Evaluation and treatment of migraine in the emergency department: a review

Headache. 2014 Jul-Aug;54(7):1131-45. doi: 10.1111/head.12399. Epub 2014 Jun 4.

Abstract

Head pain is the fifth most common reason for emergency department (ED) visits. It is second only to focal weakness as the most common reason for neurological consultation in the ED. This manuscript reviews how patients with migraine, the most common primary headache disorder for which patients seek medical treatment, are managed in the ED. We discuss existing guidelines for head imaging in patients with migraine, recommended pharmacologic treatments, and current treatment trends. We also review studies evaluating the discharge care of migraine patients in the ED. With the goal of standardizing, streamlining, and optimizing ED-based migraine care, we offer ideas for future research to improve the evaluation, treatment, and discharge care of patients who present to an ED with acute migraine.

Keywords: computerized tomography; discharge; emergency department; migraine; narcotic; pharmacology.

Publication types

  • Review

MeSH terms

  • Emergency Service, Hospital / standards*
  • Humans
  • Migraine Disorders / diagnosis*
  • Migraine Disorders / drug therapy*
  • Practice Guidelines as Topic