View in EDS HTML Full Text PDF Full Text

A retrospective analysis of triptan and dhe use for basilar and hemiplegic migraine.

Saved in:
Bibliographic Details
Title: A retrospective analysis of triptan and dhe use for basilar and hemiplegic migraine.
Authors: Mathew, Paul G., Krel, Regina, Buddhdev, Bhuvin, Ansari, Hossein, Joshi, Shivang G., Spinner, Warren D., Klein, Brad C.
Source: Headache: The Journal of Head & Face Pain. May2016, Vol. 56 Issue 5, p841-848. 8p. 12 Charts.
Subjects: Ischemia, Migraine diagnosis, Medical cooperation, Migraine, Patient safety, Research, Tryptamine, Retrospective studies, Descriptive statistics, Dihydroergotamine, Symptoms, Disease risk factors, Therapeutics
Abstract: Background Patients with basilar migraine (BM) and hemiplegic migraine (HM) have been excluded from triptan and DHE clinical trials due to a potential risk of ischemic vascular events, and the FDA mandates that package labeling state that they are contraindicated in BM and HM. The objective of this study was to demonstrate that triptans and DHE can be used for the abortive treatment of BM and HM without significant adverse ischemic vascular events. Methods A retrospective chart review of patients with BM features or HM who received acute abortive treatment with either triptans or DHE was conducted at 4 headache centers to assess the frequency of ischemic vascular events after administration. The diagnoses of BM or HM were made by headache specialists based on The International Classification of Headache Disorders, 2nd edition (ICHD-II). Searchable terms included BM, vertigo, dysarthria, diplopia, hemiplegia/hemiparesis, facial droop, weakness, confusion, altered consciousness, confusion, ataxia, and aphasia, as well as all triptans or DHE. Results The study included 67 patients with BM features and 13 patients with HM. Among those receiving triptans, 40 were in the BM group and 5 were in the HM group. Among those receiving DHE, 27 were included in the BM group and 8 were in the HM group. No side effects of stroke or myocardial infarction were reported. In the triptan group, 5 patients reported adverse effects that included GI upset, rash, neck dystonia, nightmares, and flushing. In the DHE group, 5 patients had adverse events that included chest tightness, dystonic reaction, transient asymptomatic anterior T wave inversion, and agitation. Conclusion In this retrospective study, triptans and DHE were used with no reported, subsequent acute/subacute ischemic vascular events for the abortive treatment of migraines with basilar and hemiplegic-type features. Although the small sample sizes generated theoretical statistical event rates of 4.5% for BM and 23% for HM, there has been no clear evidence that BM and HM carry an actual elevated risk for vascular events compared with migraine with aura. [ABSTRACT FROM AUTHOR]
Copyright of Headache: The Journal of Head & Face Pain is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
Full text is not displayed to guests.
FullText Links:
  – Type: pdflink
Text:
  Availability: 1
Header DbId: pbh
DbLabel: Psychology and Behavioral Sciences Collection
An: 115267897
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: A retrospective analysis of triptan and dhe use for basilar and hemiplegic migraine.
