Table 1
Chronic Migraine Patients 30 ( 15.5 %)
reported sexual Abuse history
164 ( 84.5 %)
no reported sexual Abuse history episodic migraine patients 6 ( 4.4 %)
reported sexual Abuse history
129 ( 95.6 %)
no reported sexual Abuse history
Physicians should consider a patient ’ s history of sexual abuse when assessing the various factors which may have led to transformation to chronic migraine . Although it may be difficult for patients to share this history with their physician – particularly at an initial visit – it is important that they do so . A patient ’ s history of sexual abuse can be extremely relevant when formulating a treatment regimen for a patient with episodic migraine or chronic migraine . A migraine patient with such a history , for example , may benefit more from an antidepressant medication than from the use of a blood pressure agent , such as a beta blocker or calcium channel blocker . In addition , preventive medication may need to be considered even earlier in patients with abuse histories . These patients should participate in adjunctive treatment , including biofeedback and psychotherapy to help manage the anxiety and depression which often accompany a history of sexual abuse . Although psychotherapy is generally recommended for most migraine patients , abused patients may find a particular benefit from such intervention .
Future research is necessary to further establish a link between a history of sexual abuse and migraine transformation . Directions for future work include assessing the impact of childhood sexual abuse on migraine , studying the impact of sexual abuse or assault during adulthood on migraine , and analyzing the effectiveness of psychotherapy in migraine patients who have been victims of sexual abuse . A history of sexual abuse is more commonly reported in chronic migraine patients as compared to episodic migraine patients . A history of sexual abuse may be a contributing factor in the transformation of episodic migraine to chronic migraine . These findings underscore the importance of intervention , such as psychological counseling , in patients who have a history of sexual abuse . Episodic migraine may warrant more aggressive treatment in patients with a history of sexual abuse in order to help prevent transformation to chronic migraine . HW
www . headaches . org | National Headache Foundation 21