Department of Neurology, John Hopkins Bayview Medical Center, Baltimore, MD, USA.
Pain Res Manag. 2011 May-Jun;16(3):183-6. doi: 10.1155/2011/182867.
Despite advances in treatment, patients with migraine have been underdiagnosed and undertreated, specifically in emergency departments. In addition, great variability exists with respect to the diagnosis, management and treatment of migraine patients in emergency departments. In particular, migraine-specific treatments, including serotonin receptor agonists, appear to be rarely used.
To examine the diagnosis and management of migraine patients within Ontario emergency departments.
A prospective survey was designed to inquire how emergency physicians diagnose and manage patients with migraine. Questions focused on the use of serotonin receptor agonists, the rationale behind their use or nonuse, and acute headache protocols. The survey also inquired about the use of International Classification Of Headache Disorders-2 criteria in diagnosing migraine by emergency physicians, medication prescribed on discharge, and referrals made to outpatient specialists. These surveys were distributed to and anonymously completed by emergency physicians in several departments in Ontario.
Migraine-specific treatments were underused in emergency departments. Furthermore, many departments lacked headache protocols and, often, migraine-specific treatment was not included in the few departments with protocols.
Diagnosis and management of migraines can be improved within emergency departments, and patients can be more effectively channelled toward appropriate outpatient care.
尽管在治疗方面取得了进展，但偏头痛患者仍未得到充分诊断和治疗，尤其是在急诊科。此外，在急诊科诊断、管理和治疗偏头痛患者方面存在很大的差异。特别是，偏头痛特异性治疗方法，包括 5-羟色胺受体激动剂，似乎很少使用。
调查安大略省急诊科偏头痛患者的诊断和管理情况。
设计了一项前瞻性调查，询问急诊医师如何诊断和治疗偏头痛患者。问题集中在 5-羟色胺受体激动剂的使用、使用或不使用的理由，以及急性头痛方案。该调查还询问了急诊医师使用国际头痛疾病分类-2 标准诊断偏头痛、出院时开具的药物以及向门诊专家转诊的情况。这些调查分发给安大略省几个部门的急诊医师，并由他们匿名填写。
在急诊科中，偏头痛特异性治疗方法的使用不足。此外，许多部门缺乏头痛方案，而且在少数有方案的部门中，通常也不包括偏头痛特异性治疗。
可以在急诊科改进偏头痛的诊断和管理，并且可以更有效地将患者转至适当的门诊治疗。
