title: Inpatient management of migraine.
abstract: Migraine is a frequently disabling disorder which may require inpatient treatment. Admission criteria for migraine include intractable migraine, nausea and/or vomiting, severe disability, and dependence on opioids or barbiturates. The inpatient treatment of migraine is based on observational studies and expert opinion rather than placebo-controlled trials. Well-established inpatient treatments for migraine include dihydroergotamine, neuroleptics/antiemetics, lidocaine, intravenous aspirin, and non-pharmacologic treatment such as cognitive-behavioral therapy. Short-acting treatments possibly associated with medication overuse, such as triptans, opioids, or barbiturate-containing compounds, are generally avoided. While the majority of persons with migraine are admitted on an emergency basis for only a few days, outcome studies and infusion protocols during elective admissions at tertiary headache centers suggest a longer length of stay may be needed for persons with intractable migraine.
authors.affiliation: Department of Neurology, Jefferson Headache Center, Thomas Jefferson University, 900 Walnut St. Suite 200, Philadelphia, PA, 19107, USA, Michael.marmura@jefferson.edu.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Marmura
authors.forename: Stephanie Wrobel
authors.initials: SW
authors.lastname: Goldberg
mesh_terms: D019468:Disease Management; D006801:Humans; D007297:Inpatients; D008881:Migraine Disorders / Q000175:diagnosis* / Q000628:therapy*