Transformed migraines are chronic (long-lasting), daily headaches that originate from episodic migraine headaches. Most patients who experience transformed migraines have a history of intermittent migraines, usually beginning in childhood or early adolescence. The onset of transformed migraine headaches generally occurs in people during their 20s and 30s.

Many people with a history of migraine will suddenly report that the headaches are less severe but are more frequent, until they begin occurring daily. This change may be caused by the daily use of analgesics (pain-relieving medications). This is called Medication Overuse Headache (MOH). Some people with transformed migraines report having some severe episodes accompanied by nausea and vomiting, much like migraines. Often, it is difficult to differentiate between tension-type headaches and transformed migraines, since the severity of the daily headache is milder than the migraines experienced years before.

Because of the difficulty in diagnosis, many people may be treated inappropriately. Treatment is further complicated because of the chronic nature of headache. Many people have the tendency to overuse analgesics, both prescription and over-the-counter. They may use these drugs daily with or without having a headache. Often it begins after a procedure like a dental extraction or other surgery when taking an analgesic is necessary for pain relief. If you have a history of migraine, using analgesics more than 2 days/week can cause MOH. Also, many of these medications contain caffeine, which increases the risk for MOH.In many cases, patients suffering from transformed migraines have other health problems, such as hypertension (high blood pressure), sleep apnea and/or depression or anxiety, which complicate treatment. Seeking an experienced, multidisciplinary health care team to coordinate treatment is essential to success. The program with combined physical therapy, psychological therapy, and medical therapy promises greater success in helping patients with difficult to treat transformed migraines.

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