In a given year, 18 percent of women and six percent of men experience migraines, according to the Merck Manual. These throbbing headaches occur periodically, and may last between four and 72 hours. For some individuals, migraine occurrences increase in frequency to the point of daily headaches---these are called transformed migraines or chronic migraines.
Symptoms
Migraine headaches typically have a vascular, or throbbing, quality. They can be severely painful. They are often one-sided and may be accompanied by nausea and vomiting or an aura--a disturbance of vision, sensation, balance, speech or muscle coordination. Many migraine sufferers also experience heightened sensitivity to light, sound or odors. Transformed migraines tend to be combination of migraine and tension-type headaches, and they occur more than 14 times per month. The pain level may diminish slightly from episodic migraines.
Pathophysiology
The exact pathophysiology of transformed migraines is poorly understood. Migraines are thought to be a pain syndrome that involves the neurovascular system, the nerves and the blood vessels associated with the head and brain. Hormonal imbalance may also play a role.
History & Progression
For many people who experience transformed migraine headaches, it begins with episodic migraines in childhood or early adolescence. The headaches then become daily transformed migraines in early adulthood. This transition may occur over a period of months to years. The migraines typically subside after age 50.
Causes and Triggers
Migraines tend to run in families, so there may be a genetic component. There are also a variety of triggers, which vary with the individual and may include red wine, skipped meals, weather changes, sleep deprivation, stress and certain foods or additives. Chronic migraines often develop from overusing drugs to treat acute headaches. Other risk factors include obesity and history of head trauma.
Complications
Chronic migraines do not lead to more serious brain conditions, but the disorder can diminish productivity and significantly impair quality of life. Depression commonly occurs with transformed migraine. Proper diagnosis can be challenging, but it is essential, and treatment of this complex condition should be personalized and holistic.
