Refractory Headaches

Persistent headaches that often fail to respond to standard treatments.

Home Conditions Refractory Migraine Headache

What is a Refractory Migraine Headache?

The term refractory migraine has been used to describe a persistent headache that is difficult to treat. It often fails to respond to standard and/or aggressive treatments. Impacted patients are generally highly disabled and experience impaired quality of life, despite optimal treatments.


A migraine is a chronic paroxysmal neurological disorder characterized by attacks of moderate or severe headache and reversible neurological and systemic symptoms. The most characteristic symptoms associated with migraine include photophobia, phonophobia, and gastrointestinal symptoms such as nausea and vomiting.


Our Comprehensive Headache Clinic specializes in expert treatment to help deliver your best quality of life.

Symptoms of a Refractory Migraine Headache

Migraine episodes can vary and may have several stages, including:

  1. Prodrome.
  2. Aura.
  3. Headache.
  4. Postdrome.

Symptoms that can occur in the prodrome stage include:

  • Mood changes
  • Difficulty focusing
  • Yawning
  • Food cravings
  • Frequent urination
  • Sensitivity to light and sound

Aura may occur in some people just before an episode. Aura can include flashing lights and other sensory symptoms. During the headache phase, a person can experience head pain described as follows:

  • Moderate to severe, possibly preventing the completion of daily activities
  • Throbbing or pounding
  • Occurs on one or both sides of the head
  • Affects the area around the eyes or cheeks
  • Worsens with physical activity

Refractory headache suffers often experience a “postdromal” phase that lasts for a day or two after the headache. The most common symptoms of this phase include:

  • Fatigue
  • Difficulty concentrating
  • Neck stiffness

Learn more about your specific Refractory Migraine Headache symptoms, and how they can be treated at The Morrison Clinic™. Schedule an e-consult.

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Ways to Avoid Refractory Headache Surgery

Refractory migraine typically responds poorly to common migraine treatments.

Refractory migraine can affect a person’s day-to-day life and be challenging to manage. However, there are many treatment options and lifestyle changes that a person can try to help manage their symptoms.

There may be certain triggers that exacerbate symptoms. The lifestyle changes listed below can help avoid potential triggers and manage migraine headaches and their syptoms more effectively.

Sleeping well: Good sleep hygiene may help reduce the severity and frequency of migraine episodes.

Exercising regularly: Getting regular exercise may help with migraine. A patient can start by trying a small amount and then building up over time. If exercise seems to be a migraine trigger, Dr. Morrison is prepared to discuss how to help you minimize this effect.

Eating regular meals: Hunger can be a migraine trigger. We recommend that patients afflicted with refractory headaches should aim to eat regular, balanced meals spaced throughout the day.

Keeping a food diary: A person can use a diary to keep track of their migraine frequency and severity to identify any possible triggers. Common foods and drinks that can trigger migraine episodes include chocolate, caffeine, and alcoholic drinks.

Managing stress: A person can try to manage their stress by undergoing cognitive behavioral therapy or learning mindfulness and relaxation techniques.

Refractory Headache Treatments

Standard treatments for migraine involve medications to reduce pain, such as nonsteroidal anti-inflammatory drugs. To help deliver your best quality of life, Dr. Morrison is experienced developing a treatment plan to prevent migraine episodes with medications, such as blood pressure medications, antidepressants, or anticonvulsants.

Treatment may also involve antiemetics, which can help manage nausea and vomiting. Some other medications that a doctor could consider for the treatment of refractory migraine include:

Dihydroergotamine (DHE): DHE comes in several forms, including a nasal spray, oral pills, and an IV injection.

IV magnesium sulfate: For migraines with aura.

Corticosteroids: This treatment can be administered through an IV line or give it as an oral pill.

Anti calcitonin gene-related peptides (CGRP): A doctor administers these treatments as injections under the skin, with the exception of eptinezumab, which involves an IV infusion.

Neuromodulation: This treatment involves a handheld or implanted device that can regulate activity in the nervous system that contributes to migraine. There are currently four devices with Food and Drug Administration (FDA) approval that target different areas to treat migraine episodes.

Schedule an e-consult with Dr. Morrison to discuss your Refractory Headache treatment options today.

Refractory Headache Prognosis

Symptoms generally last from two to 10 days, they can persist for several weeks. Our neurosurgeons may prescribe various treatments to help alleviate the headache pain, as well as the side effects associated with withdrawal from medications.

Refractory migraine headaches can be very challenging to treat although our South Florida neurosurgery clinic has a proven track record of doing so effectively. However, condition awareness and lifestyle changes are proven to help you reduce the severity of your migraine episodes.

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Immediately following surgery, I was standing and walking pain free. I am enjoying my life again and have Dr. Morrison to thank!

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We’ll educate you on your specific migraine symptoms, and develop a plan for your best quality of life.