Management of Migraine Headache in the Emergency Department

Carrie E Robertson; David F Black; Jerry W Swanson

doi:10.1055/s-0030-1249228

Seminars in Neurology, Table of Contents

Semin Neurol 2010; 30(2): 201-211
DOI: 10.1055/s-0030-1249228

Management of Migraine Headache in the Emergency Department

Carrie E. Robertson¹ , David F. Black² , Jerry W. Swanson¹

¹Department of Neurology, Mayo Clinic, Rochester, Minnesota
²Department of Radiology, Mayo Clinic, Rochester, Minnesota

Abstract

ABSTRACT

Headache is one of the more common reasons for adults to visit an emergency department. Most of these visits are for primary headache disorders, most commonly migraine headache. The authors discuss management options for patients presenting to the emergency department with prolonged, severe, or refractory migraine headaches. Particular attention is given to parenteral treatments and protocols that would not be options as an outpatient. The epidemiology, investigation, and outpatient management of migraine headache are discussed in other articles in this issue.

KEYWORDS

Headache - migraine - status migrainosus - triptan - dihydroergotamine

Full Text

References

REFERENCES

1 Pitts S R, Niska R W, Xu J, Burt C W. National Hospital Ambulatory Medical Care Survey: 2006 emergency department summary. Natl Health Stat Report. 2008; (7) 1-38
2 Goldstein J N, Camargo Jr C A, Pelletier A J, Edlow J A. Headache in United States emergency departments: demographics, work-up and frequency of pathological diagnoses. Cephalalgia. 2006; 26(6) 684-690
3 Friedman B W, Hochberg M L, Esses D et al.. Applying the International Classification of Headache Disorders to the emergency department: an assessment of reproducibility and the frequency with which a unique diagnosis can be assigned to every acute headache presentation. Ann Emerg Med. 2007; 49(4) 409-419 e1-e9
4 Silberstein S D, Freitag F G, Bigal M E. Migraine treatment. In: Silberstein SD, Lipton RB, Dodick DW Wolff's Headache. 8th ed. Oxford; Oxford University Press 2008
5 Vinson D R, Drotts D L. Diphenhydramine for the prevention of akathisia induced by prochlorperazine: a randomized, controlled trial. Ann Emerg Med. 2001; 37(2) 125-131
6 Lake C R, Casey D E, McEvoy J P, Siris S G, Boyer W F, Simpson G. Anticholinergic prophylaxis in young adults treated with neuroleptic drugs. Psychopharmacol Bull. 1986; 22(3) 981-984
7 Silberstein S D, Young W B, Mendizabal J E, Rothrock J F, Alam A S. Acute migraine treatment with droperidol: A randomized, double-blind, placebo-controlled trial. Neurology. 2003; 60(2) 315-321
8 Wang S J, Silberstein S D, Young W B. Droperidol treatment of status migrainosus and refractory migraine. Headache. 1997; 37(6) 377-382
9 Weaver C S, Jones J B, Chisholm C D et al.. Droperidol vs prochlorperazine for the treatment of acute headache. J Emerg Med. 2004; 26(2) 145-150
10 Miner J R, Fish S J, Smith S W, Biros M H. Droperidol vs. prochlorperazine for benign headaches in the emergency department. Acad Emerg Med. 2001; 8(9) 873-879
11 Jones J, Sklar D, Dougherty J, White W. Randomized double-blind trial of intravenous prochlorperazine for the treatment of acute headache. JAMA. 1989; 261(8) 1174-1176
12 Coppola M, Yealy D M, Leibold R A. Randomized, placebo-controlled evaluation of prochlorperazine versus metoclopramide for emergency department treatment of migraine headache. Ann Emerg Med. 1995; 26(5) 541-546
