Efficacy of intravenous dexamethasone in treatment of acute migraine headache: a randomized clinical trial running title

Migraine is characterized by unilateral and pulsatile headache with or without aura. There are various treatments of migraine attack. One of them is intravenous [IV] Corticosteroids which is used in status migrainous. The aim of this study is comparison of the efficacy of I.V Dexamethasone with intramuscular [I.M] Methadone in improvement of migraine attacks. This study was a controlled double- blind randomized clinical trial on all patients whom referred to emergency room with diagnosis of migraine attack. The patients were randomized in four groups. Groups I and II received intravenous 8 mg Dexamethasone, while groups III and IV received intramuscular 10 mg Methadone. Thereafter all of them were evaluated after 2, 4 and 6 hours. One-hundred and eighty one patients were evaluated; 107 patients were treated with IV Dexamethasone and 74 patients with IM Methadone. One-hundred and three of 107 patients [96.2%] had complete or significant improvement whereas 63 of 74 patients [85%] whom received IM Methadone had similar improvement [P= 0.01]. Our study showed that treatment of acute migraine headache by using intravenous Dexamethasone is more effective than Methadone

[Evaluation of the causes of headache in patients referred to neurological and Clinic of Ghaem Hospital]

Evaluation of the causes of headache in patients referred to Neurological Emergency and Clinic of Ghaem Hospital. In this prescribing cross-sectional study, patients who came to the Clinic Department of Ghaem Hospital of Mashhad from 1980 to 1982, with chief complaint of headache, was studied. The clinical findings, laboratory findings, and imaging of the patients were reviewed. Among 423 patients, 71% were women. The female to male ratio was 2.44%. The average age was 35. Male patients with sinusitis and female patients with classic migraine had the lowest average age, respectively 17 years old and 19 years old. The maximum average age was in patients with cervical spondylitis. The most common type of headache was tension [48%] and migraine [24%]. The most common associated symptoms were photophobia, photophobia and nausea. The most common precipitated factor of headache was stress [71%]. This study showed that stress was the most important factor of exacerbating headache, and rest was the best way to suppress headache