Resistant and refractory migraine: clinical presentation, pathophysiology, and management
Summary: Migraine is a leading cause of disability worldwide. A minority of individuals with migraine develop resistant or refractory conditions characterised by ≥ 8 monthly days of debilitating headaches and inadequate response, intolerance, or contraindication to ≥3 or all preventive drug classes,...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-01-01
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| Series: | EBioMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352396423005091 |
| _version_ | 1797377869801848832 |
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| author | Raffaele Ornello Anna P. Andreou Eleonora De Matteis Tim P. Jürgens Mia T. Minen Simona Sacco |
| author_facet | Raffaele Ornello Anna P. Andreou Eleonora De Matteis Tim P. Jürgens Mia T. Minen Simona Sacco |
| author_sort | Raffaele Ornello |
| collection | DOAJ |
| description | Summary: Migraine is a leading cause of disability worldwide. A minority of individuals with migraine develop resistant or refractory conditions characterised by ≥ 8 monthly days of debilitating headaches and inadequate response, intolerance, or contraindication to ≥3 or all preventive drug classes, respectively. Resistant and refractory migraine are emerging clinical definitions stemming from better knowledge of the pathophysiology of migraine and from the advent of migraine-specific preventive treatments. Resistant migraine mostly results from drug failures, while refractory migraine has complex and still unknown mechanisms that impair the efficacy of preventive treatments. Individuals with resistant migraine can be treated with migraine-specific preventive drugs. The management of refractory migraine is challenging and often unsuccessful, being based on combinations of different drugs and non-pharmacological treatment. Future research should aim to identify individuals at risk of developing treatment failures, prevent the condition, investigate the mechanisms of refractoriness to treatments, and find effective treatment strategies. |
| first_indexed | 2024-03-08T19:59:34Z |
| format | Article |
| id | doaj.art-d58613bd500946509c4df158a26e2d39 |
| institution | Directory Open Access Journal |
| issn | 2352-3964 |
| language | English |
| last_indexed | 2024-03-08T19:59:34Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EBioMedicine |
| spelling | doaj.art-d58613bd500946509c4df158a26e2d392023-12-24T04:45:51ZengElsevierEBioMedicine2352-39642024-01-0199104943Resistant and refractory migraine: clinical presentation, pathophysiology, and managementRaffaele Ornello0Anna P. Andreou1Eleonora De Matteis2Tim P. Jürgens3Mia T. Minen4Simona Sacco5Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, ItalyHeadache Research-Wolfson CARD, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Headache Centre, Guy's and St Thomas' NHS Foundation Trust, London, UKDepartment of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, ItalyHeadache Center North-East, Department of Neurology, University Medical Center Rostock, Rostock, Germany; Department of Neurology, KMG Hospital Güstrow, Güstrow, GermanyDepartments of Neurology and Population Health, NYU Langone Health, New York, USADepartment of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy; Corresponding author. Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy.Summary: Migraine is a leading cause of disability worldwide. A minority of individuals with migraine develop resistant or refractory conditions characterised by ≥ 8 monthly days of debilitating headaches and inadequate response, intolerance, or contraindication to ≥3 or all preventive drug classes, respectively. Resistant and refractory migraine are emerging clinical definitions stemming from better knowledge of the pathophysiology of migraine and from the advent of migraine-specific preventive treatments. Resistant migraine mostly results from drug failures, while refractory migraine has complex and still unknown mechanisms that impair the efficacy of preventive treatments. Individuals with resistant migraine can be treated with migraine-specific preventive drugs. The management of refractory migraine is challenging and often unsuccessful, being based on combinations of different drugs and non-pharmacological treatment. Future research should aim to identify individuals at risk of developing treatment failures, prevent the condition, investigate the mechanisms of refractoriness to treatments, and find effective treatment strategies.http://www.sciencedirect.com/science/article/pii/S2352396423005091Resistant migraineRefractory migraineCGRPNon-pharmacological treatmentsMigraine-related disability |
| spellingShingle | Raffaele Ornello Anna P. Andreou Eleonora De Matteis Tim P. Jürgens Mia T. Minen Simona Sacco Resistant and refractory migraine: clinical presentation, pathophysiology, and management EBioMedicine Resistant migraine Refractory migraine CGRP Non-pharmacological treatments Migraine-related disability |
| title | Resistant and refractory migraine: clinical presentation, pathophysiology, and management |
| title_full | Resistant and refractory migraine: clinical presentation, pathophysiology, and management |
| title_fullStr | Resistant and refractory migraine: clinical presentation, pathophysiology, and management |
| title_full_unstemmed | Resistant and refractory migraine: clinical presentation, pathophysiology, and management |
| title_short | Resistant and refractory migraine: clinical presentation, pathophysiology, and management |
| title_sort | resistant and refractory migraine clinical presentation pathophysiology and management |
| topic | Resistant migraine Refractory migraine CGRP Non-pharmacological treatments Migraine-related disability |
| url | http://www.sciencedirect.com/science/article/pii/S2352396423005091 |
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