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In the current issue of Neurology, Zwart et al.1 present data on the role of medication overuse in the subsequent development of chronic daily headache (CDH) and other pain disorders. CDH is defined as a primary headache disorder with attacks 15 or more days per month (or 180 or more days per year) with an average duration of 4 or more hours per day.2 Up to 80% of the patients seen in headache centers have CDH.3 In population-based surveys, the prevalence of CDH is a staggering 4%.4 Chronic migraine (CM) is the most common subtype of CDH in specialty care3 and an important disorder from the perspectives of societal costs and individual suffering.2 Subjects with CM usually undergo a process of transformation over months or years, characterized by increasing headache frequency.2,3⇓
Candidate risk factors for the development of CM include female sex, high frequency of headaches before transformation, obesity, …
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