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PEDIATRICS Vol. 107 No. 4 April 2001, p. e62

ELECTRONIC ARTICLE:
Tolerability and Effectiveness of Prochlorperazine for Intractable Migraine in Children

Received Nov 15, 2000; accepted Jan 10, 2001.

Marielle A. Kabbouche*, Anna-Liisa Bentti Vockell*, Susan L. LeCates*, Scott W. PowersDagger , §, and Andrew D. Hershey*, §

From the Divisions of * Neurology and Dagger  Psychology, Cincinnati Children's Hospital Medical Center; and the § University of Cincinnati College of Medicine, Cincinnati, Ohio.

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.  Key words:  headache, emergency department, abortive therapy, intractable headache, status migrainosis.




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