High-frequency episodic migraine and chronic migraine

Migraine is a neurological condition that causes recurring episodes that can include throbbing and/or pulsing headache and other symptoms, such as visual disturbances, sensitivity to light and sound, nausea, and fatigue. Different people experience different symptoms and patterns of symptoms. Symptoms can also vary from one migraine episode to another.

There is no cure for migraine, meaning there is no treatment that can reliably make migraines go away completely. However, there are effective treatments that can help a person with migraine manage the condition. Treatment for migraine falls into two general categories:

• Acute therapies. Also called abortive therapies, these are taken at the first sign of a migraine attack. These are medications (usually oral medications) that help reduce the severity of symptoms and shorten the duration of the attack.
• Preventive therapies. Also called prophylactic therapies, these are medications that are taken on a continuous basis to prevent migraine attacks and reduce the number of migraine attacks a person experiences.

All people who experience migraines should also take steps to avoid migraine triggers.

What is high-frequency episodic migraine?

Treatment needs and what therapies a person is prescribed will depend on a number of factors. One of the most important factors that will be considered is the number of headache days a person is experiencing per month.

• Chronic migraine is defined as having 15 or more headache days per month, with migraine symptoms on 8 or more of those days, and symptoms that persist for at least three months.
• Episodic migraine is defined as having 14 or fewer headache days per month. Untreated or improperly managed, episodic migraine can transition into chronic migraine.

If you have ever thought something along the lines of “Is there really a significant difference between 14 headache days a month and 15 headache days a month?” or “What if I experience 14 headache days one month and 15 headache days another month?” you are not alone. While distinct conditions, episodic and chronic migraine exist on a spectrum, and treatment needs can overlap between the two.

High-frequency episodic migraine is another category that has emerged in migraine research. This refers to cases where a person experiences between 10 and 14 headache days a month (however, these numbers can vary slightly depending on the source).

What does this mean for your treatment?

High-frequency episodic migraine has a similar disease burden to chronic migraine. This means that both have a similar impact on a person’s quality of life, including physical health, mental health, relationships, finances, functioning, and other aspects of day-to-day life. This impact is an important consideration when making decisions about treatment.

Treatment for high-frequency episodic migraine is similar to the treatment of chronic migraine. Reducing the number of headache days is a treatment goal for both. Preventive therapies should be considered for a person who is experiencing more than eight headache days per month, and preventive therapies can help reduce the risk of episodic migraine progressing into chronic migraine.

While migraine disorders are common medical conditions, they are also conditions that affect different people in different ways. People present with different migraine symptoms, different patterns of symptoms, and different frequencies of symptoms. Contributing factors, migraine triggers, and the impact on quality of life vary from person to person. Individualized care is essential.

If you are living with migraine, experiencing frequent migraines, and find that migraines are impacting your quality of life and functioning, talk to your healthcare provider about what you are experiencing and your treatment options.