title: Refractory migraine and chronic migraine: pathophysiological mechanisms.
abstract: Despite increased understanding of primary headaches and their treatment, the underlying causes of refractory migraine remain unknown. This note considers potential genetic, structural, functional and pharmacological factors that could contribute to this relatively intractable condition. Further understanding of refractory migraine will require the use of medical imaging technologies, clinical experimental medicine studies on novel pharmacological agents and astute observations in clinical practice to direct potential novel therapeutic approaches.
authors.affiliation: Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Goadsby
authors.forename: Richard
authors.initials: R
authors.lastname: Hargreaves
mesh_terms: D002908:Chronic Disease; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy / Q000235:genetics / Q000503:physiopathology*; D010148:Intractable Pain / Q000188:drug therapy / Q000235:genetics / Q000503:physiopathology*