$refractory migraine with aura icd 10$

Identification of biomarkers for refractory migraine has the potential to stimulate research into disease-modifying agents. There are currently no biological markers that predict migraine progression. Whether these factors are also important in refractory migraine is unclear. Migraineurs with major depression reported physical and sexual abuse in higher frequencies compared with those without depression. Migraine is a progressive disorder in some patients and modifiable risk factors for progression include obesity, caffeine, medication, overuse, and sleep problems. It would be useful to identify the risk factors for developing refractory migraine. Defining and studying this group will enable characterisation of the current patterns of treatments and possibly help identify the best treatment modalities. The most effective treatment for refractory migraine, whether there should be various levels of triage, and who should be assigned to what level, remains unclear. This may include a multidisciplinary approach, utilizing behavioural medicine and psychological support. The headache characteristics, drug usage, disability status and comorbid features are often used to stage illness and triaging of patients to the proper level of care. Improved recognition of refractory migraine will help patients obtain the appropriate level of care. It is unknown whether there are differences in the clinical phenotype, genetic makeup, or serum and neuroimaging biomarkers of refractory patients compared to those who are responsive to treatments. In the Refractory Headache Survey conducted by the AHS, the estimated prevalence of refractory migraine in responders’ practice ranged from “less than 5%” to “greater than 31%” (median 5–10%). The epidemiology of refractory migraine in population samples is unknown and the unmet medical need of the patients is largely undefined. A widely accepted definition of refractory migraine will allow better characterization of the disorder and enable identification of the optimum therapeutic strategy. There are numerous reasons to better define and characterize refractory migraine. They require adequate treatment of psychiatric or other comorbidities by a multidisciplinary team, if available, but acute treatments and degree of disability were not included in these criteria.Īn overview of these proposals reveals that there is a lack of consensus on the definition of refractory migraine as well as the factors included in their operational criteria (see Table 1). These criteria are restricted to CM and require the failure of three classes of preventive treatments. The European Headache Federation (EHF) provided a consensus statement on the definition of chronic migraine (CM) in 2014. They build upon the AHS criteria, proposing a graded classification scheme for intractability to acute and preventive treatments as well as rating of headache-related disability. Silberstein et al proposed a definition for pharmacologically intractable headache in 2010. Medication overuse and degree of disability were included as modifiers.

$refractory migraine with aura icd 10$

In addition, patients needed to fail 3 classes of acute treatments. These criteria required only failure of two classes of preventive treatments. In 2008, the Refractory Headache Special Interest Section (RHSIS) of the American Headache Society (AHS) definition of refractory migraine were published. Acute treatments and degree of disability were not included in these criteria. It required the failure of four preventive drugs applicable to the type of headache being treated. Goadsby et al proposed a definition of intractable migraine and cluster headaches in 2006. Over the last decade there have been several attempts to define refractory migraine albeit that there is still a lack of consensus on this issue. However, little attention was subsequently paid to this term until just over a decade ago.

$refractory migraine with aura icd 10$

The term “refractory migraine” was first used by Reisman in 1952 when he reported the use of suppositories of ergot-alkaloids to treat migraine.

$refractory migraine with aura icd 10$

Refractory migraine with aura icd 10