Snapshot A 26-year-old female presents with chronic headache. The headache commonly begins in the morning, and persists for most of the day. The headache occurs almost daily and averaging around 20 headaches per month. She reports that abortive therapy with zolmitriptan and acetaminophen are no longer effective. She has taken these medications approximately 15-20 times per month for the last 4 months. Her medical history is significant for migraine with aura. Physical examination is completely normal. Introduction Secondary headache disorder due to medication overuse in patients with a primary headache disorder (e.g., migraine, tension-type headache) login to view 8 more bullets Epidemiology Prevalence is higher in women Patients with a history of migraine, tension-type headache, or both are at risk Pathophysiology not fully elucidated login to view 4 more bullets Presentation Symptoms login to view 5 more bullets Evaluation Clinical diagnosis login to view 5 more bullets Differential Chronic migraine Chronic tension-type headache Treatment Discontinue overused headache medication (first-line) Bridge therapy login to view 1 more bullet Prognosis, Prevention, and Complications Prevention login to view 2 more bullets