Skip to main content Accessibility help
×
Hostname: page-component-7bb8b95d7b-dtkg6 Total loading time: 0 Render date: 2024-10-05T09:48:40.911Z Has data issue: false hasContentIssue false

7 - The Migraine Patient in the Emergency Department

Published online by Cambridge University Press:  09 October 2017

Serena L. Orr
Affiliation:
Children’s Hospital of Eastern Ontario, Ottawa
Benjamin W. Friedman
Affiliation:
Albert Einstein College of Medicine, New York
David W. Dodick
Affiliation:
Mayo Clinic, Phoenix, AZ
Get access

Summary

Abstract

Migraine is the most common primary headache disorder seen in the emergency department (ED). Patients with migraine present to the ED for a variety of reasons, including intolerable pain severity, failure of at-home treatment strategies, and debilitating associated symptoms. The diagnosis and management of migraine in the ED can be challenging. In this chapter, the epidemiology of migraine in the ED will be reviewed. A detailed and practical approach to the diagnosis and management of migraine in the ED will be outlined, followed by a discussion of discharge planning issues in this population.

Type
Chapter
Information
Emergency Headache
Diagnosis and Management
, pp. 65 - 79
Publisher: Cambridge University Press
Print publication year: 2017

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Smitherman, TA, Burch, R, Sheikh, H, Loder, E. The prevalence, impact, and treatment of migraine and severe headaches in the United States: a review of statistics from national surveillance studies. Headache. 2013;53(3):427–36.Google Scholar
2.Cooke, LJ, Becker, WJ. Migraine prevalence, treatment and impact: the Canadian women and migraine study. Can J Neurol Sci. 2010;37(5):580–7.Google Scholar
3.Stovner, LJ, Andree, C. Prevalence of headache in Europe: a review for the Eurolight project. J Headache Pain. 2010;11(4):289–99.CrossRefGoogle ScholarPubMed
4.Vos, T, Flaxman, AD, Naghavi, M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2163–96.Google Scholar
5.Lucado, J, Paez, K, Elixhauser, A. Headaches in US Hospitals and Emergency Departments, 2008: Statistical Brief #111. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. 2011;24:112.Google Scholar
6.Friedman, BW, Hochberg, ML, 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):409–19.Google Scholar
7.Marco, CA, Kanitz, W, Jolly, M. Pain scores among emergency department (ED) patients: comparison by ED diagnosis. J Emerg Med. 2013;44(1):4652.Google Scholar
8.Lafata, JE, Moon, C, Leotta, C, et al. The medical care utilization and costs associated with migraine headache. J Gen Intern Med. 2004;19(10):1005–12.Google Scholar
9.Bloudek, LM, Stokes, M, Buse, DC, et al. Cost of healthcare for patients with migraine in five European countries: results from the International Burden of Migraine Study (IBMS). J Headache Pain. 2012;13(5):361–78.Google Scholar
10.Sanderson, JC, Devine, EB, Lipton, RB, et al. Headache-related health resource utilisation in chronic and episodic migraine across six countries. J Neurol Neurosurg Psychiatry. 2013;84(12):1309–17.CrossRefGoogle ScholarPubMed
11.Gerth, WC, Carides, GW, Dasbach, EJ, Visser, WH, Santanello, NC. The multinational impact of migraine symptoms on healthcare utilisation and work loss. Pharmacoeconomics. 2001;19(2):197206.Google Scholar
12.Friedman, BW, Serrano, D, Reed, M, Diamond, M, Lipton, RB. Use of the emergency department for severe headache: a population-based study. Headache. 2009;49(1):2130.Google Scholar
13.Munakata, J, Hazard, E, Serrano, D, et al. Economic burden of transformed migraine: results from the American Migraine Prevalence and Prevention (AMPP) Study. Headache. 2009;49(4):498508.Google Scholar
14.Buse, DC, Pearlman, SH, Reed, ML, et al. Opioid use and dependence among persons with migraine: results of the AMPP study. Headache. 2012;52(1):1836.CrossRefGoogle ScholarPubMed
15.Colman, I, Rothney, A, Wright, S, Zilkalns, B, Rowe, BH. Use of narcotic analgesics in the emergency department treatment of migraine headache. Neurology. 2004;62(10):1695–700.Google Scholar
16.Lainez, MJA. The effect of migraine prophylaxis on migraine-related resource use and productivity. CNS Drugs. 2009;23(9):727–38.CrossRefGoogle ScholarPubMed
