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Are Episodic and Chronic Migraine One Disease or Two?

  • Episodic Migraine (R Cowan, Section Editor)
  • Published:
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Abstract

Migraine is a debilitating headache disorder that has a significant impact on the world population, in both economic and sociologic capacities. Migraine has two main categories: (1) chronic migraine (CM), defined as the patient having 15 or more headache days per month, with at least five attacks fulfilling measures for EM with aura or EM without aura, and (2) episodic migraine (EM), defined as less than 15 headache days per month. With this definition, CM can only exist in the presence of EM, and it questions whether the two are separate diseases. Migraine has a significant impact on the population, as each year, about 2.5 % of patients with EM develop new-onset CM (Manack et al., Curr Pain Headache Rep 15:70–78, 2011) (Loder et al. Headache 55:214–228, 2015), with certain risk factors being evident only with CM. In addition, there are comorbid diseases that are only associated with CM, suggesting two separate diseases rather than one. Differentiation in response to treatments, both preventive and abortive, demonstrates both a similarity and a difference in EM versus CM. Also, comparing the two processes based upon functional imaging has been a recent development, beginning to show a physiological difference in regional cortical thickness, cortical surface area, and regional volumes in patients with EM and CM. Evidence regarding whether EM and CM demonstrate one disease with a significant level of complication or if two independent processes is inconclusive, and additional research must be performed to further characterize their relationship.

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Authors and Affiliations

  1. Hofstra North Shore LIJ Department of Neurology, 611 Northern Blvd., Suite 150, Great Neck, NY, 11021, USA

    Noah Rosen

  2. 165 Main Pkwy West, Plainview, NY, 11803-2924, USA

    Reuben Burshtein

  3. 3 Tanbark Trl., Saddle River, NJ, 07458, USA

    Aaron Burshtein & Joshua Burshtein

Authors
  1. Reuben Burshtein
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  2. Aaron Burshtein
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  3. Joshua Burshtein
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  4. Noah Rosen
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Correspondence to Noah Rosen.

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Conflict of Interest

Reuben Burshtein, Aaron Burshtein, and Joshua Burshtein declare that they have no conflict of interest.

Noah Rosen declares personal fees, non-financial support, and other fees from Allergan for serving on the advisory board, in research, and speakers’ panel; personal fees from Avanir and the American Headache Society; and other compensation from Curelator for consultation.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Episodic Migraine

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Burshtein, R., Burshtein, A., Burshtein, J. et al. Are Episodic and Chronic Migraine One Disease or Two?. Curr Pain Headache Rep 19, 53 (2015). https://doi.org/10.1007/s11916-015-0529-5

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  • DOI: https://doi.org/10.1007/s11916-015-0529-5

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