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Optimizing Acute Headache Treatment in the Setting of Chronic Migraine

  • Amanda Tinsley
  • John Farr Rothrock
Chapter

Abstract

Chronic migraine (CM) is a prevalent neurologic disorder which accounts for a disproportionate share of the direct and indirect costs associated with migraine generally. Successful suppression of CM typically requires an integrated management plan whose various components include the aggressive treatment of acute headache episodes while avoiding overuse of symptomatic medication. Patients with CM frequently will need multiple self-administered therapies to treat the various stages of their acute “breakthrough” headaches, and when self-administered therapy fails, rapid access to enlightened provider-administered treatment should be available. Left unchecked, status migrainosus will reinforce CM, with prolonged attacks of severe migrainous head pain provoking biologic sensitization of the pathways that subserve head pain conduction and undermining prophylactic therapies intended to desensitize those pathways. In this chapter we discuss pharmacologic strategies intended to terminate acute migrainous headache successfully.

Keywords

Migraine Chronic migraine Acute migraine Status migrainosus Medication overuse headache 

References

  1. 1.
    Burstein R. Deconstructing migraine headache into peripheral and central sensitization. Pain. 2001;89:107.CrossRefPubMedGoogle Scholar
  2. 2.
    Scher A, Stewart W, Ricci J, Lipton R. Factors associated with the onset and remission of chronic daily headache in a population-based study. Pain. 2003;106:81.CrossRefPubMedGoogle Scholar
  3. 3.
    Dodick D, Freitag F. Evidence-based understanding of medication-overuse headache: clinical implications. Headache. 2006;46((suppl) 4):S202.CrossRefPubMedGoogle Scholar
  4. 4.
    Katsavara Z, Jensen R. Medication-overuse headache: where are we now? Curr Opin Neurol. 2007;20:326.CrossRefGoogle Scholar
  5. 5.
    Abrams B. Medication overuse headache. Med Clin North Am. 2013;97:337.CrossRefPubMedGoogle Scholar
  6. 6.
    Scher A, Rizzoli P, Loder E. Medication overuse headache. An entrenched idea in need of scrutiny. Neurology. 2017;89(12):1296–304.CrossRefPubMedGoogle Scholar
  7. 7.
    Headache Classification Committee of the International Headache Society (HIS). The international classification of headache disorders, 3rd edition (beta version). Cephalalgia. 2013;33:629.CrossRefGoogle Scholar
  8. 8.
    Katsavara Z, Muessig M, Dzagnidze A, et al. Medication overuse headache: rates and predictors for relapse in a 4-year prospective study. Cephalalgia. 2005;25:12.CrossRefGoogle Scholar
  9. 9.
    Choi J, Michael A, Andress-Rothrock D, Rothrock J. A regional comparison of headache clinic populations: demography, diagnoses, and frequencies/types of symptomatic medication overuse. Headache. 2016;56(suppl 1):45.Google Scholar
  10. 10.
    Mendizabal J, Rothrock J. An inter-regional comparative study of headache clinic populations. Cephalalgia. 1998;18:57.CrossRefPubMedGoogle Scholar
  11. 11.
    Srikiatkhachorn A, le Grand S, Supornsilpchai W, Storer J. Pathophysiology of medication overuse headache-an update. Headache. 2014;54:204.CrossRefPubMedGoogle Scholar
  12. 12.
    Stewart WF, Ryan RE Jr, et al. Efficacy and safety of acetaminophen, aspirin, and caffeine in alleviating migraine headache pain: three double-blind, randomized, placebo-controlled trial. Arch Neurol. 1998;55:210.CrossRefPubMedGoogle Scholar
  13. 13.
    Sato K, Hida A, Arai N, et al. Low-dose intravenous propofol as a possible therapeutic option for acute confusional migraine. Am J Emerg Med. 2017;35:195.e5.CrossRefGoogle Scholar
  14. 14.
    Krusz JC, Scott V, Belaner J. Intravenous propofol: unique effectiveness in treating intractable migraine. Headache. 2000;49:224.CrossRefGoogle Scholar
  15. 15.
    Mendes PM, Silberstein SD, Young WB, Rozen TD, et al. Intravenous propofol in the treatment of refractory headache. Headache. 2002;42:638.CrossRefPubMedGoogle Scholar
  16. 16.
    Mosier J, Roper G, Hays D, et al. Sedative dosing of propofol for treatment of migraine headache in the emergency department: a case series. West J Emerg Med. 2013;14:646.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Pomery JL, Marmua MJ, Nahas SJ, Viscusi ER. Ketamin infusions for treatment refractory headache. Headache. 2017;57(2):276.CrossRefGoogle Scholar
  18. 18.
    Burstein R, Collins B, Jakubowski M. Defeating migraine pain with triptans: a race against the development of cutaneous allodynia. Ann Neurol. 2004;55:19–26.CrossRefPubMedGoogle Scholar
  19. 19.
    Morey V, Rothrock J. Examining the utility of in-clinic “rescue” therapy for acute migraine. Headache. 2008;48:939.CrossRefPubMedGoogle Scholar
  20. 20.
    Silberstein S, Young W, Mendizabal J, Rothrock J, Alam A. Efficacy of intramuscular droperidol for migraine treatment: a dose response study. Neurology. 2003;60:315.CrossRefPubMedGoogle Scholar
  21. 21.
    Orr S, Friedman B, Christie S, et al. Management of adults with acute migraine in the emergency department: the American headache society evidence assessment of parenteral pharmacotherapies. Headache. 2016;56:911.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of NeurologyGW-MFA Headache Center, George Washington University School of Medicine and Health SciencesWashington, DCUSA

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