The main difference between episodic and chronic migraine is the frequency. Chronic migraine may cause severe pain on 15 or more days per month for at least 3 months. Episodic migraine is less frequent and may be less intense.
Depending on the frequency of your symptoms, a doctor may make a diagnosis of episodic migraine or chronic migraine.
If you go weeks or months between migraine attacks, you might have episodic migraine. But if you’ve had migraine symptoms on 15 or more days per month for 3 months or longer, you might have chronic migraine. Chronic migraine may also cause longer episodes.
Episodic and chronic migraine may require different treatment plans. It’s important to speak with a healthcare professional about how many migraine days you have each month and what other symptoms you experience.
| Episodic migraine | Chronic migraine | |
|---|---|---|
| Frequency | fewer than 15 days per month | 15 or more days per month for at least 3 months |
| Duration | typically less than 24 hours | can be continuous |
| Treatment | episodic over-the-counter (OTC) and prescription medications, such as triptans or CGRP antagonists, to stop symptoms | OTC or prescription drugs to stop symptoms, as well as preventive medications |
| Severe pain | possible | likely |
| Co-occurring conditions (depression and anxiety) | possible | likely |
Migraine attacks are often unilateral (affecting one side of your head). Some people describe the pain as a pulsing or throbbing sensation. This pain is often accompanied by:
- nausea
- vomiting
- light sensitivity
- sound sensitivity
Common triggers for episodic migraine include:
- stress
- menstruation
- weather changes
A healthcare professional may diagnose episodic migraine if you meet the following criteria:
- You’ve had at least five migraine attacks in your life.
- You experience migraine symptoms on fewer than 15 days each month.
- Your migraine episodes typically last 4 to 24 hours.
No single test exists for diagnosing migraine conditions. To diagnose episodic migraine, your doctor will ask about your symptoms and review your family and personal medical history.
Your doctor might also take steps to rule out other possible causes. For example, your migraine symptoms may be a side effect of medications or a symptom of an eye disorder or brain injury.
People with chronic migraine experience episodes on more days per month than people with episodic migraine.
A doctor may diagnose chronic migraine if you meet the following criteria:
- You experience migraine headaches or tension headaches on 15 or more days each month for at least 3 months.
- You have migraine features (e.g., light sensitivity, nausea, or vomiting) on at least 8 days per month.
- Your migraine episodes last more than 24 hours.
Chronic migraine episodes may last longer and be more severe than episodic migraine.
To treat episodic migraine, a doctor may recommend OTC medications. Depending on the frequency and severity of your symptoms, they may also suggest prescription medication.
Some preventive medications can help reduce the number of episodes that occur in episodic migraine. Treatment to prevent migraine attacks may also reduce headache intensity and the need for medications.
Treatment for chronic migraine can include:
- OTC medications to treat a migraine attack that’s in progress
- prescription medications to treat ongoing symptoms
- preventive medications (prophylaxis) to reduce the chance of future migraine attacks
Medications that can help reduce the frequency, length, or severity of migraine attacks include:
According to a 2021 review, episodic migraine progresses to chronic migraine in
Episodic migraine is more common than chronic migraine. According to the American Migraine Foundation, about 12% of people in the United States have migraine.
Some research suggests that migraine affects
Prevalence can also vary by race and ethnicity, but this may be due to socioeconomic factors, health inequities, and other variables.
For example, a
However, after adjusting for multiple variables, the same research found that only household income was linked with higher rates of chronic migraine. This may be because of cost concerns around care.
Women in their 40s appear to be the most likely to experience chronic migraine. This suggests that a hormonal factor may be involved in migraine development. In fact, the National Headache Foundation reports that 60% of women who live with migraine have migraine attacks around their menstrual period days.
Other factors that may increase the chances of chronic migraine include:
- obesity
- depression
- anxiety
- medication use
Migraine attacks are more than just painful. They can also interfere with your ability to participate in daily activities. In fact, migraine is the second leading cause of disability worldwide and the first among young women (ages 15 to 49), and contributes to missed work days.
If you have chronic migraine, you’ll likely miss more work and time with your loved ones than you would with episodic migraine. You’re also more likely to experience chronic pain, depression, and anxiety.
Data from a
And it’s not just productivity or sick days that are lost as a result of migraine. The cost of medications, office visits, emergency department visits, lab tests, and treatment side effects adds up each year.
Data from 2018 also suggests that chronic migraine is
According to another 2021 study, people who have migraine with depression and anxiety can expect to spend
Episodic migraine involves experiencing migraine symptoms on fewer than 15 days per month. Chronic migraine involves severe headaches and accompanying symptoms on more than 15 days per month for at least 3 months.
Over time, migraine can take a toll on your work, your income, and even your personal relationships. If you’re experiencing headaches regularly or if you notice other migraine symptoms, consider talking with a healthcare professional.
It’s also a good idea to attend regular checkups, especially if you notice that your symptoms are becoming more severe or frequent.
Treatment for migraine is available and often effective.