Transformed Migraines

Transformed migraines are chronic, daily headaches with a vascular quality (meaning that they are throbbing in nature). Most people who experience transformed migraines have a history of migraines, usually beginning in childhood or early adolescence. The onset of daily transformed migraine headaches generally occurs in people during their 20's and 30's.

Many people with a previous history of migraine will suddenly report the headaches are less severe but are more frequent, until they begin occurring daily. This change may be caused by the daily use of pain relievers. Some people with transformed migraines report having severe episodes accompanied by nausea and vomiting, much like migraines. Often, it is difficult to differentiate between tension headaches and transformed migraines.

Because transformed migraines are difficult to diagnose, many people may be treated inappropriately. Treatment is further complicated because of the chronic nature of headache. Many people with transformed headaches have the tendency to overuse pain relievers, both prescription and over-the-counter, using these drugs daily with or without having a headache. This puts the person at risk for building up a tolerance to the drugs. Additionally, taking large amounts of pain relievers containing caffeine can experience withdrawal headaches.

In many cases, people suffering from transformed migraines have other health problems such as hypertension and depression which complicate treatment. Seeking care by an experienced, multidisciplinary health care team to coordinate treatment is essential to finding relief.

Reviewed by The Cleveland Clinic Neuroscience Center.