Efficacy of intravenous Dexamethasone in treatment of acute migraine headache: A randomized clinical trial running title

Document Type : Original

Authors

1 Associate Professor of Neurology, Mashhad University of Medical Sciences

2 Assistant Professor of Neurology, Shiraz University of Medical Sciences

3 Department of Neurology Ghaem Hospital, Mashhad University of Medical Sciences.

4 Assistant Professor of Neurology, 5Faculty Member, MS Biostatistics- Mashhad University of Medical Sciences

Abstract

Introduction: Migraine is characterized by unilateral and pulsatile headache with or without aura. There are various treatments of migraine attack. One of them is intravenous (IV) Corticosteroids which is used in status migrainous. The aim of this study is comparison of the efficacy of I.V Dexamethasone with intramuscular (I.M) Methadone in improvement of migraine attacks. 
Materials and Methods: This study was a controlled double- blind randomized clinical trial on all patients whom referred to emergency room with diagnosis of migraine attack. The patients were randomized in four groups. Groups I and II received intravenous 8 mg Dexamethasone, while groups III and IV received intramuscular 10 mg Methadone. Thereafter all of them were evaluated after 2, 4 and 6 hours.
Results: One-hundred and eighty one patients were evaluated; 107 patients were treated with IV Dexamethasone and 74 patients with IM Methadone. One-hundred and three of 107 patients (96.2%) had complete or significant improvement whereas 63 of 74 patients (85%) whom received IM Methadone had similar improvement (P= 0.01). 
Conclusion: Our study showed that treatment of acute migraine headache by using intravenous Dexamethasone is more effective than Methadone.

Keywords


1- Victor M, Ropper A. Adams and Victor’s principles of neurology.7th ed. New York: MC Graw Hill; 2001. 82-189.
2- Rowland L. Merritt's neurology. 10th ed. Philadelphia: Williams and Wilkins; 2000.  807-813.  
3- Hardman JG, Limbird LE. Goodman and Gilman’s the pharmacological basis of therapeutics. New York: MC Graw Hill; 2001. 125-132.  
4- Bradly WG, Daroff RB, Fenchel GM. Neurology in clinical practice. 4th ed. New York: Elsevier; 2004: 2073-2103.      
5- Rapoport A, Sheftell FD, Purdy RA. Advanced therapy of headache. Hamilton: Decker BC; 1995:84-86.
6- Bertman RA, Kliegman RM. Nelson essential of  pediatrics. 14th ed. Philadelphia: SandersWB; 2002; 87: 561.
 7- Mogini F. Headache and facial pain. Stuttgart: Thieme; 1999. 13-14.                                        
 8- Jason W, Jeremy NA. Is dexamethasone effective in treating acute migraine headache? Medical j Aust. 2002, 21; 176(2):83. Available at: http://www.mja.com.au/index.htm.
9- Wall PD, Melzak R. The text book of pain. 4th ed. Edinburgh: Churchil Livingstone; 1999. 504-597.                   
10- Janson RT, Griffin JW, Arthur JC. Current  therapy in neurologic  diseases. 6th ed. St Louis: Mosby; 2002. 82-87.