What is the initial emergency department (ED) treatment of migraine headache?

Updated: Oct 21, 2019
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Helmi L Lutsep, MD  more...
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Emergency medical services personnel should transport patients in a way that minimizes visual and auditory stimulation. Once in the emergency department (ED), most patients should not receive opiate analgesics until a thorough neurologic examination can be completed by the responsible physician.

While the emergency physician must be able to identify patients with serious headache etiology, note that more than 90% of patients who present to the ED because of headache have migraine, tension, or mixed-type benign headache. Therefore, providing symptomatic relief should be a priority. Rest in a darkened, quiet room is helpful. Some patients find cool compresses to painful areas helpful.

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