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Management of Chronic Migraine: a proposal by the Belgian Headache Society.

Jean Schoenen1*
  • 1 University of LIEGE, Neurology, Belgium

Chronic Migraine (CM) is a disabling neurological condition affecting 0,5 to 2% of the population. In the current third edition of the International Classification of Headache Disorders, medication overuse is no longer an exclusion criterion and CM is diagnosed in patients suffering from at least 15 headache days per month of which at least 8 are related to migraine. CM is difficult to treat and preventive treatment options are limited. We provide a pathogenetic model for CM, integrating the latest findings from neurophysiological and neuroimaging studies. On behalf of the Belgian Headache Society, we present a management algorithm for CM based on the international literature and adapted to the Belgian situation. Pharmacological treatment options are discussed, and recent data on transcranial and invasive neuromodulation studies in CM are reviewed. An integrated multimodal treatment program may be beneficial to refractory patients, but at present this approach is only supported by a limited number of observational studies and quite variable between centers.

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Acknowledgements

The following board members of the Belgian Headache Society have contributed to this work: Koen Paemeleire, Paul Louis, Delphine Magis, Michel Vandenheede, Jan Versijpt, Bart Vandersmissen.

References

Paemeleire K, Louis P, Magis D, Vandenheede M, Versijpt J, Vandersmissen B, Schoenen J.
Diagnosis, pathophysiology and management of Chronic Migraine: a proposal of the Belgian Headache Society.
Acta Neurol Belg 2014 (submitted).

Keywords: chronic migraine, Pharmacotherapy, behavioral therapy, Botulinum Toxins, Type A, Neuromodulation, integrated management

Conference: Belgian Brain Council 2014 MODULATING THE BRAIN: FACTS, FICTION, FUTURE, Ghent, Belgium, 4 Oct - 4 Oct, 2014.

Presentation Type: Oral Presentation

Topic: Clinical Neuroscience

Citation: Schoenen J (2014). Management of Chronic Migraine: a proposal by the Belgian Headache Society.. Conference Abstract: Belgian Brain Council 2014 MODULATING THE BRAIN: FACTS, FICTION, FUTURE. doi: 10.3389/conf.fnhum.2014.214.00001

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Received: 13 Apr 2014; Published Online: 28 Apr 2014.

* Correspondence: Prof. Jean Schoenen, University of LIEGE, Neurology, LIEGE, 4000, Belgium, jschoenen@ulg.ac.be