17.Lane, P, Nituica, C, Sorondo, B. Headache patients: who does not come to the emergency department? Acad Emerg Med. 2003;10:528.Google Scholar
18.Chan, BT, Ovens, HJ. Chronic migraineurs: an important subgroup of patients who visit emergency departments frequently. Ann Emerg Med. 2004;43(2):238–42.CrossRefGoogle ScholarPubMed
19.Wilper, A, Woolhandler, S, Himmelstein, D, Nardin, R. Impact of insurance status on migraine care in the United States: a population-based study. Neurology. 2010;74(15):1178–83.CrossRefGoogle ScholarPubMed
20.Minen, MT, Tanev, K. Influence of psychiatric comorbidities in migraineurs in the emergency department. Gen Hosp Psychiatry. 2014;36(5):533–8.Google Scholar
21.Badia, X, Magaz, S, Gutierrez, L, Galvan, J. The burden of migraine in Spain: beyond direct costs. Pharmacoeconomics. 2004;22(9):591603.Google Scholar
22.Edmeads, J, Mackell, JA. The economic impact of migraine: an analysis of direct and indirect costs. Headache. 2002;42(6):501–9.Google Scholar
23.Friedman, D, Feldon, S, Holloway, R, Fisher, S. Utilization, diagnosis, treatment and cost of migraine treatment in the emergency department. Headache. 2009;49(8):1163–73.Google Scholar
24.Insinga, RP, Ng-Mak, DS, Hanson, ME. Costs associated with outpatient, emergency room and inpatient care for migraine in the USA. Cephalalgia. 2011;31(15):1570–5.Google Scholar
25.Stokes, M, Becker, WJ, Lipton, RB, et al. Cost of health care among patients with chronic and episodic migraine in Canada and the USA: results from the International Burden of Migraine Study (IBMS). Headache. 2011;51(7):1058–77.Google Scholar
26.Minen, MT, Loder, E, Friedman, B. Factors associated with emergency department visits for migraine: an observational study. Headache. 2014;54(10):1611–18.Google Scholar
27.Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013;33(9):629808.Google Scholar
28.Trottier, ED, Bailey, B, Lucas, N, Lortie, A. Diagnosis of migraine in the pediatric emergency department. Pediatr Neurol. 2013;49(1):40–5.Google Scholar
29.Lipton, RB, Dodick, D, Sadovsky, R, et al. A self-administered screener for migraine in primary care: the ID Migraine validation study. Neurology. 2003;61(3):375–82.Google Scholar
30.Mostardini, C, d’Agostino, VC, Dugoni, DE, Cerbo, R. A possible role of ID-Migraine in the emergency department: study of an emergency department out-patient population. Cephalalgia. 2009;29(12):1326–30.Google Scholar
31.Rasmussen, B, Jensen, R, Schroll, M, Olesen, J. Epidemiology of headache in a general population: a prevalence study. J Clin Epidemiol. 1991;44(11):1147–57.CrossRefGoogle Scholar
32.Forsyth, PA, Posner, JB. Headaches in patients with brain tumors: a study of 111 patients. Neurology. 1993;43(9):1678–83.Google Scholar
33.Marcus, D. Migraine and tension-type headaches: the questionable validity of current classification systems. Clin J Pain. 1992;8:2836.Google Scholar
34.Lipton, RB, Cady, RK, Stewart, WF, Wilks, K, Hall, C. Diagnostic lessons from the spectrum study. Neurology. 2002;58(9 Suppl. 6):S27–31.Google Scholar
35.Spierings, ELH, Ranke, AH, Honkoop, PC. Precipitating and aggravating factors of migraine versus tension-type headache. Headache. 2001;41(6):554–8.Google Scholar
36.Bendtsen, L, Evers, S, Linde, M, et al. EFNS guideline on the treatment of tension-type headache: report of an EFNS task force. Eur J Neurol. 2010;17(11):1318–25.Google Scholar
37.Weinman, D, Nicastro, O, Akala, O, Friedman, BW. Parenteral treatment of episodic tension-type headache: a systematic review. Headache. 2014;54(2):260–8.Google Scholar
38.D’Amico, D, Moschiano, F, Bussone, G. Early treatment of migraine attacks with triptans: a strategy to enhance outcomes and patient satisfaction? Expert Rev Neurother. 2006;6(7):1087–97.Google Scholar
39.Friedman, BW, Greenwald, P, Bania, TC, et al. Randomized trial of IV dexamethasone for acute migraine in the emergency department. Neurology. 2007;69(22):2038–44.Google Scholar
40.Tfelt-Hansen, P, Pascual, J, Ramadan, N, et al. Guidelines for controlled trials of drugs in migraine: third edition. A guide for investigators. Cephalalgia. 2012;32(1):638.Google Scholar
41.Friedman, B. Intravenous fluids for migraine: a post-hoc analysis of clinical trial data [abstract]. Headache. 2015;55(Suppl. 3):127–87.Google Scholar
