Open access Journal of Neurology & Neurosurgery

A Perspective on the Comorbidities of Chronic Migraine

Author: Egilius LH Spierings*

Published: May 27, 2017

DOI: Egilius LH Spierings*

Abstract Content: In contrast to episodic migraine, chronic migraine tends to be associated with a multitude of medical and psychiatric comorbidities. If they are taken into consideration, it is generally only to provide direction as to which category of medications to use preventively. When taken together etiologically, they are either ascribed to somatization disorder (DSM III/IV) or described as central sensitivity syndromes. Common conditions that can accompany chronic migraine are, in random order: anxiety, depression, post-traumatic stress disorder (PTSD), insomnia, fatigue, myalgias of various sorts, including myofascial temporomandibular disorder (TMD), cervicalgia, and lumbago, fibromyalgia, chronic nausea, gastritis, acid reflux (GERD), constipation, irritable bowel syndrome (IBS), menstrual cycle disorders, and dysmenorrhea. It is proposed instead that the origin of the multitude of medical and psychiatric comorbidities of chronic migraine lies in a systemic endocrine-metabolic disorder. The muscular aspect of this disorder where it affects the craniocervical muscles, is postulated to constitute the target of Botox®’s benefit in chronic migraine. This makes the painful muscles in the neck and shoulder region more than a comorbid condition, that is, a concomitant but unrelated pathological or disease process. The same may be true for some of the other comorbidities seen with chronic migraine, which, hence, should be addressed in the overall management of those patients