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Tolerability and effectiveness of prochlorperazine for intractable migraine in children
M A Kabbouche1, A L Vockell, S L LeCates
1Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA.
Insights
Prochlorperazine effectively treated severe pediatric migraines, with most children experiencing significant pain relief within hours. This medication was well-tolerated, showing promise for migraine management in children.
Area of Science:
- Pediatric Neurology
- Emergency Medicine
Background:
- Severe, intractable migraines pose a significant challenge in pediatric care.
- Limited effective acute treatment options exist for prolonged pediatric migraines.
Purpose of the Study:
- To evaluate the efficacy of prochlorperazine in resolving severe, intractable migraines in pediatric patients.
- To assess the safety and tolerability of intravenous prochlorperazine for acute migraine treatment in children.
Main Methods:
- Retrospective review of 20 pediatric patients with severe, prolonged migraines treated with intravenous prochlorperazine.
- Patients were diagnosed using clinical and International Headache Society criteria.
- Effectiveness was measured by reported pain reduction and pain-free status at 1 and 3 hours post-treatment.
Main Results:
- 90% of patients reported improvement at 1 hour, with 50% becoming pain-free.
- 60% of patients were pain-free at 3 hours, with 95% reporting significant improvement.
- Prochlorperazine demonstrated high effectiveness, with only 1 patient not responding.
Conclusions:
- Intravenous prochlorperazine is a highly effective treatment for aborting severe, intractable pediatric migraines.
- The medication was well-tolerated with no significant adverse effects observed.
- Further large-scale, randomized, placebo-controlled trials are recommended to confirm these findings.
Objective:
To study the effectiveness of prochlorperazine in aborting severe, intractable migraines in children.
Study Design:
Patients for this study were drawn from the population seen and evaluated in the Headache Center at Cincinnati Children's Hospital Medical Center. All patients were diagnosed with migraine headache by both clinical and International Headache Society criteria. The effectiveness of intravenous prochlorperazine in 20 consecutive patients referred to the emergency department for severe, prolonged migraines was retrospectively reviewed.
Results:
Patients evaluated in this study presented with a mean headache severity of 8.4 on a 0- to 10-point scale and an average duration of 54 hours. At 1 hour, 90% of the patients reported feeling better with 50% becoming pain-free. A 50% or greater reduction in severity occurred in 75% of patients at 1 hour and in 95% at 3 hours. At 3 hours, 95% of the patients reported feeling better, and 60% were pain-free. Only 1 patient failed to respond to prochlorperazine.
Conclusion:
Prochlorperzaine was shown to be highly effective in aborting intractable migraines in children. It was well tolerated with no significant side effects. Additional large, double-blinded, randomized, placebo-controlled studies are needed to further investigate its effectiveness.