Planet pain: focus on chronic migraine

Chronic headache is often described but pooly understood regarding its mechanisms. We discuss the clinical presentation, differential diagnosis of chronic headache syndromes and treatment options. Patients presenting these pain syndromes are best assessed using a multidisciplinary approach. Our purpose was to investigate these types of chronic primary pain by using an internal medicine, neurological as well as a pain-specialist approach. We developed a model for estimating the entity of central sensitization, which seems to be the pivotal feature in these painful syndromes. Our approach allowed us to gain further insight into the mechanism of central sensitization and neuronal changes in the central nervous system. The findings run counter to the possibility that these primary pain syndromes, especially chronic migraine, are refractory to specific treatments.