13 Jones J, Pack S, Chun E. Intramuscular prochlorperazine versus metoclopramide as single-agent therapy for the treatment of acute migraine headache. Am J Emerg Med. 1996; 14(3) 262-264
14 Tanen D A, Miller S, French T, Riffenburgh R H. Intravenous sodium valproate versus prochlorperazine for the emergency department treatment of acute migraine headaches: a prospective, randomized, double-blind trial. Ann Emerg Med. 2003; 41(6) 847-853
15 Seim M B, March J A, Dunn K A. Intravenous ketorolac vs intravenous prochlorperazine for the treatment of migraine headaches. Acad Emerg Med. 1998; 5(6) 573-576
16 Sun-Edelstein C, Mauskop A. Role of magnesium in the pathogenesis and treatment of migraine. Expert Rev Neurother. 2009; 9(3) 369-379
17 Bigal M E, Bordini C A, Speciali J G. Intravenous chlorpromazine in the acute treatment of episodic tension-type headache: a randomized, placebo controlled, double-blind study. Arq Neuropsiquiatr. 2002; 60(3-A, 3-A) 537-541
18 Bell R, Montoya D, Shuaib A, Lee M A. A comparative trial of three agents in the treatment of acute migraine headache. Ann Emerg Med. 1990; 19(10) 1079-1082
19 Kelly A M, Walcynski T, Gunn B. The relative efficacy of phenothiazines for the treatment of acute migraine: a meta-analysis. Headache. 2009; 49(9) 1324-1332
20 Colman I, Brown M D, Innes G D, Grafstein E, Roberts T E, Rowe B H. Parenteral metoclopramide for acute migraine: meta-analysis of randomised controlled trials. BMJ. 2004; 329(7479) 1369-1373
21 Ellis G L, Delaney J, DeHart D A, Owens A. The efficacy of metoclopramide in the treatment of migraine headache. Ann Emerg Med. 1993; 22(2) 191-195
22 Tek D S, McClellan D S, Olshaker J S, Allen C L, Arthur D C. A prospective, double-blind study of metoclopramide hydrochloride for the control of migraine in the emergency department. Ann Emerg Med. 1990; 19(10) 1083-1087
23 Rapoport A M, Silberstein S D. Emergency treatment of headache. Neurology. 1992; 42(3, Suppl 2) 43-44
24 Perry C M, Markham A. Sumatriptan. An updated review of its use in migraine. Drugs. 1998; 55(6) 889-922
25 Lobo B L, Cooke S C, Landy S H. Symptomatic pharmacotherapy of migraine. Clin Ther. 1999; 21(7) 1118-1130
26 Salonen R, Scott A. Triptans: do they differ?. Curr Pain Headache Rep. 2002; 6(2) 133-139
27 Mett A, Tfelt-Hansen P. Acute migraine therapy: recent evidence from randomized comparative trials. Curr Opin Neurol. 2008; 21(3) 331-337
28 Tfelt-Hansen P, De Vries P, Saxena P R. Triptans in migraine: a comparative review of pharmacology, pharmacokinetics and efficacy. Drugs. 2000; 60(6) 1259-1287
29 Rapoport A M, Tepper S J, Bigal M E, Sheftell F D. The triptan formulations: how to match patients and products. CNS Drugs. 2003; 17(6) 431-447
30 Silberstein S D, McCrory D C. Ergotamine and dihydroergotamine: history, pharmacology, and efficacy. Headache. 2003; 43(2) 144-166
31 Raskin N H. Treatment of status migrainosus: the American experience. Headache. 1990; 30(Suppl 2) 550-553
32 Ford R G, Ford K T. Continuous intravenous dihydroergotamine in the treatment of intractable headache. Headache. 1997; 37(3) 129-136
33 Swidan S Z, Lake III A E, Saper J R. Efficacy of intravenous diphenhydramine versus intravenous DHE-45 in the treatment of severe migraine headache. Curr Pain Headache Rep. 2005; 9(1) 65-70