42.Colman, I, Brown, MD, Innes, GD, et al. Parenteral metoclopramide for acute migraine: meta-analysis of randomised controlled trials. BMJ. 2004;329(7479):1369–72.Google Scholar
43.Sumamo Schellenberg, E, Dryden, DM, Pasichnyk, D, et al. Acute Migraine Treatment in Emergency Settings. Comparative Effectiveness Review No. 84. Rockville, MD: Agency for Healthcare Research and Quality; 2012.Google Scholar
44.Orr, SL, Aubé, M, Becker, WJ, et al. Canadian Headache Society systematic review and recommendations on the treatment of migraine pain in emergency settings. Cephalalgia. 2015;35(3):271–84.Google Scholar
45.Taggart, E, Doran, S, Kokotillo, A, et al. Ketorolac in the treatment of acute migraine: a systematic review. Headache. 2013;53(2):277–87.Google Scholar
46.Friedman, BW, Cabral, L, Adewunmi, V, et al. Diphenhydramine as adjuvant therapy for acute migraine: an emergency department-based randomized clinical trial. Ann Emerg Med. 2016;67(1):32–9.Google Scholar
47.Friedman, BW, Corbo, J, Lipton, RB, et al. A trial of metoclopramide vs sumatriptan for the emergency department treatment of migraines. Neurology. 2005;64(3):463–8.CrossRefGoogle ScholarPubMed
48.Talabi, S, Masoumi, B, Azizkhani, R, Esmailian, M. Metoclopramide versus sumatriptan for treatment of migraine headache: a randomized clinical trial. J Res Med Sci. 2013;18(8):695–8.Google Scholar
49.Colman, I, Brown, MD, Innes, GD, et al. Parenteral dihydroergotamine for acute migraine headache: a systematic review of the literature. Ann Emerg Med. 2005;45(4):393401.Google Scholar
50.Winner, P, Ricalde, O, Le Force, B, Saper, J, Margul, B. A double-blind study of subcutaneous dihydroergotamine vs subcutaneous sumatriptan in the treatment of acute migraine. Arch Neurol. 1996;53:180–4.Google Scholar
51.Vinson, DR. Treatment patterns of isolated benign headache in US emergency departments. Ann Emerg Med. 2002;39(3):215–22.Google Scholar
52.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.Google Scholar
53.Leinisch, E, Evers, S, Kaempfe, N, et al. Evaluation of the efficacy of intravenous acetaminophen in the treatment of acute migraine attacks: a double-blind, placebo-controlled parallel group multicenter study. Pain. 2005;117(3):396400.CrossRefGoogle ScholarPubMed
54.Turkcuer, I, Serinken, M, Eken, C, et al. Intravenous paracetamol versus dexketoprofen versus morphine in acute mechanical low back pain in the emergency department: a randomised double-blind controlled trial. EMJ. 2014;31(3):177–81.Google Scholar
55.Zhang, A, Jiang, T, Luo, Y, et al. Efficacy of intravenous propacetamol hydrochloride in the treatment of an acute attack of migraine. Eur J Intern Med. 2014;25(7):629–32.Google Scholar
56.Leniger, T, Pageler, L, Stude, P, Diener, HC, Limmroth, V. Comparison of intravenous valproate with intravenous lysine-acetylsalicylic acid in acute migraine attacks. Headache. 2005;45(1):42–6.Google Scholar
57.Foroughipour, M, Ghandehari, K, Khazaei, M, et al. Randomized clinical trial of intravenous valproate (Orifil) and dexamethasone in patients with migraine disorder. Iran J Med Sci. 2013;38(Suppl. 2):150–5.Google Scholar
58.Friedman, BW, Garber, L, Yoon, A, et al. Randomized trial of IV valproate vs metoclopramide vs ketorolac for acute migraine. Neurology. 2014;82(11):976–83.Google Scholar
59.Moshtaghion, H, Heiranizadeh, N, Rahimdel, A, et al. The efficacy of propofol vs. subcutaneous sumatriptan for treatment of acute migraine headaches in the emergency department: a double-blinded clinical trial. Pain Pract. 2014;15(8)701–5.Google Scholar
60.Soleimanpour, H, Ghafouri, RR, Taheraghdam, A, et al. Effectiveness of intravenous dexamethasone versus propofol for pain relief in the migraine headache: a prospective double blind randomized clinical trial. BMC Neurol. 2012;12:114.Google Scholar
61.Rowe, BH, Colman, I, Edmonds, ML, et al. Randomized controlled trial of intravenous dexamethasone to prevent relapse in acute migraine headache. Headache. 2008;48(3):333–40.Google Scholar
62.Colman, I, Friedman, BW, Brown, MD, et al. Parenteral dexamethasone for acute severe migraine headache: meta-analysis of randomised controlled trials for preventing recurrence. BMJ. 2008;336(7657):1359–61.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×