The term refractory migraine has been used to describe persistent headache that is difficult to treat or fails to respond to standard and/or aggressive treatments. This subgroup of migraine patients are generally highly disabled and experience impaired quality of life, despite optimal treatments. Several definitions and criteria for refractory migraine have been published, but as yet, an accepted or established definition is not available. This article reviews the published criteria and proposes a new set of criteria. The epidemiology, pathophysiology and management options are also reviewed.

中文翻译：

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识别和管理难治性偏头痛：障碍和机遇？

术语难治性偏头痛已用于描述难以治疗或对标准和/或积极治疗无反应的持续性头痛。尽管进行了最佳治疗，该偏头痛患者亚组通常高度残疾并且生活质量受损。一些难治性偏头痛的定义和标准已经公布，但目前还没有一个公认的或既定的定义。本文回顾了已发布的标准并提出了一套新的标准。还审查了流行病学、病理生理学和管理方案。