The state of the art in treating patients with a dual diagnosis of chronic migraine and medication-overuse headache

Jevoux, Carla; Krymchantowski, Abouch; Silva-Néto, Raimundo Pereira; Krymchantowski, Ana Gabriela; Cotrik, Ervin Michelstaedter

doi:10.48208/headachemed.2023.29

Headache Med

2023

DOI: 10.48208/headachemed.2023.29

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The state of the art in treating patients with a dual diagnosis of chronic migraine and medication-overuse headache

Carla Jevoux,

Abouch Krymchantowski,

Raimundo Pereira Silva-Néto

et al.

Abstract: Migraine is a common, highly prevalent genetic neurological disorder. Its most burdensome form is the chronic migraine, which is clinically defined by the presence of headache on ≥15 days/month for longer than three months, with eight or more typical migraine days. Medication-overuse headache (MOH) is a secondary headache disorder associated with the overuse of symptomatic headache medications on ≥10 days/month for longer than 3 months. Chronic migraine and medication-overuse headache often coexist and most ch… Show more

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State-of-the-art in the acute and preventive treatment of migraine from children to adults - a Special Collection

Valença

2023

Headache Med

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Headaches are characterized by a sensation of discomfort or pain in the cephalicregion. Due to the large number of types and subtypes of headaches, the standardization of their approach is necessary through the International Classification ofHeadache Disorders (ICHD), a document that is currently in its 3rd edition (ICHD-3).The evolution of the ICHD follows the hypothetical-deductive model of science basedon Karl Popper's philosophy, which has a strong presence in the health sciences.The classification of headaches has evolved over time, incorporating and removingcriteria, reflecting the need to adapt the classification to constantly evolving scientificand clinical demands. However, some changes can generate discrepancies betweenclinical practice and the elaborated diagnostic tools. In this context, this article reflectson whether it would be advantageous to return to old principles and foundations ofobsolete classifications. The criterion of osmophobia, which is no longer in use inICHD-3, is highlighted. This reflection can be developed following Thomas Kuhn's(1922-1996) view on science. In his main work, "The Structure of Scientific Revolutions"(1962), Kuhn proposes a three-stage model for science: the adoption of a paradigm,normal science, and a period of crisis. Kuhn also proposes the principle of incommensurability to understand the limitations and complexities of science. The applicationof this principle allows headache specialists to recognize that different approachesto headache classification have their own limitations and complexities, encouragingthem to consider a variety of perspectives, paradigms, and theories in approachingclinical cases and conducting scientific studies. An integrative approach that combinesPopper's hypothetical-deductive model with Kuhn's principle of incommensurabilityallows headache specialists to have a broader and more critical understanding ofheadache classifications.

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State-of-the-art in the acute and preventive treatment of migraine from children to adults - a Special Collection

Valença

2023

Headache Med

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The state of the art in treating patients with a dual diagnosis of chronic migraine and medication-overuse headache

Cited by 1 publication

References 39 publications

State-of-the-art in the acute and preventive treatment of migraine from children to adults - a Special Collection

State-of-the-art in the acute and preventive treatment of migraine from children to adults - a Special Collection

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