Migraine Prevention - Chronic Disease Management

Principles of Chronic Disease Management

Applies to all disease that are chronic in nature
Migraine, Epilepsy, MS, UC, Crohn's disease

Principle 1: Chronic Medication

  • If prescribed daily medication take it on time daily
  • Do NOT Forget
  • Medical Adherence is key
Chronic Medication Selection
  • It is a process
  • Trial & Error
  • First Line > Second > Third
  • Max out and then combination

Principle 2: Any Disturbance create flares

Routine, Routine, Routine
Consistency, Consistency, Consistency
General Good Hygiene measures
Any Disturbance late nights, mild flus can trigger a flare

Principle 3: Measure

If you can't measure you can't improve
Create your own spread sheet "Date, Time, Symptoms"
There is an app for that
Headache Diary App for Migraine Patients

Principle 4: Anticipate

  • Anticipate Flare
  • Be Proactive
  • Season of Asthma, Days of the month for Migraine

Special Note - Recognizing Red Flags

It is important to differentiate between your Flare up and other "Red Flags"
You can still have other new diagnosis other than your regular headaches.
This brings the importance of Logging
Infection (Fever, Chills, Weight loss)
New Neurological Symptoms

Lifestyle considerations in Migraine Management

  • Sleep Hygiene
    • I can't treat your headache if you do not get enough good sleep
    • Priority
    • Food 3-4 hours before going to bed
    • Avoid Benzodiazepines
    • Bedroom for sleep and sex only
      • Only a book or kindle is allowed
      • Ditch the phone and TV.
      • If need a phone which to night mode
    • Special Note: Sleep Apnea
      • I have treated headaches with CPAP
  • Exercise
    • People who do not find time to exercise will have to find time for illness
    • 10 min brisk walk daily preferably outdoors
  • De-Stress
    • Yoga
    • Meditation
    • Support Groups
    • Breathing Technique
    • Sleep, Hydration, Exercise


American Migraine Foundation - Patient Guides
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