No, there is no cure for chronic migraine, but there is a genuinely achievable goal that is often mistaken for one: chronic migraine frequently reverts to episodic migraine. Moving from fifteen or more headache days a month to a handful is the target, and a substantial proportion of people get there.
No, there is no cure for chronic migraine, but there is a genuinely achievable goal that is often mistaken for one: chronic migraine frequently reverts to episodic migraine. Moving from fifteen or more headache days a month to a handful is the target, and a substantial proportion of people get there.
Chronic migraine is a specific diagnosis: fifteen or more headache days a month for more than three months, of which at least eight have migraine features. It is not simply severe migraine. The distinction matters practically, because it changes which treatments are approved and it identifies a state that most people arrived at over months or years of escalating episodic migraine. Reversion, going back below that threshold, is what treatment aims at.
Medication-overuse headache. Frequent use of acute treatment, including over-the-counter combination analgesics, triptans, and anything with caffeine, codeine or butalbital, sustains the chronic state and blunts every preventive you try. Unwinding it is uncomfortable for a period and is often the single change that moves someone from chronic to episodic. Being told this can feel like blame; it is not, because the escalation is what the headaches drive people to do.
Untreated obstructive sleep apnoea, depression and anxiety, irregular sleep, sustained neck pain, and in this climate chronic underhydration and heat exposure. Each of these is treatable in its own right and each raises headache frequency independently. This is why the useful visit is not a search for a stronger painkiller but an inventory of what is feeding the frequency.
OnabotulinumtoxinA injections are approved specifically for chronic migraine and not for episodic migraine, so the diagnosis itself opens that option. CGRP monoclonal antibodies and the oral gepants are effective for many, and the established oral preventives, topiramate and beta blockers among them, remain reasonable choices. Any of these needs eight to twelve weeks before judging. Ask any practice directly which of these treatments it provides on site.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: MedlinePlus: migraine; American Academy of Neurology; MedlinePlus: headache.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.