Transformed Migraine

Migraine headaches bring some of the most excruciating pain a person will ever know. Many migraineurs say the only good thing about a migraine is the relief, sometimes even euphoria, they feel when the headache is over. Knowing that a good feeling is waiting on the other side is the only thing that helps some of them get through the pain.

People who live with transformed migraine (TM) do not have anything to look forward to. Transformed migraine is the name of a condition some migraineurs develop after years of migraine episodes. Most people develop transformed migraines in their 20s or 30s.

Migraineurs report less severe headaches suddenly, but they come more often until they turn into chronic daily headaches (CDH). The daily headache is less intense than a migraine episode, but still painful, and most transformed migraine patients still have occasional full-blown migraine episodes.

Not all migraineurs will develop transformed migraines. In fact, most won't. Those who do are predominantly women and approximately 90% of them previously had migraine with aura (classic migraine). Migraine with aura is relatively rare, affecting less than 20% of all migraineurs.

The exact cause of transformed migraines is, like all migraine types, unknown. Many transformed migraineurs are heavy users of pain-relievers, both over the counter items like acetaminophen and naproxen and prescription medications like Vicodin or Darvon. Some even take them daily, whether they have a migraine or not, thinking they may help prophylactically.

TM patients of this type are particularly hard to treat because of a developed tolerance for pain medication. The first step in treating these patients is to wean them from their daily medications. Sometimes this step alone will stop the chronic lesser headaches. Once weaned, like non-medication dependent TM patients, their migraines are manageable with a regular treatment regimen just like any other migraineur.

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