Migraine is one of the most common and disabling neurological disorders, yet many patients continue to experience frequent or severe symptoms despite trying multiple treatments.
In a recent Q&A with Healio, Dr. Lauren Aymen, Medical Director of MIND’s Headache & Facial Pain Center, board-certified neurologist and fellowship-trained headache medicine & facial pain specialist, shares clinical insights into managing difficult-to-treat migraine.
Dr. Aymen discusses when primary care providers and general neurologists should consider referring patients to a dedicated headache center, particularly when headaches are increasing in frequency or severity, patients are relying heavily on acute medications, or multiple preventive treatments have failed.
“Referring early allows us to intervene before high frequency becomes their permanent baseline and deep-seated disability sets in,” Dr. Aymen told Healio.
She also addresses medication-overuse headache and the importance of carefully reviewing a patient’s complete treatment history to understand why previous therapies may have failed. Rather than simply adding another medication, Dr. Aymen emphasizes developing an individualized treatment plan based on each patient’s headache pattern, triggers and overall burden.
The Q&A also explores advanced treatment options available in specialty headache practice, including Botox®, peripheral nerve blocks and infusion therapy, as well as the role of interdisciplinary care. Dr. Aymen also discusses how integrated access to MRI and neuroradiology can streamline evaluation for patients with atypical headache patterns or facial pain syndromes.
Looking ahead, Dr. Aymen shares her perspective on emerging therapies targeting pituitary adenylate cyclase-activating polypeptide (PACAP), an area of ongoing migraine research that may further expand treatment options.
Read the full interview in Healio: Q&A: How to Manage Refractory Migraine in Specialty Practice
Learn more about MIND’s Headache & Facial Pain Center and specialized migraine, headache and facial pain care: https://mindonline.com/headache-and-facial-pain-center/






























