Refractory headache basically is “what to do for difficult, frequent headaches when things have not easily worked”. I started the Refractory Headache Section of the American Headache Society 11 years ago; we have spent a decade defining refractory headache(my new article, a 10 year study on refractory headaches using a unique refractory scale, is on homepage here on this site, and is open access on The Journal of Headache and Pain).
There are many subsets to the topic of refractory headaches: refractory to preventives and refractory to abortives…..adolescent refractory headaches….refractory in older folks(after age 65, for instance)….pathophysiology(or, what is going on in the nervous system in refractory patients..including neuroimaging, such as fMRI and DTI)….Treatment, both inpt. and outpt(I have published extensively on these options, some of which is on this site…opioids/MAOI’s/Botox/Stimulants/Daily Triptans)……and the role of medication overuse. Medication overuse must be distinguished from Medication Overuse Headache, which is much different..some overuse the meds but do not have rebound, or withdrawal, headache from the drugs/caffeine overuse. More on this later on…
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