Hope for Refractory Chronic Migraine

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Key Questions
  • How does migraine progress from episodic to chronic, and then to refractory headache?
  • When changes occur, why is it important to keep a record of the number of days with migraine and the use of acute drugs?
  • Why will CGRP antagonists be important in the treatment of refractory migraine?
  • How is refractory migraine defined?
  • How could incorrect use of onobotulinumtoxinA lead to refractory headache?
  • Is inpatient treatment necessary for the refractory migraine patient?
  • Why is it so important to be treated by a migraine specialist?
  • How will more physicians be trained to treat migraine patients?
Interview Notes

Find more about Paolo Martelletti, MD and his work here:


Paolo Martelletti, MD

Professor & Director, Master of Headache Medicine
Sapienza University of Rome, Italy

Dr. Paolo Martelletti is director of internal medicine and of the emergency medicine ward at Sant’Andrea Hospital, and associate professor at Sapienza University of Rome. He is the past president of the European Headache Federation and the Italian Society for the Study of Headache. He has also been chairman of the World Health Organization’s global campaign against headache called Lifting The Burden. Dr. Martelletti has published over 400 articles and book chapters. He is the editor-in-chief and founder of The Journal of Headache and Pain, and has served as an editor of many other journals.

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