Problem: Without adequate preventive treatment, chronic migraine tends to become self-reinforcing. Repeated attacks progressively lower the migraine threshold through central sensitization - sustained changes in trigeminal nociceptive processing and dysfunctional descending pain modulation. This manifests clinically as cutaneous allodynia (non-painful stimuli perceived as painful), which is both a marker of disease progression and a predictor of poorer treatment response. Structural brain changes, including periaqueductal gray matter abnormalities and increased white matter hyperintensities, have been documented in patients with high-frequency migraine and may be progressive. Chronic migraine with medication overuse headache is linked to greater preventive treatment failure, higher psychiatric comorbidity burden, and worse disability scores compared to chronic migraine alone. Other severe complications include major depression, suicidal ideations, and cardiovascular events (stroke, MI, atrial fibrillation, venous thromboembolism. Chronic migraine can be crippling leading to poor quality of life, disability, activity and work productivity impairment. Shorten and rewrite. Need Assignment Help?