Migraine diagnosis and management in general emergency departments in France.
BACKGROUND
We conducted a prospective study of patients admitted to 22 general emergency departments in France over 1 week.


METHODS
Of 15,835 adult patients, 483 (3.1%) had headache and 98 (0.6%) had migraine.


RESULTS
Compared with the migraine population in France, our migraine patients were similar in terms of proportion of female patients (75%) and mean age (37.6 ± 13.8 years) but presented earlier in their disease course. Patients sought emergency treatment because of a severe attack (49%) or because of ineffective treatment (20%). Non-opioid analgesics excluding non-steroidal anti-inflammatory drugs (NSAIDs), and NSAIDs, were most commonly prescribed as acute treatment, yet it took more than 48 h for symptom resolution in 36% of 92 follow-up patients.


CONCLUSIONS
Results suggest there is room for improvement in choice of agents prescribed. We propose additional education and training of clinicians to improve adherence to clinical practice guidelines.
Valade
D
D
Centre d'Urgences Céphalées, Hôpital Lariboisière, France. dominique.valade@lrb.aphp.fr
Lucas
C
C
Calvel
L
L
Plaisance
P
P
Derouet
N
N
Meric
G
G
Lanteri-Minet
M
M
Giroud
M
M
D000328:Adult; D019468:Disease Management; D004636:Emergency Service, Hospital / Q000639:trends; D004638:Emergency Treatment / Q000379:methods* / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D011446:Prospective Studies; D055815:Young Adult