Dihydroergotamine and its use in migraine with posterior fossa symptoms.

Abstract:

BACKGROUND:Dihydroergotamine (DHE) has been used for decades to treat migraine, but is currently contraindicated in patients with hemiplegic migraine and basilar-type migraine (BTM). OBJECTIVE:To assess the safety of DHE in patients with symptoms of BTM that do not meet criteria for BTM. METHODS:Retrospective analysis of patients admitted to an outpatient infusion room at a tertiary care center caring for patients with headache disorders. Incidence and types of adverse events as well as pain levels were reviewed and analyzed. Pain was assessed via the visual analog scale (VAS). RESULTS:Fifty consecutive patient records were reviewed. Mean age was 38.42. All patients met International Classification of Headache Disorders-II (ICHD-II) criteria for migraine and reported 1 posterior fossa symptom as defined by the ICHD-II criteria for BTM. Patients did not necessarily have a posterior fossa symptom in the attack treated. Eighteen percent (9/50) patients had adverse events, and only 3 of these halted DHE infusion. No patients had neurologic or cardiologic events. The mean decrease in pain was 3 points on the VAS (P <.0001). Sixty-two percent of patients achieved complete relief of headache with co-administration of DHE and other medications. CONCLUSION:Dihydroergotamine showed no serious adverse events in patients with 1 posterior fossa symptom and migraine. Larger, adequately powered, controlled, prospective trials are indicated to assess safety of DHE in BTM.

journal_name

Headache

journal_title

Headache

authors

Whyte CA,Stillman MJ,Tepper SJ

doi

10.1111/j.1526-4610.2010.01698.x

subject

Has Abstract

pub_date

2010-10-01 00:00:00

pages

1419-23

issue

9

eissn

0017-8748

issn

1526-4610

pii

HED1698

journal_volume

50

pub_type

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