Episodic vs. chronic migraine: what you need to know

Neurologist Sanjay Gupta, MD, interviews migraine specialist Kevin Smith, MD, on chronic migraines: how they differ from episodic migraines and how they affect people.

Transcript

00:00

I mean, you think about it, you're having a migraine more than 15 days out of a month-- that's half the month. And some can go the whole month, you know?

00:08

Everybody, I'm Dr. Sanjay Gupta, and I'm very excited today to be joined by Dr. Smith

00:14

to chat about an important topic, something that I am personally very, very interested in and affected by, and that is migraines, specifically

00:23

chronic migraines. So one of the things that has always struck me in the conversation about migraines is that they're automatically characterized just

00:32

as bad headaches. They're really something very different, right? They really are, absolutely, much more severe

00:39

than just a headache. You know they're so much more debilitating than just a headache, and it's important to make that distinction. I really suffered with these things,

00:46

and of the questions that came up over and over again was, what is the difference between chronic migraines

00:53

and episodic migraines? These are migraines that people have that go anywhere between 0 and 14 days per month.

01:03

But once you get to the 15 or more days per month, and at least eight of those days within those 15 or more days

01:11

have to include a feature such as an aura or something like that for more than three months

01:18

to classify as a chronic migraine. And these patients really get disabled from them. I mean, you think about it, you have a migraine

01:25

more than 15 days out of a month-- that's half the month. And some can go the whole month. For people out there who--

01:32

they listen to you, OK, 0 to 14 days-- they're not exactly sure where their migraine experience would fall on the spectrum of episodic or chronic, what kind of advice

01:42

do you give people? Keep a headache diary. You can write this down with a pen and paper, or you can just use your cell phone nowadays.

01:49

What it does-- it allows you to track your symptoms and the frequency that you're having these symptoms so that when you go to your doctor, the doctor will have

01:56

a full picture of what your migraine attacks look like, what the symptoms are, and you can distinguish whether or not

02:02

they're episodic or whether or not they're chronic. You want to know whether or not your migraine attacks are increasing. You know, they started out maybe three days a month,

02:11

but now you're getting 10 days a month. Then you cross over into the 15-or-more days a month. If that number is going up, it's very important

02:19

to document that and then go to your health-care provider or your migraine specialist. If you are reaching for medications--

02:26

and sometimes that can be challenging to figure out what's going to work-- but if you are reaching for that bottle of medicine more and more or tracking through your own

02:36

diary 15 or more migraines per month, that's a sign then that those episodic migraines have progressed to being more chronic?

02:43

It is. And once you've gotten that information, you talk to your doctor about any preventative treatments that you can take.

02:50

These are medications or medicines that you can take to actually stop the migraine from happening rather than taking

02:56

a medicine is just going to stop the symptoms once the migraine has already started. So it's very important that you take care of yourself,

03:03

that you eat well, you exercise, you stay hydrated. You just don't want to let your migraines totally isolate you. Well, look, I appreciate this, and I

03:10

know that there's a lot of people out there who struggle with this. And you're absolutely right, I think, about that last point, Dr. Smith.

03:16

So Dr. Smith, thanks so much for your time. I really appreciate it. [MUSIC PLAYING]