Refractory Migraine: Mechanisms and Management

Elliot A. Schulman, FACP, MD · Morris Levin, MD · Alvin E. Lake, III., PhD · Elizabeth Loder, MPH, MD

ago 2010 · Oxford University Press

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A must-have book for any health professional who treats patients with headache disorders, Refractory Migraine is written by international experts from the world's top headache centers. It describes how they approach the treatment of migraine patients who continue to suffer despite appropriate medical treatment. First, it highlights current ideas about the definition and characterization of refractory migraine, and reviews underlying causes and contributing factors. Then, individual chapters cover every important aspect of migraine treatment with the focus entirely on refractory forms of the disorder. Its many features include detailed algorithms for outpatient and inpatient withdrawal from overused medications, innovative drug therapy and nonpharmacological treatments, a list of questions to ask before deciding to try hormonal therapies, and detailed descriptions of how to recognize and interact with patients who have challenging personality disorders or concomitant psychiatric problems. We're confident you'll often turn to this book for advice about challenges in migraine management. When you do, the bulleted lists and boxes that highlight and condense the main messages of each chapter put the information you need at your fingertips. If you treat patients with migraine, you will recognize many of the challenging situations and topics covered in this book - and you will be encouraged by the innovative and resourceful therapeutic strategies suggested by seasoned headache doctors with a wealth of clinical experience. Readable, comprehensive and up to date, this book gives you access to ingenious treatment approaches developed and refined in specialty headache clinics that regularly - and successfully - treat patients with refractory headache problems. When you meet the next migraine patient who says "I've tried it all, and nothing works", you will know where to go for practical advice about what to do next.

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Dr. Schulman is in the Department of Headache Management and General Neurology at Lankenau Hospital in Wynnewood, PA. He is also an Adjunct Clinical Professor of Neurology at Jefferson School of Medicine in Philadelphia, PA. Dr. Levin is an Associate Professor of Medicine in the Section of Neurology at Dartmouth Medical School, in Hanover, New Hampshire, USA. He is also Associate Professor of Psychiatry at Dartmouth Medical School. He is the Co-Director of the Dartmouth Headache Clinic. He is director of the Dartmouth Neurology Residency Training Program. He also directs the Dartmouth Headache Fellowship training program and is the director of the Dartmouth Medical School student clerkship in neurology. Dr. Lake, III is the Division Director for Behavioral Medicine at the Michigan Head-Pain & Neurological Institute in Ann Arbor, MI. Dr. Loder is the Chief, Division of Headache and Pain, for the Department of Neurology at Brigham and Women's Hospital in Boston, MA.