Objective: Migraine is a common cause of medical consultation in neurology policlinics. Chronic migraine usually develops as a complication of episodic migraine. It causes significant distress with substantial impact on the quality of life of an individual and huge economic cost to the society through occupational disability and healthcare consultations. Chronic migraine and medication-overuse headache often coexist. The aim of this study was to determine the risk factors for the transformation to chronic migraine and treatment for chronic migraine.

Methods: One hundred thirty-nine patients diagnosed with chronic migraine between January 2014-January 2015 were included in the study. These patients were observed for risk factors and prophylactic treatment.

Results: 92.8% of the patients in the study were female and were between the ages of 18-63. 85% of patients had headache for more than five years. Risk factors for the transformation from episodic to chronic migraine were determined as low-level of education, low-middle social economic status, emotional stress, obesity and sleep disorders. All patients were treated with prophylactic treatment. 19 patients were not evaluated because they failed to follow the protocol of treatment. 72% of patients responded to treatment and 27.5% of patients failed treatment. It was determined that only the accompanying depression had a negative effect on treatment response.

Conclusion: In our study, female gender, low educational level, low-middle socioeconomic level, obesity, preobesity, comorbid psychiatric disease and analgesic overuse have been shown as risk factors for the transformation from episodic to chronic migraine. Prophylactic drugs used in the treatment of episodic migraine had similar rates of response to treatment when used in chronic migraine prophylaxis. Treatment with botulinum toxin A and dry needle therapy used in the treatment-resistant patient has been shown to significantly increase treatment compliance and response. The presence of depression has been shown to negatively affect treatment.