Treating migraine in the emergency department

doi:10.1136/bmj.39560.696748.80

BMJ 2008;336:1320 (14 June), doi:10.1136/bmj.39560.696748.80 (published 9 June 2008)

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Treating migraine in the emergency department

Corticosteroids do not relieve acute pain but do reduce recurrence

The first 150 words of the full text of this article appear below.

In the accompanying systematic review, Colman and colleaguesassess the effectiveness of parenteral corticosteroids for treatingacute severe migraine and preventing recurrence.¹ In WesternEurope and the United States, about 12% of adults experiencemigraine each year, and 63% of these people have one to fourmigraines a month. Most people have nausea and moderate to severepain, which results in severe impairment or requires bed rest,and one third have vomiting.² If untreated, these headacheslast for four to 72 hours, with a median duration of 24 hours.

In the US, only 56% of affected patients have received a medicaldiagnosis of migraine and instead believe that they have sinus,tension, or stress headache. About half of these people useover the counter drugs,³ which are effective in up to 59% ofcases. But even with seven different types of triptans and variousways of giving them, 25% of . . . [Full text of this article]

Randolph W Evans, clinical professor of neurology

¹ Baylor College of Medicine, Houston, TX 77004, USA

rwevans@pol.net

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