. This may stop your chronic headache, and can make the drugs more effective again.

In addition, many people who have transformed or chronic migraine suffer from symptoms of depression.

Getting appropriate treatment is part of the puzzle that may lessen your head pain.

Sources:

Goadsby, Silberstein, Dodick. "Chronic Daily Headache for Clinicians." BC Decker, Inc. London. 2005.

National Headache Foundation. Chronic Migraine (Transformed Migraine) fact sheet. Accessed Nov. 29, 2015.

Negro A. et al. Chronic migraine: current concepts and ongoing treatments. European Review for Medical and Pharmacological Sciences. 2011 Dec;15(12):1401-20.

Negro A. et al. Chronic migraine plus medication overuse headache: two entities or not? The Journal of Headache and Pain. 2011 Dec;12(6):593-601.

Silberstein SD et al. "Understanding the Clinical Features, Biology, and Management of Transformed Migraine: The Evidence Base." Continuing Education. Annual Scientific Meeting of the American Headaches Society. Boston. June 2005.

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