CAUSES AND THERAPEUTIC APPROACHES IN CHRONIC MIGRAINE: A NARRATIVE REVIEW
Keywords:
Chronic migraine; Headache disorders; Pathophysiology; CGRP; Preventive therapy; Non-pharmacological treatmentAbstract
Chronic migraine is a common and disabling neurological disorder that significantly affects patients’ quality of life and socioeconomic productivity. It is characterized by frequent headache episodes accompanied by sensory and autonomic symptoms. The pathophysiology of chronic migraine is complex and involves genetic predisposition, central sensitization, neurovascular dysfunction, and alterations in neurotransmitter systems, particularly calcitonin gene-related peptide (CGRP).
This article aims to analyze the main causes of chronic headache, with a particular focus on migraine, and to review current therapeutic approaches based on recent clinical evidence. A narrative review of the literature was conducted using international databases, including PubMed, Scopus, Web of Science, and Google Scholar. Relevant studies published between 2015 and 2024 were analyzed, focusing on etiological factors, clinical features, and treatment strategies for chronic migraine.
The results indicate that stress, sleep disturbances, hormonal changes, and medication overuse play a significant role in migraine chronification. Pharmacological management includes acute and preventive therapies, with CGRP monoclonal antibodies demonstrating superior efficacy in reducing migraine frequency and improving quality of life. Non-pharmacological interventions, such as lifestyle modification and behavioral therapy, were shown to enhance treatment outcomes when combined with medical therapy.
In conclusion, effective management of chronic migraine requires a comprehensive and individualized approach that integrates pharmacological and non-pharmacological strategies. Further research is needed to develop cost-effective and personalized treatment options to improve long-term disease control.
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