Kowa Hisanori, Nakashima Kenji
Division of Neurology, Department of Brain and Neurological Sciences, Faculty of Medicine, Tottori University.
Rinsho Shinkeigaku. 2011 Nov;51(11):1147-9. doi: 10.5692/clinicalneurol.51.1147.
Migraine is one of the common diseases, suffering 8.4 million patients in Japan. Recently conditions associated with chronic migraine were considered to be worse than episodic migraine in socio-economic status, health-related quality of life, and headache-related burden. Preventing the chronification, and improving treatment and management, the natural disease course could give us some clues. Several reports suggested that a population prevalence of chronic migraine is about 2% and approximately 2.5% of patients with episodic migraine develop new-onset chronic migraine each year. The risk factors for converting episodic to chronic migraine were demonstrated as follows: age, low education/socioeconomic status, head injury, attack frequency, obesity, medication overuse, stressful life events, caffeine overuse, snoring, other pain syndromes, allodynia, proinflammatory states, prothrombotic states, and specific genes. It was also focused in comobidity with chronic migraine, such as depression, anxiety, chronic pain, asthma, bronchitis, hypertension, and so on. The ratio converting in reverse was reported as a fourth in two years. We should recognize the burden of migraine patients, and improve patients' outcome under reducing risk factors and assessing the effect of treatment on headache progression.
偏头痛是一种常见疾病，日本有840万患者。最近，在社会经济地位、与健康相关的生活质量以及与头痛相关的负担方面，慢性偏头痛患者的状况被认为比发作性偏头痛患者更差。预防偏头痛的慢性化以及改善治疗和管理，疾病的自然病程可能会给我们一些线索。几份报告表明，慢性偏头痛的人群患病率约为2%，每年约有2.5%的发作性偏头痛患者会发展为新发慢性偏头痛。发作性偏头痛转变为慢性偏头痛的风险因素如下：年龄、低教育水平/社会经济地位、头部受伤、发作频率、肥胖、药物过度使用、生活压力事件、咖啡因过度使用、打鼾、其他疼痛综合征、痛觉过敏、促炎状态、血栓前状态以及特定基因。慢性偏头痛的合并症也受到关注，如抑郁症、焦虑症、慢性疼痛、哮喘、支气管炎、高血压等。据报道，两年内反向转变的比例为四分之一。我们应该认识到偏头痛患者的负担，并在降低风险因素和评估治疗对头痛进展的效果的同时，改善患者的治疗效果。
