Chronic Migraine is underdiagnosed

Patients in your practice might be silently “powering through” a migraine condition. Inquiring about headache severity and frequency may help identify patients with undisclosed symptoms.


Understanding the differences between Chronic Migraine and Episodic Migraine1,2



≥ 15 headache days per month; ≥ 8 headache days are migraine days; ≥ 4 hours of headache per day

≤ 14 headache days per month1,2

Persistent disability (79.1% of patients report a MIDAS Grade IV score of ≥ 21)3,*,†

Intermittent disability (23.6% of patients report a MIDAS Grade IV score of ≥ 21)3,*,†

Higher prevalence of common comorbidities such as depression, anxiety, chronic pain, obesity, gastrointestinal issues, or neck pain4-6

Lower prevalence of comorbidities4,5

Acute medication overuse5

Acute medication use5

Likely associated with structural changes to the brain2,7

May be associated with structural changes to the brain2,5

*Based on a survey of 499 Chronic Migraine patients and 8227 Episodic Migraine patients.3

MIDAS = Migraine Disability Assessment.

Understanding how Chronic Migraine may be misdiagnosed

Chronic Migraine may be misdiagnosed due to the following:

  • Patients did not accurately account for all their headache days
  • Classifying some migraine attacks as tension-type headaches, leading to a diagnosis of mixed headache disorder. In fact, 90% of patients with disabling tension headaches actually had a form of migraine disease8,‡
  • Not accounting for headache features, leading to an underdiagnosis of migraine days

Based on a study of 432 patients.

Download chart documentation tools

Effectively tracking the severity, frequency, and impact of headache days is critical to arriving at a true chronic migraine diagnosis. Here are some helpful tools to help you and your patients notate all pertinent symptoms.

Establishing a comprehensive dialogue with your patient is key

To secure an accurate Chronic Migraine diagnosis for your patients, encourage them to be open and honest about their migraine symptoms and the impact they are having on their lives.

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