34 Saadah H A. Abortive migraine therapy in the office with dexamethasone and prochlorperazine. Headache. 1994; 34(6) 366-370
35 Jakubowski M, Levy D, Goor-Aryeh I, Collins B, Bajwa Z, Burstein R. Terminating migraine with allodynia and ongoing central sensitization using parenteral administration of COX1/COX2 inhibitors. Headache. 2005; 45(7) 850-861
36 Krymchantowski A V. The use of combination therapies in the acute management of migraine. Neuropsychiatr Dis Treat. 2006; 2(3) 293-297
37 Brandes J L, Kudrow D, Stark S R et al.. Sumatriptan-naproxen for acute treatment of migraine: a randomized trial. JAMA. 2007; 297(13) 1443-1454
38 Baden E Y, Hunter C J. Intravenous dexamethasone to prevent the recurrence of benign headache after discharge from the emergency department: a randomized, double-blind, placebo-controlled clinical trial. CJEM. 2006; 8(6) 393-400
39 Rowe B H, Colman I, Edmonds M L, Blitz S, Walker A, Wiens S. Randomized controlled trial of intravenous dexamethasone to prevent relapse in acute migraine headache. Headache. 2008; 48(3) 333-340
40 Fiesseler F W, Shih R, Szucs P et al.. Steroids for migraine headaches: a randomized double-blind, two-armed, placebo-controlled trial. J Emerg Med. 2009; , October 19 (Epub ahead of print)
41 Singh A, Alter H J, Zaia B. Does the addition of dexamethasone to standard therapy for acute migraine headache decrease the incidence of recurrent headache for patients treated in the emergency department? A meta-analysis and systematic review of the literature. Acad Emerg Med. 2008; 15(12) 1223-1233
42 Colman I, Friedman B W, Brown M D et al.. Parenteral dexamethasone for acute severe migraine headache: meta-analysis of randomised controlled trials for preventing recurrence. BMJ. 2008; 336(7657) 1359-1361
43 Gallagher R M. Emergency treatment of intractable migraine. Headache. 1986; 26(2) 74-75
44 Rozen T D. Acute therapy for migraine headaches. Semin Neurol. 2006; 26(2) 181-187
45 Edwards K R, Norton J, Behnke M. Comparison of intravenous valproate versus intramuscular dihydroergotamine and metoclopramide for acute treatment of migraine headache. Headache. 2001; 41(10) 976-980
46 Mathew N T, Kailasam J, Meadors L, Chernyschev O, Gentry P. Intravenous valproate sodium (depacon) aborts migraine rapidly: a preliminary report. Headache. 2000; 40(9) 720-723
47 Cete Y, Dora B, Ertan C, Ozdemir C, Oktay C. A randomized prospective placebo-controlled study of intravenous magnesium sulphate vs. metoclopramide in the management of acute migraine attacks in the emergency department. Cephalalgia. 2005; 25(3) 199-204
48 Corbo J, Esses D, Bijur P E, Iannaccone R, Gallagher E J. Randomized clinical trial of intravenous magnesium sulfate as an adjunctive medication for emergency department treatment of migraine headache. Ann Emerg Med. 2001; 38(6) 621-627
49 Bigal M E, Bordini C A, Tepper S J, Speciali J G. Intravenous magnesium sulphate in the acute treatment of migraine without aura and migraine with aura. A randomized, double-blind, placebo-controlled study. Cephalalgia. 2002; 22(5) 345-353
50 Mauskop A, Altura B T, Cracco R Q, Altura B M. Intravenous magnesium sulfate rapidly alleviates headaches of various types. Headache. 1996; 36(3) 154-160
51 Friedman B W, Kapoor A, Friedman M S, Hochberg M L, Rowe B H. The relative efficacy of meperidine for the treatment of acute migraine: a meta-analysis of randomized controlled trials. Ann Emerg Med. 2008; 52(6) 705-713
