Abstract
Physicians, researchers and clinical trial developers from around the world, working in the headache field, speak a common language based on the International Classification of Headache Disorders (ICHD). The current ICHD-3 does not include a definition of refractoriness for primary headaches. To fill the gap, the European Headache Federation (EHF) developed new consensus criteria for refractory chronic migraine (rCM) and refractory chronic cluster headache (rCCH) particularly for the purposes of randomized-controlled trials (RCTs) involving experimental medications and neuromodulation, but they may also help for referral from a primary care provider to a headache specialist and for medical cost reimbursement. EHF definitions of rCM and rCCH have to be considered as a useful and mandatory tool in any multidisciplinary or innovative therapeutic approach.
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References
Headache Classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia. 1988;8(Suppl 7):1–96.
Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia. 2004;24(Suppl 1):9–160.
Headache Classification Committee, Olesen J, Bousser MG, Diener HC, Dodick D, First M, Goadsby PJ, Göbel H, Lainez MJ, Lance JW, Lipton RB, Nappi G, Sakai F, Schoenen J, Silberstein SD, Steiner TJ. New appendix criteria open for a broader concept of chronic migraine. Cephalalgia. 2006;26(6):742–6.
Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013;33(9):629–808.
Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1–211.
Martelletti P, Jensen RH, Antal A, Arcioni R, Brighina F, de Tommaso M, Franzini A, Fontaine D, Heiland M, Jürgens TP, Leone M, Magis D, Paemeleire K, Palmisani S, Paulus W, May A. Neuromodulation of chronic headaches: position statement from the European Headache Federation. J Headache Pain. 2013;14:86.
EA S, Peterlin BL, Lake AE 3rd, Lipton RB, Hanlon A, Siegel S, Levin M, Goadsby PJ, Markley HG. Defining refractory migraine: results of the RHSIS survey of American Headache Society members. Headache. 2009;49(4):509–18.
Reisman EE Jr. The use of experimental suppositories in treating refractory migraine. Am Pract Dig Treat. 1952;3(4):308–10.
Levin M. Refractory headache: classification and nomenclature. Headache. 2008;48:783–90.
Martelletti P, Katsarava Z, Lampl C, Magis D, Bendtsen L, Negro A, Russell MB, Mitsikostas DD, Jensen RH. Refractory chronic migraine: a consensus statement on clinical definition from the European Headache Federation. J Headache Pain. 2014;15:47.
Mitsikostas DD, Edvinsson L, Jensen RH, Katsarava Z, Lampl C, Negro A, Osipova V, Paemeleire K, Siva A, Valade D, Martelletti P. Refractory chronic cluster headache: a consensus statement on clinical definition from the European Headache Federation. J Headache Pain. 2014;15:79.
Negro A, D’Alonzo L, Martelletti P. Chronic migraine: comorbidities, risk factors, and rehabilitation. Intern Emerg Med. 2010;5(Suppl 1):S13–9.
Mitsikostas DD, Thomas AM. Comorbidity of headache and depressive disorders. Cephalalgia. 1999;19(4):211–7.
Rozen TD, Fishman RS. Cluster headache in the United States of America: demographics, clinical characteristics, triggers, suicidality, and personal burden. Headache. 2012;52:99–113.
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Negro, A., Mitsikostas, D.D. (2020). Definition of Refractory Chronic Headache. In: Lambru, G., Lanteri-Minet, M. (eds) Neuromodulation in Headache and Facial Pain Management. Headache. Springer, Cham. https://doi.org/10.1007/978-3-030-14121-9_2
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