The main difference between episodic and chronic migraine is the duration. If you live with chronic migraine, you may experience severe pain for 15 or more days a month, for at least 3 months. Episodic migraine may be less frequent and 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 may have episodic migraine. If you’ve gone 3 months or more while experiencing migraine symptoms for 15 days or more per month, you may have chronic migraine. Those with chronic migraine may also experience 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 to stop symptoms, like triptans or CGRP antagonists | OTC, prescription drugs to stop symptoms, and preventive medications |
| Severe pain | possible | likely |
| Comorbidities (depression and anxiety) | possible | likely |
Migraine attacks are often unilateral (on one side of the head). Some people describe it as a pulsing or throbbing sensation. The pain is often accompanied by:
- nausea
- vomiting
- light sensitivity
- sound sensitivity
Common triggers for episodic migraine include:
- stress
- menstruation
- weather changes
Your healthcare professional may make a diagnosis of episodic migraine if you have:
- at least 5 migraine attacks in your lifetime
- migraine headaches that affect you on fewer than 15 days each month
- episodes that typically last 4–24 hours
No single test exists for diagnosing migraine conditions. To diagnose episodic migraine, your doctor will ask about your symptoms and revise your family and personal medical history.
Your healthcare professional may also take steps to rule out other possible causes. For example, you might experience migraine headaches as 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 have:
- migraine or tension headaches that affect you on 15 or more days each month for at least 3 months
- migraine headaches and related symptoms for at least 8 days per month
- episodes that 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 people with episodic migraine have fewer episodes. Treatment to prevent migraine attacks may also reduce headache intensity and the need for medications.
Treatment for chronic migraine includes:
- OTC medications to treat an ongoing migraine attack
- prescription medications to treat ongoing symptoms
- medications that reduce the chance of other migraine attacks, called prophylaxis
Medications that can help reduce the frequency, length, or severity of migraine attacks include:
According to a 2021 review, about
Episodic migraine is more common than chronic migraine. According to the American Migraine Foundation, about 12% of people in the United States have migraine.
Migraine has a higher prevalence in females (18%) than in males (6%). Studies have found that chronic migraine affects between 3–5% of U.S. adults.
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.
Females in their 40s appear most likely to experience chronic migraine. This points to a hormonal factor in migraine development. In fact, the National Headache Foundation says that 60% of women have migraine attacks around their menstrual period days.
Other factors that may increase the chance of chronic migraine include:
- obesity
- depression
- anxiety
- medication use
Migraine headaches are more than just painful. They can also interfere with your ability to participate in daily activities. In fact, migraine is the
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
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 annually.
According to a 2021 study, people who have migraine with depression and anxiety can expect to spend
Episodic migraine refers to experiencing migraine headaches fewer than 15 days per month. Chronic migraine involves severe headaches and accompanying symptoms for more than 15 days per month for at least 3 months.
Over time, migraine can take a toll on your work, income, and even personal relationships. If you’re experiencing headaches on a regular basis, or if you notice other migraine symptoms, consider talking with a healthcare professional.
It’s also a good idea to attend regular controls, particularly if you notice your symptoms are becoming more severe or frequent.
Treatment for migraine is available and often effective.