Martina Guglielmetti1,2, Alberto Raggi3, Raffaele Ornello4, Simona Sacco4, Domenico D'Amico5, Matilde Leonardi3, Paolo Martelletti1,6. 1. Sant'Andrea Hospital, Regional Referral Headache Centre, Rome, Italy. 2. University of Sassari, Department of Medical, Surgical and Experimental Sciences, Sassari, Italy. 3. Fondazione IRCCS Istituto Neurologico Carlo Besta, Neurology, Public Health, Disability Unit, Milan, Italy. 4. University of L'Aquila, Department of Applied Clinical Sciences and Biotechnology, Neuroscience Section, L'Aquila, Italy. 5. Fondazione IRCCS Istituto Neurologico Carlo Besta, Division of Neuroalgology, Milan, Italy. 6. Sapienza University, Department of Clinical and Molecular Medicine, Rome, Italy.
Abstract
BACKGROUND: The definition of chronic migraine has long been debated. Recently, it was suggested to define subjects with at least 8/migraine days as chronic migraine; that is, incorporating so-called high frequency episodic migraine (eight or more migraine days but less than 15 headache days per month). METHODS: We addressed the possible problems that might arise based on this proposal accounting for clinical, pathophysiological, impact and public health aspects. RESULTS AND CONCLUSIONS: Defining chronic migraine on the basis of headache frequency alone does not account for clinical and pathophysiological aspects, as well as for the impact of chronic migraine in terms of disability and quality of life. Moreover, it is potentially harmful for patients in terms of allocation of resources. These issues are discussed in the present manuscript, and we support the idea of defining high frequency episodic migraine as an independent entity as a viable path to follow.
BACKGROUND: The definition of chronic migraine has long been debated. Recently, it was suggested to define subjects with at least 8/migraine days as chronic migraine; that is, incorporating so-called high frequency episodic migraine (eight or more migraine days but less than 15 headache days per month). METHODS: We addressed the possible problems that might arise based on this proposal accounting for clinical, pathophysiological, impact and public health aspects. RESULTS AND CONCLUSIONS: Defining chronic migraine on the basis of headache frequency alone does not account for clinical and pathophysiological aspects, as well as for the impact of chronic migraine in terms of disability and quality of life. Moreover, it is potentially harmful for patients in terms of allocation of resources. These issues are discussed in the present manuscript, and we support the idea of defining high frequency episodic migraine as an independent entity as a viable path to follow.