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From Transformed Migraine to Episodic Migraine:
Reversion Factors
Jung Im Seok, Hyung In Cho, Chin-Sang Chung
Posted: January 2007  
Headache 2006;46:1186-1190

Objective:   To identify the factors contributing to the reversion of transformed migraine into episodic migraine.

Background:   Transformed migraine, the most common and important subtype of chronic daily headache, has a great effect on a patient’s quality of life. However, its clinical course and outcome predictors have rarely been studied prospectively.

Method:   Of 1142 consecutive headache patients seen at the Headache Clinic of the Samsung Medical Center, the patients with transformed migraine were followed for at least 1 year. We analyzed the demographic data, clinical course, and compliance factors, such as those of the physician’s management protocol and recommended lifestyle modification.

Results:   A total of 136 patients finished the final follow-up assessment 1 year after the initial evaluation. Ninety-five patients converted from transformed migraine to episodic migraine. Forty-one patients continued to suffer daily headaches without a period of improvement. The demographic and clinical information collected before the treatment was not significantly related to outcome, except for chronic use of analgesics for other medication conditions. Of the compliance factors, good compliance with preventive medication, withdrawal from continuous use of analgesics for headache relief, and regular exercise were significant positive contributors to the reversion of transformed migraine into episodic migraine.

Conclusion:   Compliance factors are the most important factors that determine the reversion of transformed migraine into episodic migraine.