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Headache Medicine Connections


Headache Medicine Connections

Year: 2022, Volume: 2, Issue: 3, Pages: 1-4

Original Article

World Headache Society’s Definition of Refractory Migraine

Received Date:25 September 2022, Accepted Date:28 October 2022, Published Date:03 November 2022


To expand the current description of refractory migraine, the World Headache Society advocates the use of both simple and complex definitions. Simple would be for the general use of patients and support groups, and complex for research and clinical purposes. These definitions include the roles of preventive and abortive medications, non-medication treatments, medication overuse headache (MOH), and a refractory scale to rate severity. The complex definition provides criteria for the categorization of responses to both abortives and preventives based on the availability of migraine treatments in different countries. It is suggested that refractoriness is defined as failure of adequate trials of at least 3 classes of preventives or 2 classes of abortives. For countries with limited access to both preventive and abortive therapies, the patient should have failed at least half of the available preventive classes, or all of the classes of the available abortive therapies. The rationale behind the definitions is discussed in the subsequent sections.

Keywords: Headache, Refractory, Definition, Classification, Terminology, Syndromes


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© 2022 Published by World Headache Society. This is an open-access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/)


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