Miguel Angel Medina Pabon and Olga Viviana Zaraza Moncayo
Chronic migraine is a disabling and debilitating disease, affecting 1.7-4% of the general population. It is the third cause of moderate to severe pain in the emergency department, in under 50. These case series describe the experience of managing chronic migraine in a headache program of IPS Envigado, Colombia, highlighting the importance of non-pharmacological management and doing a review of the subject. We included 22 patients who met the criteria of chronic migraine and one-year follow-up, using preventive management (propranolol, amitriptyline, and valproic acid) and non-pharmacological (aerobic exercise, meal times, balanced diet, sleep hygiene, avoiding sun exposure, behavioral psychotherapy, psychoneuroimmunotherapy techniques). Finally, there were found a reduction of migraine episodes in 88% and 75% in half of the adherents and pharmacological non-adherent, respectively. Furthermore, it is considered that non-pharmacological therapy had a significant impact not only improving the prognosis but preventing chronicity.