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Chronic migraine medication overuse — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Chronic migraine medication overuseUSMLE Step 3

A 38-year-old woman with migraine now has daily headaches. She takes combination acetaminophen-caffeine-butalbital tablets on 20 days each month. Neurologic examination is normal. Which of the following is the most likely explanation for this patient's findings?

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Correct answer: B — Medication-overuse headache

Frequent use of acute headache medications, especially butalbital-containing products, can transform episodic migraine into medication-overuse headache.

Reference: American Headache Society guidance