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Mathew%2C+Paul+G%2E%22">Mathew, Paul G.</searchLink><br /><searchLink fieldCode="AR" term="%22Krel%2C+Regina%22">Krel, Regina</searchLink><br /><searchLink fieldCode="AR" term="%22Buddhdev%2C+Bhuvin%22">Buddhdev, Bhuvin</searchLink><br /><searchLink fieldCode="AR" term="%22Ansari%2C+Hossein%22">Ansari, Hossein</searchLink><br /><searchLink fieldCode="AR" term="%22Joshi%2C+Shivang+G%2E%22">Joshi, Shivang G.</searchLink><br /><searchLink fieldCode="AR" term="%22Spinner%2C+Warren+D%2E%22">Spinner, Warren D.</searchLink><br /><searchLink fieldCode="AR" term="%22Klein%2C+Brad+C%2E%22">Klein, Brad C.</searchLink>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="JN" term="%22Headache%3A+The+Journal+of+Head+%26+Face+Pain%22">Headache: The Journal of Head & Face Pain</searchLink>. May2016, Vol. 56 Issue 5, p841-848. 8p. 12 Charts.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Ischemia%22">Ischemia</searchLink><br /><searchLink fieldCode="DE" term="%22Migraine+diagnosis%22">Migraine diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+cooperation%22">Medical cooperation</searchLink><br /><searchLink fieldCode="DE" term="%22Migraine%22">Migraine</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+safety%22">Patient safety</searchLink><br /><searchLink fieldCode="DE" term="%22Research%22">Research</searchLink><br /><searchLink fieldCode="DE" term="%22Tryptamine%22">Tryptamine</searchLink><br /><searchLink fieldCode="DE" term="%22Retrospective+studies%22">Retrospective studies</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Dihydroergotamine%22">Dihydroergotamine</searchLink><br /><searchLink fieldCode="DE" term="%22Symptoms%22">Symptoms</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+risk+factors%22">Disease risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutics%22">Therapeutics</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background Patients with basilar migraine (BM) and hemiplegic migraine (HM) have been excluded from triptan and DHE clinical trials due to a potential risk of ischemic vascular events, and the FDA mandates that package labeling state that they are contraindicated in BM and HM. The objective of this study was to demonstrate that triptans and DHE can be used for the abortive treatment of BM and HM without significant adverse ischemic vascular events. Methods A retrospective chart review of patients with BM features or HM who received acute abortive treatment with either triptans or DHE was conducted at 4 headache centers to assess the frequency of ischemic vascular events after administration. The diagnoses of BM or HM were made by headache specialists based on The International Classification of Headache Disorders, 2nd edition (ICHD-II). Searchable terms included BM, vertigo, dysarthria, diplopia, hemiplegia/hemiparesis, facial droop, weakness, confusion, altered consciousness, confusion, ataxia, and aphasia, as well as all triptans or DHE. Results The study included 67 patients with BM features and 13 patients with HM. Among those receiving triptans, 40 were in the BM group and 5 were in the HM group. Among those receiving DHE, 27 were included in the BM group and 8 were in the HM group. No side effects of stroke or myocardial infarction were reported. In the triptan group, 5 patients reported adverse effects that included GI upset, rash, neck dystonia, nightmares, and flushing. In the DHE group, 5 patients had adverse events that included chest tightness, dystonic reaction, transient asymptomatic anterior T wave inversion, and agitation. Conclusion In this retrospective study, triptans and DHE were used with no reported, subsequent acute/subacute ischemic vascular events for the abortive treatment of migraines with basilar and hemiplegic-type features. Although the small sample sizes generated theoretical statistical event rates of 4.5% for BM and 23% for HM, there has been no clear evidence that BM and HM carry an actual elevated risk for vascular events compared with migraine with aura. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Headache: The Journal of Head & Face Pain is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=115267897
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1111/head.12804
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 8
        StartPage: 841
    Subjects:
      – SubjectFull: Ischemia
        Type: general
      – SubjectFull: Migraine diagnosis
        Type: general
      – SubjectFull: Medical cooperation
        Type: general
      – SubjectFull: Migraine
        Type: general
      – SubjectFull: Patient safety
        Type: general
      – SubjectFull: Research
        Type: general
      – SubjectFull: Tryptamine
        Type: general
      – SubjectFull: Retrospective studies
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Dihydroergotamine
        Type: general
      – SubjectFull: Symptoms
        Type: general
      – SubjectFull: Disease risk factors
        Type: general
      – SubjectFull: Therapeutics
        Type: general
    Titles:
      – TitleFull: A retrospective analysis of triptan and dhe use for basilar and hemiplegic migraine.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Mathew, Paul G.
      – PersonEntity:
          Name:
            NameFull: Krel, Regina
      – PersonEntity:
          Name:
            NameFull: Buddhdev, Bhuvin
      – PersonEntity:
          Name:
            NameFull: Ansari, Hossein
      – PersonEntity:
          Name:
            NameFull: Joshi, Shivang G.
      – PersonEntity:
          Name:
            NameFull: Spinner, Warren D.
      – PersonEntity:
          Name:
            NameFull: Klein, Brad C.
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 05
              Text: May2016
              Type: published
              Y: 2016
          Identifiers:
            – Type: issn-print
              Value: 00178748
          Numbering:
            – Type: volume
              Value: 56
            – Type: issue
              Value: 5
          Titles:
            – TitleFull: Headache: The Journal of Head & Face Pain
              Type: main
ResultId 1