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Published on: June 2, 2014
Refractory migraine in a headache clinic population
Pablo Irimia1, Jose-Alberto Palma, Roberto Fernandez-Torron
1Department of Neurology, Headache Unit, University Clinic of Navarra, Av, Pio XII, 36, Pamplona 31008, Spain. pirimia@unav.es
BMC Neurology
|August 3, 2011
Summary
Refractory migraine affects 5.1% of patients in headache units. This disabling condition, characterized by high disability scores, requires specific diagnostic criteria for effective treatment and research.
Area of Science:
- Neurology
- Clinical Neuroscience
- Headache Medicine
Background:
- Migraineurs often present with treatment-resistant headaches.
- Epidemiology of refractory migraine was previously unclear due to lack of diagnostic criteria.
- Recent advancements provided criteria for identifying refractory migraine.
Purpose of the Study:
- To determine the frequency of refractory migraine in a tertiary care headache unit.
- To apply recently proposed diagnostic criteria for refractory migraine.
- To characterize refractory migraine patients.
Main Methods:
- A consecutive sample of 370 new patients in a headache unit was analyzed.
- Data collected included clinical features, treatment history, and final diagnosis.
- Migraine Disability Assessment Score (MIDAS) was used to assess disability.
Main Results:
- Refractory migraine was identified in 5.1% of the patient cohort.
- Migraine and tension-type headache were diagnosed in 46.4% and 20.5% of patients, respectively.
- Refractory migraine patients had a mean MIDAS score of 96, with 36.8% being medication-overusers.
Conclusions:
- Refractory migraine is a common and highly disabling condition in specialized headache centers.
- The proposed criteria aid in identifying patients needing specialized care or advanced treatments.
- These criteria can facilitate clinical studies and treatment selection for refractory migraine.
