Status migrainosus treatments are largely ineffective

  • Iljazi A & al.
  • Cephalalgia
  • 12/03/2020

  • Kelli Whitlock Burton
  • Clinical Essentials
L'accesso ai contenuti di questo sito è riservato agli operatori del settore sanitario italiano L'accesso ai contenuti di questo sito è riservato agli operatori del settore sanitario italiano

Takeaway

  • Current treatments most commonly used to treat status migrainosus are largely ineffective, with only 22% of patients being pain free at 48 hours after treatment.

Why this matters

  • Status migrainosus, a condition characterized by migraines that last longer than 3 days even with treatment, is widely understudied.

Study design

  • Study of patients with episodic and chronic migraine who experienced continuous and prolonged attacks for >72 hours and who were treated with dexamethasone, ketorolac, lidocaine 2%, or naratriptan.
  • Outcome: response rate after 24 hours of treatment.
  • Funding: Migraine Research Foundation.

Key results

  • Overall response rate of rendering patients pain-free within 24 hours and maintaining the pain-free status for 48 hours was 22%.
  • Treatment success rates for achieving pain-free status within 24 hours were higher for dexamethasone (30.8%) and nerve blocks (24.1%) compared with ketorolac (11.1%) and naratriptan (11.1%).
  • Proportion of patients achieving a pain-free status increased with time (at 2, 12, 24, 48, 72, and 96 hours it increased gradually from 2% to 8% to 23% to 37% to 43% to 53%).

Limitations

  • Observational study.
  • Small sample size.