Emergency department and inpatient management of status migrainosus and intractable headache

Research output: Contribution to journalReview article

15 Scopus citations

Abstract

Purpose of Review: This article discusses the treatment of status migrainosus in the emergency department and the treatment of intractablemigraine in an inpatient setting. Recent Findings: Multiple agents of various drug classes have been tried for the treatment of acute migraine in the emergency department, but few have adequate medical evidence to support their use. Opioids, which are less effective than other medications used for the acute treatment of migraine and also carry the risk of adverse CNS side effects, habituation, and addiction, have been prescribed for migraine in the emergency department at an increasing rate over the last decade, which is a worrisome trend. Very few patientswithmigraine derive sustained relief from pain after emergency department treatment, and most have a high frequency of headache recurrence. Summary: Treatment of status migrainosus and intractable migraine should focus on adequate fluid hydration and combination IV therapywithmultiple nonopioid medications from multiple drug classes. Dopamine receptor antagonists appear to have some of the highest medical evidence for efficacy.

Original languageEnglish (US)
Pages (from-to)1004-1017
Number of pages14
JournalCONTINUUM Lifelong Learning in Neurology
Volume21
Issue number4
DOIs
StatePublished - Aug 1 2015
Externally publishedYes

ASJC Scopus subject areas

  • Clinical Neurology
  • Genetics(clinical)

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