Migraine headache - Revision history

Danbot: Add MedicationDose SMW annotations (6 entries: prochlorperazine, diphenhydramine, metoclopramide, ketorolac, dexamethasone, magnesium); dosing verified per AAN/AHS guidelines

2026-03-20T16:21:01Z

Add MedicationDose SMW annotations (6 entries: prochlorperazine, diphenhydramine, metoclopramide, ketorolac, dexamethasone, magnesium); dosing verified per AAN/AHS guidelines

@@ Línea 89: / Línea 89: @@
 *Outpatient
 ==See Also==
 *[[Headache]]

Masoodrm: /* BackgroundAshina, Messoud. Migraine. The New England Journal of Medicine. 2020;383(19): 1866-1876 */

2025-12-10T18:22:52Z

BackgroundAshina, Messoud. Migraine. The New England Journal of Medicine. 2020;383(19): 1866-1876

← Revisión anterior		Revisión del 18:22 10 dic 2025
Línea 1:		Línea 1:
	==Background<ref>Ashina, Messoud. Migraine. The New England Journal of Medicine. 2020;383(19): 1866-1876</ref>==		==Background<ref>Ashina, Messoud. Migraine. The New England Journal of Medicine. 2020;383(19): 1866-1876</ref>==
	*Female-to-male ratio of 3:1		*Female-to-male ratio of 3:1
	*~~Tend~~ to be familial		*Tends to be familial
	**~~heritability~~ estimated to be approximately 42%		**Heritability estimated to be approximately 42%
	*Pathogenesis is thought to involve the trigeminovascular system, which when activated results in parasympathetic dilation of intracranial arteries.		*Pathogenesis is thought to involve the trigeminovascular system, which when activated results in parasympathetic dilation of intracranial arteries.
	*Migraine without aura most common (~80%)<ref>Russi CS, Walker L. Headache. In: Walls RM, Hockberger RS, Gausche-Hill M, et al., eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier Saunders; 2018:(Ch) 17:153–159.</ref>		*Migraine without aura most common (~80%)<ref>Russi CS, Walker L. Headache. In: Walls RM, Hockberger RS, Gausche-Hill M, et al., eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier Saunders; 2018:(Ch) 17:153–159.</ref>

Zbuchwald: /* Management */

2024-10-11T12:42:54Z

Management

← Revisión anterior		Revisión del 12:42 11 oct 2024
Línea 69:		Línea 69:
	*[[Ketorolac]]		*[[Ketorolac]]
	*[[Steroids]]		*[[Steroids]]
	*[[Dexamethasone]] to prevent recurrence 48-72 hours post-ED discharge, if history of migraines and recurrent headaches<ref>Colman et al Parenteral dexamethasone for acute severe migraine headache: meta-analysis of randomised controlled trials for preventing recurrence. BMJ 2008 Jun.;336(7657):1359–1361</ref>		**[[Dexamethasone]] to prevent recurrence 48-72 hours post-ED discharge, if history of migraines and recurrent headaches<ref>Colman et al Parenteral dexamethasone for acute severe migraine headache: meta-analysis of randomised controlled trials for preventing recurrence. BMJ 2008 Jun.;336(7657):1359–1361</ref>
	** 10 mg IV single dose is commonly accepted regimen, 4 mg IV dose was shown to be as efficacious in a follow up study. <ref>Friedman BW, Solorzano C, Kessler BD, Martorello K, Lutz CL, Feliciano C, Adler N, Moss H, Cain D, Irizarry E. Randomized Trial Comparing Low- vs High-Dose IV Dexamethasone for Patients With Moderate to Severe Migraine. Neurology. 2023 Oct 3;101(14):e1448-e1454.</ref>		*** 10 mg IV single dose is commonly accepted regimen, 4 mg IV dose was shown to be as efficacious in a follow up study. <ref>Friedman BW, Solorzano C, Kessler BD, Martorello K, Lutz CL, Feliciano C, Adler N, Moss H, Cain D, Irizarry E. Randomized Trial Comparing Low- vs High-Dose IV Dexamethasone for Patients With Moderate to Severe Migraine. Neurology. 2023 Oct 3;101(14):e1448-e1454.</ref>

	{{Non-specific headache treatment}}		{{Non-specific headache treatment}}

Zbuchwald: /* Management */

2024-10-11T12:42:08Z

Management

← Revisión anterior		Revisión del 12:42 11 oct 2024
Línea 69:		Línea 69:
	*[[Ketorolac]]		*[[Ketorolac]]
	*[[Steroids]]		*[[Steroids]]
	**Consider dexamethasone 10mg IV x 1 to prevent recurrence 48-72 ~~hrs~~ post-ED discharge, if history of recurrent headaches ~~(NNT = 10)~~<ref>Colman et al ~~Paraenteral~~ dexamethasone for acute severe migraine headache: meta-analysis of randomised controlled trials for preventing recurrence. BMJ 2008 Jun.;336(7657):1359–1361</ref>		*[[Dexamethasone]] to prevent recurrence 48-72 hours post-ED discharge, if history of migraines and recurrent headaches<ref>Colman et al Parenteral dexamethasone for acute severe migraine headache: meta-analysis of randomised controlled trials for preventing recurrence. BMJ 2008 Jun.;336(7657):1359–1361</ref>
			** 10 mg IV single dose is commonly accepted regimen, 4 mg IV dose was shown to be as efficacious in a follow up study. <ref>Friedman BW, Solorzano C, Kessler BD, Martorello K, Lutz CL, Feliciano C, Adler N, Moss H, Cain D, Irizarry E. Randomized Trial Comparing Low- vs High-Dose IV Dexamethasone for Patients With Moderate to Severe Migraine. Neurology. 2023 Oct 3;101(14):e1448-e1454.</ref>

