Persistent Chronic Migraine Symptoms Between Attacks

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Key Questions
  • What happens in the brain when migraine becomes chronic?
  • Does having chronic migraine for a longer period of time make it harder to reverse to episodic migraine?
  • Can symptoms linger in between attacks with chronic migraine?
  • When counting headache days, should we include days with nonheadache symptoms like light sensitivity or nausea?
  • Where do you start when you have migraine symptoms that are 24/7?
  • How do you find the balance between taking medication early to treat an attack, but avoiding medication overuse headache?
  • What role is there for preventive medication versus lifestyle and behavioral factors in chronic migraine?
  • Can one person have multiple types of headache disorders?
  • What other disorders have symptoms that resemble those of chronic migraine?
  • What are some symptoms that might differentiate other disorders from migraine?
Interview Notes

Find more about Christine Lay, MD, FAHS and her work here:

Treatments Mentioned
  • Antidepressants
  • Blood pressure medication
  • Exercise
  • Meditation
  • Mindfulness
  • Monoclonal antibodies
  • Nutraceuticals
  • OnabotulinumtoxinA
  • Stress management
  • Triptans

Christine Lay, MD, FAHS

Professor of Neurology, Deborah Ivy Christiani Brill Chair
University of Toronto

Dr. Christine Lay is a professor of neurology and the founding director of the headache program at the University of Toronto, where she holds the Deborah Ivy Christiani Brill chair for neurology research. She completed her residency at the Mayo Clinic and her headache fellowship at Albert Einstein College of Medicine in New York.

In addition to directing and growing the headache program at the University of Toronto and heading a very busy patient practice, she is actively involved in research and teaching. She directs the Canadian Headache Society fellowship program in Toronto; she is actively engaged in advocacy and education, serving as the chair of the American Migraine Foundation; and she is a board member of the American Headache Society and the Canadian Headache Society.

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The American Migraine Foundation (AMF) is a non-profit organization dedicated to the advancement of research and awareness surrounding migraine, a disabling condition that impacts more than 37 million men, women and children in the United States. The AMF was founded in 2010 to provide global access to information and resources for individuals with migraine as well as their family and friends.

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