Inpatient Management of Migraine

Neurol Clin. 2019 Nov;37(4):771-788. doi: 10.1016/j.ncl.2019.07.007.

Abstract

Migraine is a frequently disabling neurologic condition which can be complicated by medication overuse headache and comorbid medical disorders, including obesity, anxiety and depression. Although most migraine management takes place in outpatient clinics, inpatient treatment is indicated for migraine refractory to multiple outpatient treatments, with intractable nausea or vomiting, need for detoxification from medication overuse (such as opioids and barbiturates), and significant medical and psychiatric disease. The goals of inpatient treatment include breaking the current cycle of headache pain, reducing the frequency and/or severity of future attacks, monitored detoxification of overused medications, and reducing disability and improving quality of life.

Keywords: Chronic migraine; Inpatient management; Medication overuse; Refractory headache.

Publication types

  • Review

MeSH terms

  • Disease Management*
  • Headache Disorders, Secondary / diagnosis
  • Headache Disorders, Secondary / psychology
  • Headache Disorders, Secondary / therapy
  • Humans
  • Inpatients / psychology*
  • Mental Disorders / diagnosis
  • Mental Disorders / psychology
  • Mental Disorders / therapy
  • Migraine Disorders / diagnosis
  • Migraine Disorders / psychology*
  • Migraine Disorders / therapy*
  • Pain, Intractable / diagnosis
  • Pain, Intractable / psychology
  • Pain, Intractable / therapy
  • Patient Admission / trends*
  • Quality of Life / psychology
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / psychology
  • Substance-Related Disorders / therapy