Migraine Continuum: Episodic & Chronic Labels Are Inadequate

A perpetual migraine for 18 days followed by eight days with a new migraine each day — that’s what I’ve just come out of. You think I’d be used to it, having done the severe constant migraine thing for a decade with only slight, infrequent reprieves. I suppose I was, but having had a break and then returning to it, I can see clearly how incredibly draining it is to have a migraine all the time.

Even when I felt my best this spring, I still have a migraine attack more days than not. For me, that’s easy to cope with compared to having a continuous migraine. It’s hard to articulate just how physically and emotionally taxing it is to never get a break.

Migraine is talked about as episodic or chronic, but those terms don’t account for the tremendous variation in quality of life. Someone can have a few migraine attacks a year or seven a month and still be considered episodic. Someone with chronic migraine can have eight migraine days and 15 headache days a month or have a non-stop migraine. How can two categories possibly capture that range?

Some researchers do break down episodic migraine into low-, medium- and high-frequency, though there’s distinction between degrees of chronic migraine. Hmm, degrees of migraine. I like that framing, though I wonder if it is possible to talk about degrees of migraine without people ranking their pain in relation to that of others.