Abstract
Management of the patient with status migrainosus in the emergency department includes a multimodal therapeutic arsenal seeking to improve pain and to reduce recurrence; the majority of patients respond to enhanced initial management, but in non-negligible cases this result is not obtained with first-line medications and the use of other medications and therapeutic options is necessary, including: pericranial blocks, lidocaine, levetiracetam, propofol and in selected cases the use of opioids. In this review we present a clinical case of migraine that does not improve in the initial management in the emergency department and requires the use of other options for management.
References
Avcu N, Dogan NO, Pekdemir M, Yaka E, Yiknaz S, Alyesil C, et al. Intranasal lidocaine in acute treatment of migraine: a randomized controlled trial. Ann Emerg Med. 2017;69(6):743-51.
Swidan SZ, Lake AE III, Saper JR. Efficacy of intravenous diphenhydramine versus intravenous DHE-45 in the treatment of severe migraine headache. Curr Pain Headache Rep. 2005;9(1):65-70.
Williams DR, Stark RJ. Intravenous lignocaine (lidocaine) infusion for the treatment of chronic daily headache with substantial medication overuse. Cephalalgia. 2003;23(10):963-71.
Rosen N, Marmura M, Abbas M, Silberstein S. Intravenous lidocaine in the treatment of refractory headache: a retrospective case series. Headache. 2009;49(2): 286-91.
Gil-Gouveia R, Goadsby PJ. Neuropsychiatric side effects of lidocaine: examples from the treatment of headache and a review. Cephalalgia. 2006;26:1399.
Friedman B. Migraine in the Emergency Department. Neurol Clin. 2019;37:743-52.
Friedman BW, West J, Vinson DR, Minen M, Restivo A, Gallagher E. Current management of migraine in US emergency departments: an analysis of the National Hospital Ambulatory Medical Care Survey. Cephalalgia. 2015;35(4):301-9.
Friedman BW, Kapoor A, Friedman MS, Hochberg ML, Rowe BH. The relative efficacy of meperidine for the treatment of acute migraine: a meta-analysis of randomized controlled trials. Ann Emerg Med. 2008;52(6):705-13.
Friedman BW, Irizarry E, Solorzano C, Latev A, Rosa K, Zias E. Randomized study of IV prochlorperazine plus diphen ramine vs IV hydromorphone for migraine. Neurology. 2017; 89(20):2075-82.
Friedman BW, Mohamed S, Robbins MS, Irizarry E, Tarsia V, Pearlman S, et al. A randomized, sham-controlled trial of bilateral greater occipital nerve blocks with bupivacaine for acute migraine patients refractory to standard emergency department treatment with metoclopramide. Headache. 2018;58(9):1427-34.
Allen SM, Mookadam F, Cha SS, Freeman JA, Staling AJ, Mookadam M. Greater occipital nerve block for acute treatment of migraine headache: A large retrospective cohort study. J Am Board Fam Med. 2018;31 (2):211-18.
Soleimanpour H, Taheraghdam A, Ghafouri RR, Taghizadiet A, Mariany K, Soleimannpour M. Improvement of refractory migraine headache by propofol: Case series. Int J EmergMed. 2012;5(1):19.
Salloum NC, Fava M, Freeman MP, Flynn M, Hoeppner B, Hock R. Efficacy of intravenous ketamine treatment in anxious versus nonanxious unipolar treatment-resistant depression. Depress Anxiety. 2019;36(3):235-43.
Pomeroy JL, Marmura MJ, Nahas SJ, Viscusi ER. Ketamine infusions for treatment refractory headache. Headache. 2017;57(2):276-82.
Etchison AR, Bos L, Ray M, McAllister K, Mohammed M, Park B. Low-dose ketamine does not improve migraine in the emergency department: a randomized placebo-controlled trial. The West J Emerg Med. 2018;19(6):952-60.hyd
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