Refractory Migraine - A Review

Refractory migraine has long been a challenge to all headache specialists. This subgroup of migraine patients experience disability and impaired quality of life, despite optimal treatment. This article reviews the proposed definitions and epidemiology of refractory migraine, as well as the pathophys...

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Bibliographic Details
Published in:Headache 2013-04, Vol.53 (4), p.599-613
Main Author: Schulman, Elliott
Format: Article
Language:English
Subjects:
abuse
definition
Drug Resistance
headache
Humans
Migraine
Migraine Disorders - epidemiology
Migraine Disorders - physiopathology
Migraine Disorders - therapy
placebo
refractory
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Summary:Refractory migraine has long been a challenge to all headache specialists. This subgroup of migraine patients experience disability and impaired quality of life, despite optimal treatment. This article reviews the proposed definitions and epidemiology of refractory migraine, as well as the pathophysiology that may contribute to the genesis of this disorder. Aspects of treatment, including pharmacological, complementary/adjunct, and invasive approaches, are reviewed. Comorbid factors, medication overuse, potential pitfalls to treatment, and areas for future investigation are highlighted.
ISSN:0017-8748
1526-4610
DOI:10.1111/head.12047