From the Headache Care Center and Primary Care Network, Springfield, Mo.
Understanding the Patient With Migraine: The Evolution From Episodic Headache to Chronic Neurologic Disease. A Proposed Classification of Patients With Headache
Article first published online: 7 MAY 2004
Headache: The Journal of Head and Face Pain
Volume 44, Issue 5, pages 426–435, June 2004
How to Cite
Cady, R. K., Schreiber, C. P. and Farmer, K. U. (2004), Understanding the Patient With Migraine: The Evolution From Episodic Headache to Chronic Neurologic Disease. A Proposed Classification of Patients With Headache. Headache: The Journal of Head and Face Pain, 44: 426–435. doi: 10.1111/j.1526-4610.2004.04094.x
- Issue published online: 7 MAY 2004
- Article first published online: 7 MAY 2004
- Accepted for publication September 19, 2003.
- convergence hypothesis;
- phase model;
- chronic daily headache
Traditionally, episodic primary headache disorders are characterized by a return of preheadache (normal) neurologic function between episodes of headache. In contrast, patients with chronic headache often do not return to normal neurologic function between headache attacks. This article proposes that the evolution from episodic migraine to chronic headache may parallel the neurologic disruption observed during the progression of an acute migraine attack and that changes in baseline neurologic function between episodes of headache may be a more sensitive indicator of headache transformation than headache frequency alone. Early recognition of nonheadache changes in nervous system function may offer a more sensitive and specific approach to migraine prevention.