Do you also have frequent headaches? Could this be a chronic migraine?

Do you also get headaches all the time? Sometimes it's not just a headache, but an unbearable migraine. Having a headache like this for several days a month is a big obstacle to carrying out daily activities, isn't it? Today, let's talk about this ongoing migraine, or `(Chronic Migraine)` condition.

What is Chronic Migraine?

Simply put, a chronic migraine is when you have frequent, or even daily, headaches. Your symptoms can change from day to day, and sometimes even hour to hour. This makes it difficult to pinpoint exactly where one migraine ends and another begins.

Are headaches and migraines the same thing?

This is very important . A migraine is not just a bad headache. There is a big difference between the two.

A common headache (especially a common type like ``Tension-type headache - TTH'') can be a bit uncomfortable and can interfere with our daily activities. But it is not so bad that it makes us unable to do our daily activities. In this case, there is pain in the head or face, but it does not directly affect the brain.

But, migraines are something that directly affects your brain . That's what makes them so bad. When you have a migraine, it can be so unbearable that even carrying out daily activities can be unbearable.

How common is this condition?

Worldwide, between 12% and 15% of people have migraines. However, chronic migraine is a little less common. Experts say that between 1% and 2.2% of the world's population has this condition.

Most of the time, this ``Chronic Migraine`` condition affects women more .

Migraines usually begin around puberty and gradually decrease as you get older. After menopause, migraines often do not occur, or they almost disappear completely.

What are the symptoms of this?

The symptoms of chronic migraine are similar to those of episodic migraine. The main difference is that it lasts longer and occurs more frequently . Headaches are also associated with it.

To receive this diagnosis, you must meet the following requirements:

• You must have a headache or migraine for at least 15 days in a month. This must be for at least three consecutive months.
• Also, your headaches must include migraine symptoms or characteristics for at least 8 days in a month. This must also be present for at least three consecutive months.

What exactly are the symptoms of migraine?

A migraine can feel different for everyone, and sometimes even the same person will experience it differently. There can be up to four main stages (although not all migraines have all four stages):

• (Prodrome): These are the little signs you feel before a migraine starts. You may think, "Oh... I feel like I'm about to have a migraine." You may experience things like a feeling of discomfort, a change in appetite, etc.
• (Aura): These symptoms occur when certain areas of the brain are affected. Symptoms may include seeing lights before the eyes, numbness in the limbs, and difficulty speaking.
• Headache: This is the main and most painful phase of a migraine.
• Postdrome: This is similar to the side effects you feel after a migraine. Some people call it a "migraine hangover." You may feel tired and lightheaded.

Now, to be accurate in calling it ``Chronic Migraine'', your symptoms should be categorized as follows:

Migraine without aura

This can usually last between 4 and 72 hours.

During the headache phase, at least two of the following symptoms must be present:

• Pain on one side of the head (either right or left).
• The pain feels like a throbbing, stabbing pain.
• The pain is moderate to severe.
• Pain that increases when doing normal tasks (such as walking or climbing stairs), or feeling like avoiding such tasks.

Also, during the headache phase, at least one of the following symptoms should be present:

• Nausea.
• Vomiting.
• Having both photophobia and phonophobia.

Migraine with aura

One or more of the following `(Aura)` characteristics must be present :

• Visual symptoms: seeing lights before the eyes, seeing fog, seeing zig-zag patterns before the eyes, or other visual changes.
• Tactile symptoms: tingling, prickling sensation in the limbs.
• Speech/language symptoms: Difficulty speaking, difficulty understanding what others are saying.
• Motor symptoms: `(Hemiplegia)` (loss of consciousness or weakness on one side - can affect the body and/or face).
• Brainstem-related symptoms: Loss of coordination, balance problems, vertigo, tinnitus, stomach upset (such as diarrhea or constipation).
• Retinal symptoms: Complete or partial loss of vision in one eye, or seeing flashing lights.

Also, at least three of the following criteria must be met:

• At least one ``Aura'' symptom that gradually spreads over 5 minutes or more.
• The occurrence of two or more ``Aura'' symptoms one after the other.
• Each ``Aura'' symptom lasts between 5 minutes and 1 hour.
• At least one `(Aura)` feature is present on only one side.
• At least one of the ``Aura'' characteristics becomes a ``positive symptom'' (meaning that something new is added because of that characteristic; the ability to be affected by ``negative symptoms'' is completely or partially lost).
• Headache that begins immediately after the aura or within 60 minutes of the aura.

Why do these migraines occur?

Migraines can be hereditary . This means that if someone in your family, especially your parents or grandparents, has migraines, you are more likely to develop them too.

In addition, there are several other factors that researchers think may contribute to this migraine:

• Changes in blood flow due to widening or narrowing of blood vessels in the brain.
• A temporary disruption in the transmission of electrical signals in brain cells.
• Changes in brain chemicals. For example, changes in levels of neurotransmitters like serotonin.
• Wrong signals coming from the nerve fibers around the eyes or from other parts of the head.
• Malfunctioning of pain and signal processing centers in various parts of the brain.
• Persistent pain causes changes in the way the body recognizes and feels pain.

What are the risk factors that contribute to this development?

The following factors may increase your risk of developing chronic migraines, or make existing ones worse:

• Obesity.
• Head injuries, for example concussions.
• Other chronic illnesses, especially pain-related illnesses like fibromyalgia.
• Mental health problems, for example, depression or anxiety.
• Sleep disorders, especially sleep apnea.

Can a common migraine become a persistent migraine?

Yes, sometimes a normal, occasional migraine can "transform" into a chronic migraine. This happens through processes that even experts don't fully understand.

But one thing has been discovered. It is that the overuse of certain prescription drugs can be a cause of this. When we say "overuse," it does not necessarily mean substance use disorder. This can happen even with non-addictive drugs.

Therefore, if you are someone who gets migraines occasionally, experts strongly advise that it is best to avoid using certain medications frequently. Overuse of medications can also sometimes be a trigger that increases migraines.

What are migraine triggers?

Food, drinks, certain substances, smells, sounds, or certain things and situations in the environment can trigger a migraine within a few hours or a few days. These are what we call migraine triggers .

These are the most common ``Triggers``:

• Stress is okay, anxiety is okay.
• Hormonal changes related to menstruation.
• Hunger or dehydration.
• Changes in atmospheric pressure (such as those that occur with weather changes).
• It's okay to sleep too much, and it's okay to not get enough sleep.
• Some scents, perfumes.
• Certain foods or additives to foods (old cheese, red wine, chocolate, and aged or preserved meats are prime examples).
• Light (some types of lights, or even just a second of light shining into the eyes from something shiny, can trigger a migraine).
• Caffeine (especially if you take too much, but it's okay to take less than you normally take).
• Some sounds, especially low-frequency sounds (like the sound of a jackhammer) or high-frequency sounds (like the sound of power tools), are either
• Taking medication for frequent headaches (this is called medication overuse headaches or "rebound headaches").

What complications can this cause?

Complications from migraines can occur, but they are uncommon . Some examples are:

• `(Status migrainosus)` (a very severe migraine lasting more than three days).
• Strokes.
• Seizures associated with `(Aura)`.
• Heart attacks (this is very rare).

How do doctors detect this?

A doctor diagnoses this condition (Chronic Migraine) by combining several methods. First, they often perform a neurological exam. Then they ask you a few questions about your health history, daily life, your habits, and activities. Common questions asked are:

• How does your headache feel? Specifically, your description of the pain, where in your head it is, and how severe the pain is.
• Have you ever had a migraine before? If so, how often do you get them?
• Are there any other symptoms that accompany the headache? (such as sensitivity to light or sound)
• Do you drink beverages containing caffeine? If so, how much do you usually drink?
• Do you have any ``Triggers'' that make your migraines worse? (like food, drink, smells, noises)
• How long do you usually sleep? How have your sleep habits been lately?
• What are your general stress and anxiety levels? Do you have any reason to feel stressed or anxious, now or recently?

What kind of tests are done to find this?

Your doctor may order some tests. They may also order imaging tests, such as a CT scan, to rule out life-threatening conditions, such as stroke. This is often done if you have severe neurological symptoms, especially hemiplegia (loss of consciousness on one side of the body). This is a common symptom of paralysis. In non-emergency cases, an MRI scan may be done in addition to or instead of a CT scan.

Other tests may be done depending on your symptoms. Your doctor is the best person to tell you about these tests and why they are needed.

What are the treatments for this? Can it be completely cured?

Treatment for chronic migraine is very similar to treatment for regular migraines. The main thing is medication . There are two main types of treatment:

1. Preventive treatment: In this, medication is used to prevent migraines from occurring, or to reduce their severity or frequency if they do occur.

2. Rescue medications: These medications are used to reduce the duration and severity of a migraine attack.

In addition, there are some medical procedures that can be used for `(Chronic Migraine)`. Mental health counseling can also be an important part of treatment.

Preventive Medications

These medications are very useful for the condition `(Chronic Migraine)`, because they reduce the frequency of migraines, or even reduce the severity of them. These types of medications are usually given:

• Angiotensin II receptor blockers (ARBs) (e.g. candesartan)
• Some antiseizure medications (e.g. valproic acid, topiramate)
• Antidepressants (e.g. amitriptyline, nortriptyline, venlafaxine)
• Beta-blockers (e.g. atenolol, metoprolol, propranolol)
• Botulinum toxin (Botox®) injections
• Calcium channel blockers (CCBs) (e.g., verapamil, flunarizine)
• Monoclonal antibody-based injection treatments (e.g., erenumab, fremanezumab, galcanezumab)

Rescue Medications

These medications are used to reduce the duration and/or severity of migraines when they occur. However, experts say that they should be used with caution . Overuse of these medications can lead to the development or worsening of chronic migraines.

Over-the-counter (OTC) medications and NSAIDs

These are the types of over-the-counter medications and ``NSAIDs'' (Nonsteroidal anti-inflammatory drugs) that can be used to treat migraines:

• Acetaminophen (also known as Paracetamol, Tylenol®, Panadol®)*
• Aspirin
• Ibuprofen (also known as Advil®, Motrin®)
• Naproxen (available under names like Aleve®)

*> Note: Acetaminophen is not an NSAID. However, it is often referred to as an NSAID because it is available over the counter and has similar properties.*

Some over-the-counter migraine medications contain caffeine along with NSAIDs. It's a good idea to talk to your doctor about using products that contain caffeine. Also, read the label carefully when taking medications to make sure you're not unknowingly taking these.

Triptan drugs

These are the first-line medications commonly prescribed for migraines. Some examples are: `(Almotriptan)`, `(Eletriptan)`, `(Frovatriptan)`, `(Naratriptan)`, `(Rizatriptan)`, `(Sumatriptan)`, `(Zolmitriptan)`.

However, your doctor may have a different opinion about using these for chronic migraines. Because using them frequently can lead to medication overuse headaches, or even regular migraines can become chronic.

Ergotamine

This medication narrows the blood vessels in the brain and affects the processing of pain signals.

Controlled and combined drugs

These medications contain an NSAID and a controlled substance, such as a barbiturate or opioid painkiller. These medications are not usually used to treat chronic migraines because they can worsen the condition.

Medical procedures

There are several medical procedures that can help with chronic migraines:

• Nerve stimulation: This often uses the vagus nerve, occipital nerve (in the back of the head), and supraorbital nerves (in the forehead).
• Transcranial magnetic stimulation (TMS): This uses a magnetic field to influence the electrical activity of the brain.
• Alternative treatments: Other treatments, such as acupuncture, may also help some people. Although these are not as common, they may be helpful for some people. There are trained doctors and health professionals who provide these treatments.

Mental health help

Psychotherapy (the formal term used for mental health treatment) can help people with stress and anxiety, both of which can contribute to migraines. There are many types of psychotherapy, so you can choose one that works for you.

What can I expect?

Migraines are a very disruptive and disruptive part of life. It can be very difficult, sometimes even impossible, to carry out daily activities. Work, household chores, hobbies, and social relationships are all disrupted.

Chronic migraine is when migraines occur for at least eight days a month for three months. Because they occur so frequently, experts consider them to be disabling and can be a major disruption to life.

Migraines are usually not dangerous. But they can be very disruptive to life. They can also increase the risk of life-threatening conditions like stroke and heart attack. Some migraine symptoms can be similar to stroke symptoms. Therefore, specialist medical supervision and treatment are essential.

How long will this last?

This varies from person to person. For some, it may last months, years, for others, it may even last decades.

Family history, personal circumstances, migraine triggers, and the success of treatment can all affect this. Your doctor can give you the best advice on how long it will last for your condition, and what you can do to reduce the amount of time it will affect your life.

What is the outlook for this?

Chronic migraine is something that can change throughout life. The good news is that between 26% and 70% of people will eventually revert to episodic migraine. However, some people will alternate between chronic and episodic migraines from time to time.

The frequency of migraines decreases with age. In women, this can be greatly reduced or even completely eliminated after menopause.

Can this be prevented? Or can the risk of developing it be reduced?

Because experts don't fully understand why or how this condition (Chronic Migraine) develops, it's impossible to prevent it 100% . While some people can reduce their risk, those with a family history can still develop it, even if they are careful.

