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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Fiesseler, Frederick W. Shih, Richard Szucs, Paul Silverman, Michael E. Eskin, Barnet Clement, Martin Saxena, Rachna Allegra, John Riggs, Renee L. Majlesi, Nima |
| Description | Country affiliation: United States Author Affiliation: Fiesseler FW ( Department of Emergency Medicine, Morristown Memorial Hospital, Morristown, New Jersey 07962-1965, USA.) |
| Abstract | BACKGROUND: Recurrence of migraine headache after treatment in the emergency department (ED) is common. Conflicting evidence exists regarding the utility of steroids in preventing migraine headache recurrence at 24-48 h. OBJECTIVE: To determine if steroids decrease the headache recurrence in patients treated for migraine headaches in the ED. METHODS: Double-blind placebo-controlled, two-tailed randomized trial. Patients aged >17 years with a moderately severe migraine headache diagnosed by treating Emergency Physician were approached for participation. Enrollees received either dexamethasone (10 mg i.v.) if intravenous access was utilized or prednisone (40 mg by mouth × 2 days) if no intravenous access was obtained. Each medication was matched with an identical-appearing placebo. Patients were contacted 24-72 h after the ED visit to assess headache recurrence. RESULTS: A total of 181 patients were enrolled. Eight were lost to follow-up, 6 in the dexamethasone group and 2 in the prednisone arm. Participants had a mean age of 37 years (±10 years), with 86% female. Eighty-six percent met the International Headache Society Criteria for migraine headache. Of the 173 patients with completed follow-up, 20/91 (22%) (95% confidence interval [CI] 13.5-30.5) in the steroid arm and 26/82 (32%) (95% CI 21.9-42.1) in the placebo arm had recurrent headaches (p = 0.21). CONCLUSION: We did not find a statistically significant decrease in headache recurrence in patients treated with steroids for migraine headaches. |
| File Format | HTM / HTML |
| ISSN | 07364679 |
| Issue Number | 4 |
| Volume Number | 40 |
| Journal | The Journal of Emergency Medicine |
| Language | English |
| Publisher | Elsevier |
| Publisher Date | 2011-04-01 |
| Publisher Place | United States |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Discipline Emergency medicine Dexamethasone Therapeutic Use Glucocorticoids Migraine Disorders Drug Therapy Prevention & Control Prednisone Adult Chi-square Distribution Double-blind Method Female Humans Interviews As Topic Male Middle Aged Secondary Prevention Statistics, Nonparametric Treatment Outcome Journal Article Randomized Controlled Trial |
| Content Type | Text |
| Resource Type | Article |
| Subject | Emergency Medicine |
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