	{{Non-specific headache treatment}}		{{Non-specific headache treatment}}

Beren85: /* Migraine Prophylaxis */

2022-05-11T21:05:56Z

Migraine Prophylaxis

← Revisión anterior		Revisión del 21:05 11 may 2022
Línea 75:		Línea 75:
	===Migraine Prophylaxis===		===Migraine Prophylaxis===
	*Typically not the role or responsibility of the EP		*Typically not the role or responsibility of the EP
			*Lifestyle changes (avoiding caffeine, smoking and food triggers)
	*If inclined to give Rx, give very short supply and ensure proper follow up		*If inclined to give Rx, give very short supply and ensure proper follow up
	*Consider drug side effects, interactions, cormorbidities		*Consider drug side effects, interactions, cormorbidities

Beren85: /* Clinical Features */

2022-05-11T20:58:47Z

Clinical Features

← Revisión anterior		Revisión del 20:58 11 may 2022
Línea 44:		Línea 44:
	*'''D'''isabling in quality		*'''D'''isabling in quality

	*Basilar-type migraine may be associated with fully reversible dysarthria, vertigo, tinnitus, decreased hearing, double vision or ataxia		Basilar-type migraine may be associated with fully reversible dysarthria, vertigo, tinnitus, decreased hearing, double vision or ataxia

	==Differential Diagnosis==		==Differential Diagnosis==

Beren85: /* Clinical Features */

2022-05-11T20:57:44Z

Clinical Features

← Revisión anterior		Revisión del 20:57 11 may 2022
Línea 43:		Línea 43:
	*'''N'''ausea or [[vomiting]]		*'''N'''ausea or [[vomiting]]
	*'''D'''isabling in quality		*'''D'''isabling in quality

			*Basilar-type migraine may be associated with fully reversible dysarthria, vertigo, tinnitus, decreased hearing, double vision or ataxia

	==Differential Diagnosis==		==Differential Diagnosis==

Jonrako at 02:39, 18 June 2021

2021-06-18T02:39:05Z

← Revisión anterior		Revisión del 02:39 18 jun 2021
Línea 1:		Línea 1:
	==Background:<ref>Ashina, Messoud. Migraine. The New England Journal of Medicine. 2020;383(19): 1866-1876</ref>		==Background<ref>Ashina, Messoud. Migraine. The New England Journal of Medicine. 2020;383(19): 1866-1876</ref>==
	*Female-to-male ratio of 3:1		*Female-to-male ratio of 3:1
	*Tend to be familial		*Tend to be familial

Jonrako: /* Background */

2021-06-18T02:35:05Z

Background

← Revisión anterior		Revisión del 02:35 18 jun 2021
Línea 1:		Línea 1:
	==Background==		==Background:<ref>Ashina, Messoud. Migraine. The New England Journal of Medicine. 2020;383(19): 1866-1876</ref>
	*~~Affects females twice as often as males~~		*Female-to-male ratio of 3:1
	*Tend to be familial		*Tend to be familial
			**heritability estimated to be approximately 42%
			*Pathogenesis is thought to involve the trigeminovascular system, which when activated results in parasympathetic dilation of intracranial arteries.
	*Migraine without aura most common (~80%)<ref>Russi CS, Walker L. Headache. In: Walls RM, Hockberger RS, Gausche-Hill M, et al., eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier Saunders; 2018:(Ch) 17:153–159.</ref>		*Migraine without aura most common (~80%)<ref>Russi CS, Walker L. Headache. In: Walls RM, Hockberger RS, Gausche-Hill M, et al., eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier Saunders; 2018:(Ch) 17:153–159.</ref>
	===Definition: Migraine Headache without Aura<ref>International Headache Society Diagnostic Criteria</ref>===		===Definition: Migraine Headache without Aura<ref>International Headache Society Diagnostic Criteria</ref>===

Elcatracho: /* Background */

2021-01-06T19:43:04Z

Background

← Revisión anterior		Revisión del 19:43 6 ene 2021
Línea 1:		Línea 1:
	==Background==		==Background==
			*Affects females twice as often as males
			*Tend to be familial
			*Migraine without aura most common (~80%)<ref>Russi CS, Walker L. Headache. In: Walls RM, Hockberger RS, Gausche-Hill M, et al., eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier Saunders; 2018:(Ch) 17:153–159.</ref>
	===Definition: Migraine Headache without Aura<ref>International Headache Society Diagnostic Criteria</ref>===		===Definition: Migraine Headache without Aura<ref>International Headache Society Diagnostic Criteria</ref>===
	*At least 5 attacks of headache fulfilling the following criteria:		*At least 5 attacks of headache fulfilling the following criteria: