Comprehensive Inpatient Treatment for Intractable Migraine: A Prospective Long-Term Outcome Study


  • Alvin E. Lake III Ph.D.,

    Corresponding author
    1. Michigan Head-Pain and Neurological Institute, Ann Arbor, Michigan and
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  • Joel R. Saper M.D., F.A.C.P.,

  • Scott F. Madden R.N., M.B.A., M.H.S.A.,

  • Christopher Kreeger M.A., M.B.A.

Alvin E. Lake III, Ph.D,, Michigan Head-Pain and Neurological Institute, 3120 Professional Drive, Ann Arbor, Michigan 48104.



This paper describes outcome data for 100 patients with severe, intractable, persistent migraine (chronic daily headache), who were admitted to a comprehensive inpatient Head-Pain Treatment Unit for a mean of 8.5 days. Headache, pain-related behavior, depression, sleep disturbance, functional performance, work status, and medication use were assessed at admission, post-discharge (mean=2.3 weeks) and long-term follow-up (mean=8.3 months).

Significant improvement noted two weeks after discharge was maintained over time. Long-term results revealed a 64% reduction in the mean number of days in a 2-week period with severe to incapacitating headache (6.29 to 2.26), with a corresponding increase in pain-free days (1.03 to 5.40). At follow-up, the frequency of severe headaches was reduced by at least 50% for 75% of the patients. The mean rating of overall improvement was 74%. Patients on work-leave due to pain dropped from 24% to 4%, while the number of working patients rose from 31% to 53%. The data showed statistically significant reductions in days lost to pain, depression, sleep disturbance, and use of symptomatic medication. All the above analyses were significant at P=.000. These results demonstrate the efficacy of the inpatient headache program intervention for this group of patients.