Chronic Migraine + Daily Headache?
A recent review of migraine studies may have uncovered a hole in the research. Are people with chronic migraine and daily headache being overlooked?
Admittedly, it may be hard to exactly tell what’s going on when a patient simply has constant headache pain. Once you have chronic migraine, that’s an attack at least every other day. Who is to say that the headaches “in between” aren’t just migraine attacks “coming or going”?
But researchers for the Revista de Neurología (Neurology Magazine), a journal in Spain, discovered what may actually be a big problem with the research.
When a clinical trial starts for migraine, researchers are looking to be as precise and clear-cut as possible. They want people with migraine, or without it. And they want to know if it’s episodic or chronic. They don’t want people in mysterious in-between land. Which means that you’re not likely to even get into the study if you have migraine as well as some unspecified daily headache.
The researchers from Revista de Neurología 1.7 – 3.3% of migraine patients may fall into this category (in case you’re wondering, that’s a lot of people!). So, although current studies may benefit them, essentially these people are hardly being studied at all.
OK, maybe they simply have a slightly different manifestation of chronic migraine. But what if there are actual biological differences in these patients? That could mean that treatment that work might be quite different for them.
As the researchers write in their abstract:
They may have a longer lasting migraine and different response to treatment. Patients with chronic migraine and daily headache may have complex pathophysiological mechanisms that favor the daily manifestation of migraine
Chronic migraine with daily headache. Literature review
The only bit of treatment wisdom that they pulled out for the abstract was that OnabotulinumtoxinA (Botox) may be useful for these patients. But they admit simply that “management of these patients is a therapeutic challenge”. Indeed!
We need to find a way to better help these patients, and part of that is actually taking the time to study which treatments work best for them, even if they represent a smaller percentage of migraine patients.
Do you suffer from chronic migraine as well as daily headaches? Have you been shut out of a trial or treatment or service because of it? What treatments have you found helpful?