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Sunday, February 15, 2015

Treating and Preventing Migraines: Episodic vs Chronic New Article in Headache March 2015 Describes Barries to Optimal Treatment and Prevention

There is a new article " 2015 Mar;55 Suppl 2:103-22. doi: 10.1111/head.12505_2.

Episodic and chronic migraine headache: breaking down barriers to optimal treatment and prevention." in Headache that describes the problems in finding optimal treatment.


In my experience the diagnosis of episodic or chronic migraine can actually harm the patient.  As headaches are classified it then limits the treatments that physicians offer.  I frequently find that wrong assumptions as to the cause of headaches is often the largest deterrent to successful treatment.  
The following video is a patient with severe headache that was relieved in just a few minutes time with Ttrigger Point Injections and muscle stretch.  The orgin was Myofascial Pain but the symptom was headache or migraine. When I saw this patient the first time she had been in constant excruciating pain for every minute of every day for 22 years.

Watch the video and then go www.thinkbetterlife.com testimonial page to see her first video. 

https://www.youtube.com/watch?v=-VA-amBnd8A

According to the article there are only five strategies for preventing episodic migraine and one  for preventing chronic migraine.  This fact is based on the idea that drug therapy is the method of preventing migraines.   " Five US Food and Drug Association strategies are approved for preventing episodic migraine, but only injections with onabotulinumtoxinA are approved for preventing chronic migraine. Identifying persons who require migraine prophylaxis and selecting and initiating the most appropriate treatment strategy may prevent progression from episodic to chronic migraine and alleviate the pain and suffering associated with frequent migraine. "


5.
 2015 Mar;55 Suppl 2:103-22. doi: 10.1111/head.12505_2.

Episodic and chronic migraine headache: breaking down barriers to optimal treatment and prevention.

Abstract

Migraine is a common disabling primary headache disorder that affects an estimated 36 million Americans. Migraine headaches often occur over many years or over an individual's lifetime. By definition, episodic migraine is characterized by headaches that occur on fewer than 15 days per month. According to the recent International Classification of Headache Disorders (third revision) beta diagnostic criteria, chronic migraine is defined as "headaches on at least 15 days per month for at least 3 months, with the features of migraine on at least 8 days per month." However, diagnostic criteria distinguishing episodic from chronic migraine continue to evolve. Persons with episodic migraine can remit, not change, or progress to high-frequency episodic or chronic migraine over time. Chronic migraine is associated with a substantially greater personal and societal burden, more frequent comorbidities, and possibly with persistent and progressive brain abnormalities. Many patients are poorly responsive to, or noncompliant with, conventional preventive therapies. The primary goals of migraine treatment include relieving pain, restoring function, and reducing headache frequency; an additional goal may be preventing progression to chronic migraine. Although all migraineurs require abortive treatment, and all patients with chronic migraine require preventive treatment, there are no definitive guidelines delineating which persons with episodic migraine would benefit from preventive therapy. Five US Food and Drug Association strategies are approved for preventing episodic migraine, but only injections with onabotulinumtoxinA are approved for preventing chronic migraine. Identifying persons who require migraine prophylaxis and selecting and initiating the most appropriate treatment strategy may prevent progression from episodic to chronic migraine and alleviate the pain and suffering associated with frequent migraine. 
© 2015 American Headache Society.

KEYWORDS: 

chronic migraine; diagnosis; episodic migraine; iontophoretic transdermal system; onabotulinumtoxinA injection; treatment
PMID:
 
25662743
 
[PubMed - in process]

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posted by Dr Shapira at 10:55 AM

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