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Understanding and addressing unmet need in chronic migraine

  • It is estimated that 190,000 migraine attacks are experienced every day in the UK5
  • Migraine affects approximately 23.3% of adults in the UK, with a higher prevalence in females than in males6,7
  • As many as 86 million workdays could be lost annually in the UK due to migraine-related absenteeism and presenteeism6
  • Chronic migraine is a debilitating disease, affecting 1.4-2.2% of adults worldwide8


Chronic migraine is defined by the International Headache Society (IHS) as:9

Chronic migraine is a complex and fluctuating disease that debilitates patients when it is not treated effectively11,12

Patients with chronic migraine exhibit large variations in the frequency of their migraines12

Adapted from Serrano D et al, 201712

Over 70% of patients experience variation in the frequency of their headaches12

Associated with many comorbidities, including anxiety, depression and sleep disorders.11,13

Common comorbidities

The leading cause of disability among neurological disorders in people aged 15-49 years14

It can be challenging to correctly diagnose patients.15 Learn about differential diagnosis

Common symptoms of migraine

Migraine is a complex condition with a wide variety of symptoms.9 It can be classified as migraine without aura, characterised by headache with specific symptoms and features, or migraine with aura, characterised by transient focal neurological symptoms that typically precede and/or accompany the headache.9 Some patients also experience a prodromal and a postdromal phase.9

A small proportion (<10%) of women with migraine have attacks, typically without aura, associated with their menstrual cycle.9 Attacks occurring during menstruation are usually longer and accompanied by more severe nausea than those occurring at other times of the menstrual cycle.9

Chronic migraine is a complex neurological disease requiring appropriate effective management - including treatment or referrals to improve patient outcomes2,9,10

CM: chronic migraine.

BOTOX® (botulinum toxin type A) is indicated for the prophylaxis of headaches in adults with chronic migraine (headaches on at least 15 days per month of which at least 8 days are with migraine).16



  1. Allergan. Data on file. INT/0423/2016
  2. Aurora S K, Winner P et al. OnabotulinumtoxinA for treatment of chronic migraine: pooled analyses of the 56-week PREEMPT clinical program. Headache 2011;51(9):1358-1373
  3. Blumenfeld A M, Stark R J et al. Long-term study of the efficacy and safety of OnabotulinumtoxinA for the prevention of chronic migraine: COMPEL study. J Headache Pain 2018;19(1):13
  4. Allergan. Data on file. 014
  5. Steiner T J, Scher A I et al. The prevalence and disability burden of adult migraine in England and their relationships to age, gender and ethnicity. Cephalalgia 2003;23(7):519-527
  6. The Work Foundation. Society's headache: the socioeconomic impact of migraine. Available at: Accessed April 2022
  7. GBD 2016 Headache Collaborators. Global, regional, and national burden of migraine and tension-type headache, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2018;17(11):954-976
  8. Natoli J L, Manack A et al. Global prevalence of chronic migraine: a systematic review. Cephalalgia 2010;30(5):599-609
  9. International Headache Society (IHS). International classification of headache disorders (3rd edition) guidelines. Available at: Accessed April 2022
  10. Weatherall M W. The diagnosis and treatment of chronic migraine. Ther Adv Chronic Dis 2015;6(3):115-123
  11. Adams A M, Serrano D et al. The impact of chronic migraine: the Chronic Migraine Epidemiology and Outcomes (CaMEO) study methods and baseline results. Cephalalgia 2015;35(7):563-578
  12. Serrano D, Lipton R B et al. Fluctuations in episodic and chronic migraine status over the course of 1 year: implications for diagnosis, treatment and clinical trial design. J Headache Pain 2017;18(1):101
  13. Buse D C, Rains J C et al. Sleep disorders among people with migraine: results from the Chronic Migraine Epidemiology and Outcomes (CaMEO) study. Headache 2019;59(1):32-45
  14. Steiner T J, Stovner L J et al. Migraine is first cause of disability in under 50s: will health politicians now take notice? J Headache Pain 2018;19(1):17
  15. Dodick D W, Loder E W et al. Assessing barriers to chronic migraine consultation, diagnosis, and treatment: results from the Chronic Migraine Epidemiology and Outcomes (CaMEO) study. Headache 2016;56(5):821-834
  16. BOTOX® Summary of Product Characteristics. Available at: Accessed April 2022

Please refer to the BOTOX® Summary of Product Characteristics for further information on adverse events, contraindications and special warnings and precautions for use.


Adverse events should be reported. Reporting forms and information can be found at

Adverse events should also be reported to AbbVie on [email protected] 


Date of preparation: April 2022. UK-BTX-220047.