Ann Pain Med | Volume 1, Issue 1 | Review Article | Open Access

The Relation between Episodic Headache and Chronic Daily Headache (CDH)

Egilius L H Spierings*

Tufts University Schools of Medicine & Dental Medicine, Boston, Massachusetts, USA

*Correspondance to: Egilius L H Spierings 

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Abstract

Chronic daily headache (CDH) involves the daily or almost daily occurrence of headache, which affects 3% to 6% of the general adult population, with about half accounted for by chronic tension(- type) headache and the other half by chronic migraine. Two thirds of CDH develops gradually out of episodic headaches, which in approximately one third is tension (-type) headache and in approximately two thirds is migraine. The transition from episodic headache to CDH can be abrupt or gradual and in case of the latter, risk factors have been identified. If these risk factors are more than associations, they may forewarn the clinician of an impending transition, although the transition takes a decade on average. Insight into what drives the transition from episodic headache to CDH could be derived from the medical and psychiatric comorbidities of CDH versus episodic headache. These comorbidities are reviewed and discussed and proposed to be a manifestation of a systemic endocrine-metabolic disorder. The musculoskeletal component of this disorder, in particular its effect on the craniocervical muscles, is suggested to drive the high frequency of the headaches in CDH and constitutes the target of onabotulinumtoxinA’s effectiveness in chronic migraine.

Keywords:

Anxiety; Central sensitization; Chronic daily headache; Chronic migraine; Chronic tension-type headache; Comorbidities; Depression; Dysmenorrhea; Endocrine-metabolic disorder; Endometriosis; Headache amplifier; Headache chronification; Headache development; Headache presentation; Hypertension; Hypothyroidism; Insomnia; Menstrual-cycle disorders; Nausea; Neck pain; Neurogenic inflammation; Obesity; OnabotulinumtoxinA; Somatization disorder

Citation:

Spierings ELH. The Relation between Episodic Headache and Chronic Daily Headache (CDH). Annals Pain Med. 2018;1(1):1001.

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