Definition of Refractory Chronic Headache
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.
KeywordsRefractory chronic headache Refractory chronic migraine Refractory chronic cluster headache
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