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Bigal, Marcelo E.; Sheftell, Fred D.

CONTINUUM: Lifelong Learning in Neurology: December 2006 - Volume 12 - Issue 6, Headache - p 133-152
doi: 10.1212/01.CON.0000290527.00569.39

Chronic daily headache is one of the more frequently seen headache syndromes at major tertiary care centers worldwide as well as in office practices of general neurologists. One of the major classification approaches subdivides chronic daily headache into four headache types: transformed or chronic migraine, chronic tension-type headache, new daily persistent headache, and hemicrania continua. In this chapter the authors review the clinical features and classification of the chronic daily headaches, as well as the pathophysiology of chronic daily headache with a focus on chronic migraine. Effective treatment regimens will be discussed, which include the following steps: (1) education and support to the patient, establishing expectations and a follow-up plan; (2) use of nonpharmacological and behavioral therapies; (3) discontinuation of overused and potentially offending medications plus caffeine by outpatient or inpatient detoxification procedures; and (4) institution of a program of acute care and preventive pharmacological therapy.

© 2006 American Academy of Neurology
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