52 Ho T W, Mannix L K, Fan X MK-0974 Protocol 004 study group et al. Randomized controlled trial of an oral CGRP receptor antagonist, MK-0974, in acute treatment of migraine. Neurology. 2008; 70(16) 1304-1312
53 Ho T W, Ferrari M D, Dodick D W et al.. Efficacy and tolerability of MK-0974 (telcagepant), a new oral antagonist of calcitonin gene-related peptide receptor, compared with zolmitriptan for acute migraine: a randomised, placebo-controlled, parallel-treatment trial. Lancet. 2008; 372(9656) 2115-2123
54 Connor K M, Shapiro R E, Diener H C et al.. Randomized, controlled trial of telcagepant for the acute treatment of migraine. Neurology. 2009; 73(12) 970-977
55 Petersen K A, Birk S, Lassen L H et al.. The CGRP-antagonist, BIBN4096BS does not affect cerebral or systemic haemodynamics in healthy volunteers. Cephalalgia. 2005; 25(2) 139-147
56 Olesen J, Diener H C, Husstedt I W BIBN 4096 BS Clinical Proof of Concept Study Group et al. Calcitonin gene-related peptide receptor antagonist BIBN 4096 BS for the acute treatment of migraine. N Engl J Med. 2004; 350(11) 1104-1110
57 Villalon C M, Olesen J. The role of CGRP in the pathophysiology of migraine and efficacy of CGRP receptor antagonists as acute antimigraine drugs. Pharmacol Ther. 2009; 124(3) 309-323
58 Headache Classification Subcommittee of the International Headache Society . The international classification of headache disorders, 2nd edition. Cephalalgia. 2004; 24(Suppl 1) 1-160
59 Capobianco D J, Dodick D W. Diagnosis and treatment of cluster headache. Semin Neurol. 2006; 26(2) 242-259
60 The Sumatriptan Cluster Headache Study Group . Treatment of acute cluster headache with sumatriptan. N Engl J Med. 1991; 325(5) 322-326
61 Dodick D W, Capobianco D J. Treatment and management of cluster headache. Curr Pain Headache Rep. 2001; 5(1) 83-91
62 Kudrow L. Cluster Headache. Mechanisms and Management. Oxford; Oxford University Press 1980
63 Mathew N T. Cluster headache. Semin Neurol. 1997; 17(4) 313-323
64 Loder E. Migraine in pregnancy. Semin Neurol. 2007; 27(5) 425-433
65 Menon R, Bushnell C D. Headache and pregnancy. Neurologist. 2008; 14(2) 108-119
66 Briggs G G, Freeman R K, Yaffe S J. Drugs in Pregnancy and Lactation. 8th ed. Philadelphia; Lippincott Williams & Wilkins 2008
67 Marcus D A. Managing headache during pregnancy and lactation. Expert Rev Neurother. 2008; 8(3) 385-395
68 Olesen C, Steffensen F H, Sorensen H T, Nielsen G L, Olsen J. Pregnancy outcome following prescription for sumatriptan. Headache. 2000; 40(1) 20-24
69 Friedman B W, Hochberg M L, Esses D et al.. Recurrence of primary headache disorders after emergency department discharge: frequency and predictors of poor pain and functional outcomes. Ann Emerg Med. 2008; 52(6) 696-704
70 Gupta M X, Silberstein S D, Young W B, Hopkins M, Lopez B L, Samsa G P. Less is not more: underutilization of headache medications in a university hospital emergency department. Headache. 2007; 47(8) 1125-1133
71 Peterlin B L, Rapoport A M. Clinical pharmacology of the serotonin receptor agonist, zolmitriptan. Expert Opin Drug Metab Toxicol. 2007; 3(6) 899-911

Jerry W SwansonM.D. F.A.C.P.

Professor of Neurology, Department of Neurology

Mayo Clinic, 200 First Street SW, Rochester, MN 55905

Email: jwswanson@mayo.edu