急诊科偏头痛的管理与预防：综述。
Managing and Preventing Migraine in the Emergency Department: A Review.
机构信息
Department of Emergency Medicine, Queensway Carleton Hospital, Ottawa, ON, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Institut du Savoir Montfort, Ottawa, ON, Canada; 360 Concussion Care, Ottawa, ON, Canada.
Departments of Pediatrics, Community Health Sciences, and Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.
出版信息
Ann Emerg Med. 2023 Dec;82(6):732-751. doi: 10.1016/j.annemergmed.2023.05.024. Epub 2023 Jul 11.
Migraine is a leading cause of disability worldwide, and acute migraine attacks are a common reason for patients to seek care in the emergency department (ED). There have been recent advancements in the care of patients with migraine, specifically emerging evidence for nerve blocks and new pharmacological classes of medications like gepants and ditans. This article serves as a comprehensive review of migraine in the ED, including diagnosis and management of acute complications of migraine (eg, status migrainosus, migrainous infarct, persistent aura without infarction, and aura-triggered seizure) and use of evidence-based migraine-specific treatments in the ED. It highlights the role of migraine preventive medications and provides a framework for emergency physicians to prescribe them to eligible patients. Finally, it evaluates the evidence for nerve blocks in the treatment of migraine and introduces the possible role of gepants and ditans in the care of patients with migraine in the ED.
偏头痛是全球范围内导致残疾的主要原因，急性偏头痛发作是患者前往急诊部（ED）就诊的常见原因。偏头痛患者的护理最近取得了一些进展，特别是神经阻滞的新证据和 gepants 和 ditans 等新型药理学药物类别。本文全面回顾了 ED 中的偏头痛，包括偏头痛急性并发症（如偏头痛持续状态、偏头痛梗死、无梗死持续先兆和先兆触发的癫痫发作）的诊断和管理，以及 ED 中使用基于证据的偏头痛特异性治疗方法。它强调了偏头痛预防药物的作用，并为急诊医生为符合条件的患者开这些药物提供了一个框架。最后，它评估了神经阻滞治疗偏头痛的证据，并介绍了 gepants 和 ditans 在 ED 中治疗偏头痛患者中的可能作用。
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