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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Intractable migraine and other headache syndromes affect almost 40 million Americans and many more millions worldwide. Although many treatment protocols exist, mainly designed around medication regimens, there are estimated to be at least 3-5% of these headache sufferers that do not respond in a meaningful way to medications and whose lives can be severely restricted to darkened, quiet rooms, heavy doses of narcotics, failed personal relationships and an overwhelming sense of hopelessness. In this article, we describe current neuromodulation-based approach to the management of intractable headache.
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PMID:Occipital neurostimulation for treatment of intractable headache syndromes. 1769 68

Refractory migraine (RM) headaches pose important treatment challenges to the patients who live with them and the clinicians who try to treat them. Defined based on the lack of response to acute, preventive, and nonpharmacologic treatment, RM is often treated with a combination of treatments. Although combination therapy for RM has not been systematically studied in randomized trials, clinical experience suggests that a rational approach to RM treatment, utilizing a combination of treatments, may be effective where monotherapy has failed. In this article we briefly identify patient populations appropriate for more aggressive migraine prevention with combination therapy. We then discuss modifiable risk factors and comorbidities in migraine and then focus on the use of rational combination therapy, as well as the duration migraine preventatives should be considered for use. Future research is needed to evaluate the full potential of rational combination treatment as a strategy for treating and ultimately preventing RM.
Headache 2008 Jun
PMID:Rational combination therapy in refractory migraine. 1854 58

It is well known that some migraine patients recognize the change of their migraine characteristics over time. These patients often complain chronic daily headaches instead of episodic attacks of migraine. Such chronic headaches are resistant to medication, and called refractory or intractable migraine. Refractory migraine is a term, which has been used for many years, but until recently, there has been little attention paid to its definition. The criteria used for diagnosis of refractory migraine have varied considerably. In most circumstances, however, the definition has included a poor response to "standard" preventive medications. This review article introduces the proposed criteria for definition of refractory migraine and the therapeutic strategies against refractory migraine.
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PMID:[Diagnosis and therapies of refractory migraine]. 2227 99

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.
Headache 2013 Apr
PMID:Refractory migraine - a review. 2340 59