TY - JOUR
T1 - Defining the pharmacologically intractable headache for clinical trials and clinical practice
AU - Silberstein, Stephen D.
AU - Dodick, David W.
AU - Pearlman, Starr
PY - 2010/10
Y1 - 2010/10
N2 - The terms refractory headache and intractable headache have been used interchangeably to describe persistent headache that is difficult to treat or fails to respond to standard and/or aggressive treatment modalities. A variety of definitions of intractability have been published, but as yet, an accepted/established definition is not available. To advance clinical and basic research in this population of patients, a universal and graded classification scheme of intractability is needed, and must include a definition of failure, to which and how many treatments the patient has failed, the level of headache-related disability, and finally, the intended intervention (clinical or research) and intensity of the intervention. This paper addresses each of these variables with the intent of providing a graded classification scheme that can be used in defining intractability for clinical practice interventions and clinical research initiatives.
AB - The terms refractory headache and intractable headache have been used interchangeably to describe persistent headache that is difficult to treat or fails to respond to standard and/or aggressive treatment modalities. A variety of definitions of intractability have been published, but as yet, an accepted/established definition is not available. To advance clinical and basic research in this population of patients, a universal and graded classification scheme of intractability is needed, and must include a definition of failure, to which and how many treatments the patient has failed, the level of headache-related disability, and finally, the intended intervention (clinical or research) and intensity of the intervention. This paper addresses each of these variables with the intent of providing a graded classification scheme that can be used in defining intractability for clinical practice interventions and clinical research initiatives.
KW - clinical trial
KW - intractable headache
KW - migraine
KW - refractory headache
UR - http://www.scopus.com/inward/record.url?scp=77957738937&partnerID=8YFLogxK
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U2 - 10.1111/j.1526-4610.2010.01764.x
DO - 10.1111/j.1526-4610.2010.01764.x
M3 - Review article
C2 - 20958296
AN - SCOPUS:77957738937
SN - 0017-8748
VL - 50
SP - 1499
EP - 1506
JO - Headache
JF - Headache
IS - 9
ER -