Case 564 · ICHD-3 8.2.5
8.2.5 Combination-analgesic-overuse[^1] headache
- Origin
- Synthetic
- Language
- English — also available in German
- Contributed by
- Imported case — HeadAI synthetic vignettes (de Andrade JBC, da Silva Costa TB, Vasconcelos JL, Lopes TLM, Balsells MD, Cristofolini VL, Querobin SO, Filho FMR. Validation of an AI-based platform for structured diagnosis of headache disorders using ICHD-3 criteria. BMC Neurology 25, 489 (2025). doi:10.1186/s12883-025-04473-1. Dataset: Andrade J. Head.AI Platform. Mendeley Data, V2 (2025). doi:10.17632/4fms6cw2s5.2)
Anamnesis
Identification: Female patient, 45 years old, with a history of episodic migraine since adolescence.
Current Illness History:
Reports daily headaches for over 3 months, with variable characteristics (bilateral pressure-type or unilateral throbbing, moderate to severe intensity).
Excessive use of symptomatic medication: Consumes combination analgesics (e.g., paracetamol + codeine + caffeine in tablets) on ≥15 days/month for over 3 months.
Progressive worsening: Notes that the headache worsens with frequent use of medication, with only partial relief and return of pain after a few hours.
Reduced efficacy: Previously effective, the analgesics now require higher doses for minimal effect.
Physical/Neurological Examination: No significant changes.
Report this case — e.g. suspected re-identification risk.