Conflict of Interest Statement: Dr. Schulman has served as a consultant to NuPathe and Zogenix. He is on the speakers bureau of Merck and Impax. He has received research funding from NuPathe and has received royalties from Oxford University Press.
Refractory Migraine – A Review
Article first published online: 13 FEB 2013
© 2013 American Headache Society
Headache: The Journal of Head and Face Pain
Volume 53, Issue 4, pages 599–613, April 2013
How to Cite
Schulman, E. (2013), Refractory Migraine – A Review. Headache: The Journal of Head and Face Pain, 53: 599–613. doi: 10.1111/head.12047
Sources of Financial Support: None.
- Issue published online: 4 APR 2013
- Article first published online: 13 FEB 2013
- Manuscript Accepted: 29 NOV 2012
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.