Advice from a GPwSI in headache and migraine
This information is sourced from Dr Marcus Lewis GPwSI in headache and migraine
Q. In my role as a general practitioner, I have in the last 2 months come across an increasing number of people with a history of episodic migraine experience a transformation to chronic daily headaches which often need prophylactic treatment. My colleagues also report an increase in such headache cases. Is there an association between Covid-19 and increased migraine frequency? Should we have a different approach to assessing headaches during the pandemic?
- A few neurologists commented that patients with Covid-19 noticed a spike in their migraine frequency during their recovery which settled after a few weeks with usual care
- However for the patients described in this question in primary care my colleagues felt that the increase in migraine frequency was probably due to the considerable reduction in day to day routine and the loss of control of migraine triggers associated with lockdown
- Factors such as stress, sleep disturbance, overuse of caffeine, neck and shoulder discomfort due to home working, eye strain from overuse of screens are all potential factors
- In the absence of being able to control migraines through modifying lifestyle triggers perhaps more patients have turned to analgesia and all GPs should be alert to the possibility of medication overuse headache as a factor in transformation of episodic migraine to chronic migraine
- The SIGN treatment pathway on migraines is a useful aide memoire