Chronic migraine symptoms
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Chronic Migraine Symptoms: An Overview
Introduction to Chronic Migraine
Chronic migraine is a debilitating neurological condition affecting approximately 2% of the general population. It is characterized by headaches occurring on at least 15 days per month, with at least eight of those days meeting the diagnostic criteria for migraine. This condition imposes a significant burden on patients due to frequent headaches and associated symptoms, as well as on society through direct and indirect medical costs.
Key Symptoms of Chronic Migraine
Frequent Headaches
Patients with chronic migraine experience headaches on at least 15 days per month, with a median headache frequency of 25 days per month . These headaches are often severe and can last for several hours, with a median attack duration of 12 hours.
Hypersensitivity to Sensory Stimuli
Chronic migraine sufferers frequently report hypersensitivity to visual, auditory, and olfactory stimuli. This includes symptoms such as photophobia (sensitivity to light), phonophobia (sensitivity to sound), and osmophobia (sensitivity to smells) . These sensory sensitivities are closely associated with the intensity and duration of the headache attacks.
Nausea and Vomiting
Nausea and vomiting are common symptoms accompanying chronic migraine attacks. These symptoms are experienced by a significant proportion of patients, with nausea reported by 77.6% and vomiting by 40.9% of patients. The presence of these symptoms is often linked to the severity of the headache.
Fatigue
Fatigue is a prevalent symptom in chronic migraine patients, with 84.1% of patients reporting significant fatigue levels. This fatigue can be both physical and mental, and it is often associated with other conditions such as depression and anxiety . Chronic fatigue syndrome (CFS) is also common among chronic migraine sufferers, with 66.7% meeting the CDC criteria for CFS.
Dopaminergic Symptoms
Migraine attacks are often accompanied by dopaminergic symptoms such as yawning, somnolence (drowsiness), euphoria, and polyuria (excessive urination). These symptoms are believed to be related to fluctuations in dopamine levels during migraine attacks.
Pathophysiology and Risk Factors
Chronic migraine is thought to develop from episodic migraine through a gradual increase in headache frequency over months to years . Factors contributing to this transformation include genetic predisposition, inflammatory processes, and central sensitization. Neurophysiologic and functional imaging studies have shown that chronic migraine is associated with metabolic, functional, and structural abnormalities in the brainstem, as well as increased cortical hyperexcitability.
Conclusion
Chronic migraine is a complex and highly disabling condition characterized by frequent headaches, hypersensitivity to sensory stimuli, nausea, vomiting, fatigue, and dopaminergic symptoms. Understanding the symptoms and underlying mechanisms of chronic migraine is crucial for effective diagnosis and management. Ongoing research continues to shed light on the pathophysiology of chronic migraine, offering hope for improved treatments and outcomes for patients.
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