Becker W J, Riess C M, Hoag J
Department of Clinical Neurosciences, University of Calgary, Alberta, Canada.
Headache. 1996 Mar;36(3):144-8. doi: 10.1046/j.1526-4610.1996.3603144.x.
The effectiveness of dihydroergotamine administered by home subcutaneous injection by the patient or family for severe headache attacks was assessed retrospectively in 51 patients. Average follow-up was 21 weeks. Twenty-one patients had intermittent migraine attacks, 27 had transformed migraine with chronic daily headache, and 3 had chronic tension-type headache. Of the 51 patients taught home injection, 35% had an excellent overall response, 18% had a good response, 12% had a poor response but continued to use dihydroergotamine, and 35% had discontinued dihydroergotamine use. Side effects were the main reason for stopping dihydroergotamine. These included nausea or vomiting or both, limb pain or numbness or both, chest or throat tightness or both, and soreness at the injection site. Thirty-three patients (65%) continued to use dihydroergotamine at the end of the follow-up period. In patients who previously required injections from medical personnel for headache crises and in whom home injection of dihydroergotamine was effective, a dramatic reduction occurred in hospital emergency room and physician office utilization. Dihydroergotamine use by home injection can be an effective treatment for a significant proportion of patients with severe migraine including patients with transformed migraine and medication overuse.
对51例患者进行回顾性评估，以确定患者或其家属在家自行皮下注射双氢麦角胺治疗严重头痛发作的有效性。平均随访时间为21周。21例患者有间歇性偏头痛发作，27例有转变型偏头痛伴慢性每日头痛，3例有慢性紧张型头痛。在接受家庭注射培训的51例患者中，35%总体反应极佳，18%反应良好，12%反应较差但继续使用双氢麦角胺，35%已停止使用双氢麦角胺。副作用是停用双氢麦角胺的主要原因。这些副作用包括恶心或呕吐或两者兼有、肢体疼痛或麻木或两者兼有、胸部或喉咙发紧或两者兼有以及注射部位疼痛。33例患者（65%）在随访期结束时继续使用双氢麦角胺。对于那些以前因头痛发作需要医护人员注射治疗且在家自行注射双氢麦角胺有效的患者，医院急诊室和医生办公室的就诊率大幅降低。在家自行注射双氢麦角胺对相当一部分严重偏头痛患者，包括转变型偏头痛患者和药物过度使用患者，可能是一种有效的治疗方法。
