Spotlight on Migraine®
What is Refractory Migraine?
Jan 8, 2024
Dr. Jennifer Robblee discusses refractory migraine and its differences from other migraine types. She explores off-label treatments and strategies, and emphasizes the importance of seeking medical attention. The chapter also highlights the need for more research and advocacy in this area.
29:41
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Quick takeaways
- Refractory migraine is a complex condition that lacks a universally accepted definition and is not included in the international classification of headache disorders.
- Treating refractory migraine often requires a multidisciplinary approach with individualized treatment plans that can include off-label medication trials, neuromodulation devices, cognitive-behavioral therapy, and surgical options.
Deep dives
Understanding the Definition of Refractory Migraine
Refractory migraine is a complex condition that lacks a universally accepted definition. While the international classification of headache disorders guides diagnoses for various migraine types, refractory migraine is not included. Proposed criteria, such as those from the European Head Exeterations, suggest that refractory migraine requires a diagnosis of migraine with debilitating headaches occurring at least eight days per month for a minimum of three months. Additionally, a patient must have tried all classes of medications with established evidence for migraine prevention, or have a clear contraindication or intolerance to these medications.
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