What’s episodic migraine, and how does it differ from a headache?

Migraine affects around 40 million people in the United States. It’s often misdiagnosed as sinusitis or other sinus issues, muscle spasms, a primary eye problem, temporomandibular dysfunction, or arthritis within the neck.

Migraine is a disease characterized by pain, sensitivity to light, sensitivity to sound, nausea, vomiting, and disability.

In addition to these features, there are four phases of migraine. That is how we know migraine is not just a headache. The four phases include:

  1. Prodromal phase:characterized by irritability, depression, food cravings, difficulty concentrating, and difficulty sleeping, among other symptoms
  2. Aura phase:includes neurological symptoms such as changes in vision, numbness, tingling, weakness, or speech changes
  3. Headache phase:characterized by pain, sensitivity to light and sound, nausea, vomiting, neck pain, and disability
  4. Postdrome phase:described as feeling hungover and experiencing depression, poor concentration, and difficulty thinking

We can define migraine based on the presence or absence of neurological symptoms (migraine with aura versus migraine without aura, respectively).

We can also define migraine based on the frequency of headaches:

  • Episodic migraine is the likely diagnosis when a person experiences headaches less than 15 days a month.
  • Chronic migraine is the likely diagnosis when a person experiences headaches 15 or more days a month for at least 3 months.

When will a doctor diagnose chronic migraine?

After other causes of headache have been excluded and a patient describes their headaches as consistent with a diagnosis of migraine, I narrow down how frequent the headaches are and how long they last.

According to the International Classification of Headache Disorders, a patient who has 15 or more headache days a month, of which at least 8 days have migraine features, likely has chronic migraine.

Are chronic migraine symptoms more intense than episodic migraine symptoms?

People with chronic migraine are certainly more affected in their everyday lives. The CaMEO studyTrusted Source showed the rates of disability days per month was 3.63 times greater in people with chronic migraine than those with episodic migraine.

People with chronic migraine miss more workdays and leisurely activities.


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