Chronic Migraine

Doctor-Led Assessment for Chronic Migraine

Migraine is more than simply a headache. For people living with chronic migraine, frequent headaches and migraine symptoms can have a significant impact on work, family life and everyday activities.

At ReNu Medical Aesthetics, Dr Jackie offers medical assessment for adults with chronic migraine who may be suitable for preventative treatment.

The first step is a detailed consultation to understand your headache pattern, previous treatments and whether specialist preventative treatment is appropriate.

What Is Chronic Migraine?

Chronic migraine is defined as experiencing:

Headache on 15 or more days each month
For at least 3 months
With migraine features on at least 8 days each month

Migraine symptoms can include headache, nausea, sensitivity to light or sound and other neurological symptoms.

Not everyone experiencing frequent headaches has chronic migraine, so establishing the nature and pattern of your headaches is important before considering treatment.

Your Consultation

Dr Jackie will discuss:

Your headache and migraine frequency
How long you have experienced symptoms
Typical migraine symptoms and triggers
The effect migraines have on everyday life
Current and previous migraine treatments
Preventative medications you have previously tried
Painkiller use and possible medication-overuse headache
Your medical history and current medications

Keeping a headache diary before your appointment can be particularly helpful in establishing your headache and migraine frequency.

Where your symptoms are atypical, your diagnosis is uncertain or further investigation is required, assessment through your GP or specialist headache/neurology service may be recommended.

Treatment Options

Management of chronic migraine can involve several approaches, including lifestyle measures, management of triggers and medication-overuse, acute migraine treatments and preventative medicines.

For suitable adults with established chronic migraine, specialist prescription treatment may also be considered following medical assessment.

NICE recommends botulinum toxin type A as an option for prevention in adults with chronic migraine when at least three preventative medicines have failed, are not tolerated or are unsuitable, and medication overuse has been appropriately managed.

Any prescription treatment will only be considered following an appropriate assessment of your individual circumstances.

What to Expect

Assessment
Your headache pattern, previous treatments, medical history and suitability for further preventative treatment will be reviewed.

Treatment
Where specialist injectable preventative treatment is considered appropriate, treatment involves a series of precisely placed injections across specific areas of the head and neck.

Follow-Up
Migraine frequency should continue to be recorded following treatment so that response can be assessed objectively.

Treatment is not continued automatically. Whether further treatment is appropriate depends upon your response and ongoing migraine pattern.

Measuring Your Response

The aim of preventative migraine treatment is to reduce the frequency and burden of migraine, rather than guarantee that headaches disappear completely.

Keeping a headache diary allows changes in headache days and migraine days to be compared with your baseline.

NICE defines an inadequate response to this particular preventative treatment as less than a 30% reduction in headache days per month after two treatment cycles.

Our Approach to Chronic Migraine

• Doctor-led assessment

• Evidence-based eligibility

• Appropriate prescribing

• Objective follow-up

Dr Jackie will review your symptoms and previous treatment history before considering whether specialist preventative treatment is appropriate.

Where your symptoms require further investigation or specialist neurological assessment, appropriate referral will be recommended.

Still have questions?

If you experience frequent migraine and headaches on 15 or more days each month, book a consultation with Dr Jackie to discuss your symptoms and whether further preventative treatment may be appropriate.

Book a consultation

Chronic Migraine FAQs

Is this treatment for occasional migraine?

No. This service is intended for people with chronic migraine, rather than occasional or episodic migraine. Chronic migraine generally means experiencing headaches on at least 15 days each month, with migraine features on at least 8 of those days.

Do I need to have tried other migraine treatments first?

Yes, this is an important part of the assessment. NICE recommends this specialist treatment option when at least three preventative medicines have not worked, have not been tolerated or are unsuitable, and medication overuse has been appropriately managed. Dr Jackie will review your previous treatment history during your consultation.

Do I need a diagnosis of chronic migraine?

A headache pattern consistent with chronic migraine needs to be established before treatment is considered. If your diagnosis is unclear, your symptoms have changed or there are features requiring further investigation, you may be advised to seek assessment through your GP or an appropriate specialist service.

Should I keep a headache diary?

Yes. Recording headache days, migraine days, severity and medication use before and after treatment provides useful information both for establishing your baseline and assessing whether preventative treatment is working.

Will treatment completely stop my migraines?

Not necessarily. The aim of preventative treatment is to reduce migraine frequency and overall migraine burden. Individual responses vary and complete elimination of migraine cannot be guaranteed.

How often is treatment given?

Where this particular specialist preventative treatment is prescribed, treatment is generally administered at approximately 12-week intervals. Whether treatment should continue depends upon your individual response and migraine frequency.

What happens if treatment doesn't work?

Response should be assessed objectively using your headache diary.

NICE recommends stopping treatment when there has been less than a 30% reduction in headache days per month after two treatment cycles. Alternative migraine management can then be discussed with your usual medical team.

Is this treatment safe?

All medical treatments carry potential risks.

Common effects associated with injections can include discomfort, bruising, swelling or tenderness around the treated area. Where botulinum toxin is prescribed, there are additional recognised side effects and contraindications which Dr Jackie will discuss with you before treatment.

Very rarely, botulinum toxin can produce effects beyond the area treated and symptoms consistent with botulism, including generalised muscle weakness, difficulty swallowing or speaking, or breathing difficulties. Urgent medical attention is required if these symptoms develop.