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Abstract
CM is currently defined as headache on 15 days month for 3 months with 8 days month fulfilling criteria for migraine and or respond to a triptan or ergot. The estimated prevalence of CM worldwide is 1% to 3%, and every year, between 2.5 and 4.6% of people with episodic migraine experience progression to chronic migraine. Long-term follow up over 3 years indicates that only 26% experience remission of chronic migraine (defined as 10 days per month) acute headache pain medications. Experiments in animal models have revealed persistent pronociceptive adaptations following exposure to opioids and triptans, resulting in enhanced sensitivity to stimuli that trigger migraine in humans. These findings could provide insight into the adaptive changes that occur in patients who have chronic migraine associated with medication overuse and thus further elucidate the pathophysi-ology of chronic migraine.
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