If you have occasional migraines, the only thing you can do is to prevent your medication from turning into a regular migraine. To do this, talk to your doctor about how to use your medication properly and how to reduce your risk.

How do I take care of myself?

If you have chronic migraines, there are many things you can do to take care of yourself. Try these things:

• Keep a migraine journal. This is especially helpful in the early stages, but it is useful no matter how long you have had migraines. This will help you see how your migraines change over time. This is especially important when it comes to finding triggers.
• Manage your lifestyle. What you eat and your activity level can affect migraines. While physical activity can sometimes worsen or trigger migraines, finding ways to stay active can also help improve your symptoms. It's also important to maintain a healthy weight for you, as obesity and being overweight can contribute to chronic migraines.
• Don't be afraid to seek help from technology. Many smartphones have apps that can log and track your migraines. Many apps are free, but some have paid options with more features. You can also use other apps, such as weather apps, to alert you to things that might trigger your migraines, such as air pollution or changes in atmospheric pressure.
• Identify your migraine triggers. Once you know what triggers you have, you can either avoid them or reduce the impact they have on your life. This will help you reduce the frequency of your migraines. This is a key way to turn chronic migraines into regular migraines again.
• Talk to others who have this condition. There is a lot you can learn from other people who have chronic migraines. You can join support groups in your area. You can also find support groups on social media platforms or through the websites of migraine organizations.

What are the things I can't eat or drink?

Triggers that trigger migraines are different for everyone. Keeping a migraine journal can help you identify and avoid your triggers.

Often, `(Trigger)` is prepared using similar methods to other foods. Examples:

• Fermentation: This process is used to make alcoholic beverages such as wine, beer, cider, and spirits. It is also important in making cheese, yogurt, and some types of bread (e.g., sourdough).
• Pickling: This method is used to preserve foods such as vegetables and meat. Examples include pickles, sauerkraut, kimchi, eggs, and meats.
• Curing and aging: This method is used to preserve meats. Some preservatives, especially nitrates and nitrites, can trigger migraines. Aging some foods, especially meat and cheese, can also be a trigger.

When should I see a doctor or seek medical advice?

If you have chronic migraines, you should see a doctor (usually a neurologist) regularly for ongoing treatment. Your doctor will give you a schedule for your visits. Also, if you notice any changes in your symptoms, especially if they affect your daily activities, lifestyle, or work, talk to your doctor right away.

When should I go to the Emergency Treatment Unit (ETU) ?

If you have symptoms of a serious or life-threatening medical condition, go to the emergency room immediately. Examples:

• Thunderclap headache: This is a headache that starts suddenly and becomes more severe within a few minutes. This can be a sign of bleeding inside the brain.
• A severe headache: This means that you feel like you have the worst headache of your life. This could be a sign of a brain aneurysm, a brain hemorrhage, or a stroke.
• Hemiplegia: This is a major symptom of paralysis . If you experience this, you may not be able to tell if it is a migraine or a stroke . Hemiplegia caused by a migraine will usually go away after a while, but don't wait for it to go away. If it is too late , it could lead to permanent brain damage or death.

Is Chronic Migraine a serious condition?

Persistent migraines (except in rare cases) are not directly life-threatening, but they are serious . Migraines can make life very difficult, making it difficult to perform daily tasks, and sometimes even impossible. Because they occur so frequently, experts consider them a serious condition.

Will this ever go away completely?

Yes, chronic migraines (and migraines in general) can go away. One way is to get older. It can also become a regular, occasional migraine (episodic migraine). That is often the main goal of treatment. Regular migraines are easier to control, easier to treat, and less disruptive to life because they don't occur frequently.

Finally, things to remember

A migraine is not just a bad headache. When you get a migraine, you often have to stay in a dark, quiet room. Because the light and noise can cause unbearable pain, nausea, and many other symptoms. Being in a dark, quiet room doesn't make the symptoms go away. It just stops them from getting worse. If you have migraines, you probably know that these symptoms are very annoying. But sometimes it's even more annoying to try to explain them to people who don't understand them and who have the wrong idea about what they feel like.

Fortunately, chronic migraines can often be treated. Even small changes in your daily life can help reduce the frequency and severity of migraines. By working to manage your migraines with medical treatment, you can reduce the frequency and severity of your migraines. Instead of living with one migraine after another, you can focus on your life and enjoy it. Don't worry, you're not alone. Doctors and your loved ones can help you.

` Migraine, Chronic Migraine, Headache, Headaches, Migraine Symptoms, Migraine Treatment, Migraine Triggers