REVIEW – February 2009

Chronification of primary headache and related problems


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Migraine is a chronic disorder with periodic headaches. Between attacks the tendency to react to different factors with migraine headaches is retained, which significantly reduces quality of life. In addition, migraineous process can become progressive. Chronic migraine can develop as a complication of migraine. Chronic daily headache (CDH) as a syndrome can also originate from tension-type headache or rarely from other primary headaches. The most frequent risk factors for developing CDH are obesity, overuse of caffeine and psychoemotional stress, but most important is medication overuse. Medication overuse headache (MOH) is a form of CDH which by nature includes the signs of both headache and addiction. This disorder is particularly resistant to treatment. Discontinuation of analgesics is obligatory but it is hard to achieve due to initial worsening of headaches and other related symptoms. Use is made of symptomatic treatment as well as treatment for chronic headaches.