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Review
. 2019 Aug 23;20(1):89.
doi: 10.1186/s10194-019-1040-x.

Identifying and managing refractory migraine: barriers and opportunities?

Linda D'Antona  1 , Manjit Matharu  2
Affiliations
Review

Identifying and managing refractory migraine: barriers and opportunities?

Linda D'Antona et al. J Headache Pain. .

Abstract

The term refractory migraine has been used to describe persistent headache that is difficult to treat or fails to respond to standard and/or aggressive treatments. This subgroup of migraine patients are generally highly disabled and experience impaired quality of life, despite optimal treatments. Several definitions and criteria for refractory migraine have been published, but as yet, an accepted or established definition is not available. This article reviews the published criteria and proposes a new set of criteria. The epidemiology, pathophysiology and management options are also reviewed.

Keywords: Abortive; Comorbidities; Disability; Medication overuse; Migraine; Preventive; Refractory.

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Conflict of interest statement

LD’s research fellowship is sponsored by B. Braun. MSM serves on the advisory board for Abbott, Allergan, Autonomic Technologies Inc., Eli Lilly, Medtronic, Novartis and TEVA, and has received payment for the development of educational presentations from Abbott, Allergan, Medtronic and electroCore.

References

    1. Headache Classification Subcommittee of The International Headache Society The international classification of headache disorders 3rd edition. Cephalalgia. 2018;38:1–211. - PubMed
    1. Reisman EE., Jr The use of experimental suppositories in treating refractory migraine. Am Pract Dig Treat. 1952;3(4):308–310. - PubMed
    1. Goadsby PJ, Schoenen J, Ferrari MD, Silberstein SD, Dodick D. Towards a definition of intractable headache for use in clinical practice and trials. Cephalalgia. 2006;26(9):1168–1170. - PubMed
    1. Schulman EA, Lake AE, 3rd, Goadsby PJ, Peterlin BL, Siegel SE, Markley HG, et al. Defining refractory migraine and refractory chronic migraine: proposed criteria from the refractory headache special interest section of the American headache society. Headache. 2008;48(6):778–782. - PubMed
    1. Silberstein SD, Dodick DW, Pearlman S. Defining the pharmacologically intractable headache for clinical trials and clinical practice. Headache. 2010;50(9):1499–1506. - PubMed

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